ATRAF is not required if all criteria are met
- No recent chemotherapy has been administered
- Symptoms are controlled
- Hgb >90g/L and electrolytes are in the normal range
Considerations
Patient should not fly during active administration of a cytotoxic medicine, especially when this involves slow-release cytotoxic drugs via vascular access
ATRAF is not required if all criteria are met
>48 hours with stable rhythm
Considerations
Patients flying within a week of the procedure are considered high risk for DVT
ATRAF is not required if all criteria are met
- No symptoms at rest
- Can walk 50m without significant shortness of breath or chest pain
- Symptoms controlled with medication
Considerations
- Angina with minor exertion may require O2 in flight (CCS III)
- Individuals with symptoms at rest should defer travel (CCS IV)
ATRAF is not required if all criteria are met
>24 hours with original condition judged as stable
ATRAF is not required if all criteria are met
>3 days, asymptomatic and stable underlying health issues
ATRAF is not required if all criteria are met
- 4 weeks post procedure without complicating factors
- Stable medications
- CXR excluding pneumothorax
- Hgb >90 g/L
ATRAF is not required if all criteria are met
- Controlled and stable chronic heart failure
- No exacerbations in the past 6 weeks
- Able to walk 50m or one flight of stairs without shortness of breath or chest pain
Considerations
- Symptoms with exertion (NYHA class 3) may require O2 in flight
- NYHA class 4 should defer all non-essential travel and must fly with inflight O2
Considerations
- ATRAF form recommended for all patients
- Consideration of inflight O2 in all cases
ATRAF is not required if all criteria are met
Asymptomatic and stable on anticoagulant therapy
ATRAF is not required if all criteria are met
Not required for isolated hypertension
Considerations
Travel should be deferred for those with severe and uncontrolled hypertension
ATRAF is not required if all criteria are met
MI >2 weeks ago and is asymptomatic with stabilization of medications
Considerations
- Low risk-<65 years of age, first event, successful reperfusion, EF >45%, no complications, no investigations or interventions planned may fly earlier with approval
- High Risk-EF<40%, heart failure, pending investigation, revascularization, or device therapy should have travel deferred until stabilization of the condition
ATRAF is not required if all criteria are met
- >2 days if rhythm is stable
- CXR has ruled out pneumothorax
ATRAF is not required if all criteria are met
- Resolved pulmonary edema
- Resolution of the precipitating condition
ATRAF is not required if all criteria are met
>2 weeks since onset
Adequate anticoagulation
Asymptomatic
Considerations
Consideration can be given to those requiring essential travel after 5 days if adequately anticoagulated, asymptomatic and PaO2 normal on room air
ATRAF is not required if all criteria are met
- Mild impairment
- Functions independently in the community
- No paranoia, aggressive behaviour, or agitation.
- No history of deterioration in flight.
- Patient is alert and orientated x3 (person/place/time)
Considerations
Consider support of an attendant
ATRAF is not required if all criteria are met
- 14-28 days since event
- Stable condition
Considerations
Flights under 14 days may require supplemental oxygen.
ATRAF is not required if all criteria are met
- Mild concussion
- Minimal symptoms (headache only)
- Injury >48 hours
Considerations
Recent (<4weeks), skull fractures, subarachnoid or subdural bleeds an ATRAF is recommended
ATRAF is not required if all criteria are met
Stable control with no seizures in the past 30 days
Considerations
- Flight is contraindicated if unstable seizure disorder or grand mal seizure in the past 24 hours
- Relative hypoxia onboard can lower the seizure threshold in some individuals
ATRAF is not required if all criteria are met
- Age <70 with classic vasovagal syncope
- Age >70 and non-vasovagal syncope investigated, and underlying condition stabilized
- >24 hours since episode
ATRAF is not required if all criteria are met
- >72 hours since event
- Asymptomatic
- Investigations completed
Considerations
Crescendo TIAs should avoid travel
ATRAF is not required if all criteria are met
- >24 hours since procedure
- Pain controlled
Considerations
Recommend all patients with recent dental procedures bring their own prescribed or over the counter pain medication for travel
ATRAF is not required if all criteria are met
- Bleeding has stopped for more than 24 hours
- No packing is in place
- Hgb >90 g/L
ATRAF is not required if all criteria are met
- >10 days since surgery
- Uncomplicated surgery
- Clearance from ENT surgeon
ATRAF is not required if all criteria are met
- >10 days postoperative
- Uncomplicated surgery
- ENT clearance to fly
ATRAF is not required if all criteria are met
