UÇUŞ SIRASINDA KARŞILAŞILABİLECEK MEDİKAL ACİLLER VE COVİD-19 ÖNLEMLERİ

Yıl 2020, Cilt: 1 Sayı: 2, 74 - 97, 31.08.2020

Doğaç Niyazi Özüçelik

Öz

Uçuş acilleri, spesifik bir konu gibi görülmesine rağmen hava yolu ulaşımının günümüzde hemen her ülkede aktif olarak kullanılan en önemli iç ve dış ulaşım aracı haline gelmesi nedeniyle önem kazanmıştır. Uçuş sırasında karşılaşılan acil durumlar, son yıllarda uçakların yolcu kapasitesi ve uçuş mesafelerinin giderek artması nedeniyle daha fazla önem kazanmaktadır. Genel olarak ticari uçuşlarda acil medikal durumlarla karşılaşma olasılığına karşılık acil medikal yardımda bulunmak için görevli doktor veya hemşire gibi bir sağlık personeli bulunudurma zorunluluğu bulunmamaktadır. Ancak her uçak personelinde ilk yardım eğitimi alma zorunluluğu bulunmaktadır. Dünyada uçuş sayısı artışı ile beraber uçuş sırasında görülen acil medikal durumlar ve bunun sonucunda görülen ölüm sayıları da artmaya başlamıştır. Uçuş ölümlerinin incelendiği çalışmalarda her 1,5-4,7 milyar yolcu mili için 1 ölüm bildirilmektedir. Bu derlemede uçuş sırasında karşılaşılan acil medikal durumlar, yönetimi, uçaklarda bulunması gereken acil medikal malzeme ve ilaçlar ile Covid-19 sürecinde uçaklarda alınan ve alınması gereken tedbirlerle ilgili bilgiler sunulmuştur.

Anahtar Kelimeler

Uçak;, Uçuş;, Medikal aciller;, Covid-19

MEDICAL EMERGENCIES AND COVID-19 MEASURES THAT MAY BE ENCOUNTERED DURING FLIGHT

Öz

Although flight emergencies are seen as a specific issue, they have gained importance due to the fact that airline transportation has become the most important domestic and international transportation tool actively used in almost every country today. Flight emergencies have become more important due to the gradual increase in passenger capacity and flight distances of aircrafts in recent years. In general, there is no obligation to have a medical personnel such as a doctor or a nurse on duty to provide emergency medical assistance in case of the possibility of encountering emergency medical situations on commercial flights. However, first aid training is required for every aircraft personnel. With the increase in the number of flights around the world, the number of emergency medical conditions during flights and the resulting deaths have started to increase. In studies examining deaths during flight, 1 death is reported for every 1.5-4.7 billion passenger miles. In this review, information about the emergency medical conditions encountered during flight, their management, emergency medical equipment and medicines that should be available on the aircraft, and the measures taken and need to be taken on the aircraft during the Covid-19 process are presented.

