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Year : 2017  |  Volume : 10  |  Issue : 4  |  Page : 1079
Critical ill patients and flight

1 Sanitation 1 Medical Academic Center, Bangkhae, Bangkok, Thailand
2 Wiwanitkit House, Bangkhae, Bangkok, Thailand

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Date of Web Publication5-Oct-2017

How to cite this article:
Joob B, Wiwanitkit V. Critical ill patients and flight. Ann Trop Med Public Health 2017;10:1079

How to cite this URL:
Joob B, Wiwanitkit V. Critical ill patients and flight. Ann Trop Med Public Health [serial online] 2017 [cited 2021 Apr 14];10:1079. Available from:

Dear Editor,

In emergency management of the patients, the delivery of the patient to the medical center is an important issue to be considered in public health system.[1] Smedley and Gault recenty noted that “the proper and safe use of air medical transport requires a basic understanding of the medical implications of flight, and the capabilities and constraints involved in transporting patients by air”.[1] The recent report by Smedley et al. is very interesting.[2] These authors reported an interesting case with “cerebral arterial gas embolism after pre-flight ingestion of the hydrogen peroxide”.[2] Smedley et al. discussed on “the safety of aero-medical transfer following the hydrogen peroxide ingestions”.[2] It is no doubt that the possible problems arise due to the aero-medical transfer, but the concern on the other side of the coin needs to be mentioned. “Can the case be delayed transferred” is the big question. As reported by Rider et al., “ingestion of even a small amount of concentrated hydrogen peroxide can result in cerebral air gas embolism”.[2],[3],[4] Indeed, there are also many other controversial cases for air transfer such as pneumothorax [5] and intraorticballon pump.[6]

Hence, whether the aero-medical transfer is used or not, the embolism can dependently occur. Since it was reported that “complete neurologic recovery occurred quickly with the hyperbaric therapy”, the primary focus should be the fastest transfer of the patient.

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Conflicts of interest

There are no conflicts of interest.

   References Top

Smedley BL, Gault A, Gawthrope IC. Cerebral arterial gas embolism after pre-flight ingestion of hydrogen peroxide. Diving Hyperb Med 2016;46:117-9.  Back to cited text no. 1
Rider SP, Jackson SB, Rusyniak DE. Cerebral air gas embolism from concentrated hydrogen peroxide ingestion. ClinToxicol (Phila) 2008;46:815-8.  Back to cited text no. 2
Mullins ME, Beltran JT. Acute cerebral gas embolism from hydrogen peroxide ingestion successfully treated with hyperbaric oxygen. J Toxicol Clin Toxicol 1998;36:253-6.  Back to cited text no. 3
Fromm RE, JrVaron J. Air medical transport. J Fam Pract 1993:36313-8.  Back to cited text no. 4
Duchateau FX, Legrand JM, Verner L, Brady WJ. Commercial aircraft repatriation of patients with pneumothorax. Air Med J 2013:32200-2.  Back to cited text no. 5
Berset A, Albrecht R, Ummenhofer W, Erne JJ, Zuercher M. Air transfer of patients with intraaortic balloon pump support: Swiss experience and recommendations. Swiss Med Wkly 2012;142:w13552.  Back to cited text no. 6

Correspondence Address:
Beuy Joob
Sanitation 1 Medical Academic Center, Bangkok
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1755-6783.196688

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