Anahtar Kelimeler

Airplane;, Flight;, Medical emergencies;, Covid-19

Kaynakça

• 1. Manual on aır passenger health ıssues. European cıvıl avıatıon conference. http://www.aerohabitat.eu/uploads/media/06-07-2009_-_ECAC_-_UE_-_Manual_on_air_passenger_health.pdf.Erişim:30.06.2020
• 2. Goodwin T. In-flight medical emergencies: an overview. BMJ. 2000 Nov 25;321(7272):1338-41.
• 3. Donaldson E, Pearn J. First aid in the air. Aust N Z J Surg. 1996 Jul;66(7):431-4.
• 4. Cottrell JJ, et al. In-flight Medical Emergencies One Year of Experience With the Enhanced Medical Kit. JAMA. 1989;262(12):1653-1656.
• 5. Martin-Gill C, Doyle TJ, MD, Yealy DM. In-Flight Medical Emergencies A Review. JAMA.2018;320(24):2580-2590.
• 6. DeHart RL. Health ıssues of aır travel. Annu. Rev. Public Health 2003. 24:133–51
• 7. Chandra A, Conry S. In-flight Medical Emergencies. West J Emerg Med. 2013 Sep;14(5):499-504.
• 8. Ruskin KJ, Hernandez KA, Barash PG. Management of In-flight Medical Emergencies. Anesthesiology 2008; 108:749–55.
• 9. Tuttle T, Ali A, Filsoof D, Higgins J. High altitude, air travel, and heart disease. https://www.uptodate.com/contents/high-altitude-air-travel-and-heart-disease/print#. Erişim 30.06.2020.
• 10. Sivil havacılık genel müdürlüğü faaliyet raporu 2018. http://web.shgm.gov.tr/documents/sivilhavacilik/files/pdf/kurumsal/faaliyet/2018.pdf
• 11. İstanbul'da yolcu sayısı 104 milyonu geçti. https://www.ntv.com.tr/ekonomi/istanbulda-yolcu-sayisi-104-milyonu-gecti,VF25VtHZz0aNk7tNgNN6fQ. Erişim: 20.11.2020
• 12. Robert A. O’Rourke. Saving Lives in the Sky. Circulation. 1997;96:2775–2777.
• 13. Crewdson, J. Code blue: survival in the sky. Chicago Tribune 30 June 1996:9.
• 14. Garrett JS. Experience with 1132 in-flight medical emergencies: what have we learned? Presented at South Californian Institute, 15 January 1999.
• 15. McKenas DK. The evolving role of corporate medical departments in commercial aviation. Occup Med. Apr-Jun 2002;17(2):169-78, iii.
• 16. Rayman RB. 1998. Inflight medical kits. Aviat. Space Environ. Med. 69:1007–9.
• 17. Peterson DC, et al. Outcomes of medical emergencies on commercial airline flights. N Engl J Med. 2013;368(22):20752083.
• 18. Sand M, Bechara FG, Sand D, Man B. Surgical and medical emergencies on board European aircraft: a retrospective study of 10189 cases. Critical Care Vol 13 No 1. http://ccforum.com/content/13/1/R3. Erişim: 22.06.2020.
• 19. Alexandria, VA. Medical Guidelines for Airline Travel, 2nd Edition. Aviation, Space, and Environmental Medicine. 2003 May. Vol. 74, No. 5, Section II.
• 20. Csorba R, Tsikouras P. Air travel during pregnancy. Hippokratia. 2017 Jan-Mar; 21(1): 62.
• 21. Robert F. Ruckman. ER in the Skies: In-Flight Medical Emergencies. J. Air L. & Com. 1999; 65(1):77-99.
• 22. ACC/AHA Task Force. Guidelines for the early management of patients with acute myocardial infarction. J Am Coll Cardiol 1990;16:249-92.
• 23. Smith SD. Characterizing the effects of airborne vibration on human body vibration response. Aviation Space and Environmental Medicine, 2002; 73(1):36-45
• 24. Mellert V, Baumann I, Freese N, Weber R. Impact of sound and vibration on health, travel comfort and performance of flight attendants and pilots. Aerospace Science and Technology, 2008; 12(1):18-25.
• 25. American College of Obstetricians and Gynecologists, Committee on Obstetric Practice. ACOG Committee opinion. Air travel during pregnancy. Int J Gynaecol Obstet. 2002;76(3):338–9.
• 26. Voss M, Cole R, Moriarty T, Pathak M, Iskaros J, Rodeck C. Thromboembolic disease and air travel in pregnancy: a survey of advice given by obstetricians. J Obstet Gynaecol. 2004;24(8):859–62.
• 27. Hinkelbein J, et al. In-flight cardiac arrest and in-flight cardiopulmonary resuscitation during commercial air travel: consensus statement and supplementary treatment guideline from the German Society of Aerospace Medicine (DGLRM). Intern Emerg Med. 2018 Dec;13(8):1305-1322.
• 28. Handley AJ. Cardiac arrest in the air. Trends in Anaesthesia and Critical Care, 21 (2018), August, 38-42.
• 29. Joy M. Cardiovascular disease and airline travel. Heart. 2007 Dec; 93(12): 1507–1509.
• 30. Covıd-19 measures for flıght operatıons. http://www. shgm.gov.tr/documents/sivilhavacilik/files/covid-19/dgca-aırlıne-guıdelınes.pdf. Erişim: 28.11.2020.
• 31. Coronavirus (COVID-19) Travel Information. https://www.turkishairlines.com/en-int/announcements/coronavirus-outbreak/. Erişim: 28.06.2020
• 32. Yataklı sağlık tesislerinde acil servis hizmetlerinin uygulama usul ve esasları hakkında tebliğde değişiklik yapılmasına dair tebliğ. 2018. https://www.resmigazete.gov.tr/eskiler/2018/02/20180220-4.htm. Erişim: 29.06.2020