- Able to clear ears
- Illness is improving
- No additional infectious disease concerns (e.g., COVID-19)
ATRAF is not required if all criteria are met
- >3 weeks since surgery
- Hgb >90 g/L
Considerations
Due to bleeding risk, travel prior to 3 weeks will require an ATRAF with ENT surgeon consultation
ATRAF is not required if all criteria are met
- Escorted travel with knowledge of how to use cutters to remove in an emergency
- Unescorted quick release wiring
ATRAF is not required if all criteria are met
- Symptom resolution
- Antibiotics completed
- Chronic disease not requiring antibiotics
Considerations
Travel is contraindicated with acute symptoms (pain/fever)
ATRAF is not required if all criteria are met
- No bleeding in > 10 days
- Hgb > 90g/L
Considerations
1-9 days may consider travel if endoscopic confirmation and rising Hgb levels
ATRAF is not required if all criteria are met
- Uncomplicated surgery >14 days ago
- Hgb >90 g/L
- Pain controlled
Considerations
Time can be reduced to 7 days if the intestinal lumen was not opened
ATRAF is not required if all criteria are met
24 hours past the last episode of vomiting and diarrhea and is currently asymptomatic
Considerations
Travel is contraindicated with active symptoms or symptoms of dehydration
ATRAF is not required if all criteria are met
>5 days if uncomplicated recovery
Considerations
- More complex laparoscopic procedures such as a hemicolectomy would follow major abdominal surgery requirements
- Flight prior to 5 days will be considered if bloating symptoms are absent
ATRAF is not required if all criteria are met
- Stable remission
- Hgb >90g/L
ATRAF is not required if all criteria are met
Hgb > 90g/L and underlying health conditions are stable
Considerations
- If acute anemia, repeat Hgb should be completed 24 hours after last blood loss
- Supplemental O2 should be considered for significant anemia or those with concurrent lung or cardiac disease
Considerations
Air travel is contraindicated if active bleeding is occurring
ATRAF is not required if all criteria are met
Anticoagulation is stable
Considerations
Air travel is contraindicated if deep vein thrombosis or pulmonary embolism within 2 weeks of air travel.
Considerations
Always require supplemental O2
ATRAF is not required if all criteria are met
>24 hours and uncomplicated surgery
ATRAF is not required if all criteria are met
>24 hours and uncomplicated surgery
Considerations
- Depending on the gas injected in the globe, travel may be required to be delayed for 2-6 weeks
- Prior to travel, ophthalmologist will need to confirm fitness to fly and confirm gas used
ATRAF is not required if all criteria are met
- >7 days since injury
- Any gas in the globe must be resorbed
- Confirmation with ophthalmologist prior to travel
ATRAF is not required if all criteria are met
- Able to mobilize with a walking aid
- Able to sit fully upright for take-off and landing
- Pain controlled
ATRAF is not required if all criteria are met
- >48 hours since cast placed
- Hgb >90g/L
- No other injuries of significance
- Able to mobilize with a walking aid
- Able to sit fully upright for take-off and landing
Considerations
Risk of DVT on longer flights so consideration for anticoagulation should be considered
ATRAF is not required if all criteria are met
- Surgery >14 days prior
- Able to mobilize with a walking aid
- Able to sit fully upright for take-off and landing
- Pain controlled
- Post-operative Hgb > 90 g/L
- DVT prophylaxis is important and should be assessed if surgery was in the past 6 weeks
Considerations
If DVT prophylaxis is not utilized, longer travel in the first six weeks travel should only be taken if essential
ATRAF is not required if all criteria are met
- Uncomplicated surgery >14 days ago
- Pain controlled
- Must be able to sit upright for take-off and landing
- Must be able to tolerate unexpected turbulence and vibration
Considerations
Attendant would be required if unable to provide self-care
Considerations
Consideration will be given on an individual basis in consultation with treating obstetrician
ATRAF is not required if all criteria are met
- No active bleeding or pain for at least 24 hours
- Hgb >90 g/L
ATRAF is not required if all criteria are met
- <36 weeks gestation
- Uncomplicated pregnancy
- No history of preterm labour
ATRAF is not required if all criteria are met
- <32 weeks gestation
- Uncomplicated pregnancy
- No history of preterm labour
ATRAF is not required if all criteria are met
Fit and healthy babies after 7 days
ATRAF is not required if all criteria are met
- Medical condition is stable and risk of deterioration inflight is judged to be low
- Individual is living in the community independently
- No episodes of acute psychosis (mania, schizophrenia, drug induced) in the past 30 days
- Patient is alert and orientated x3 (person/place/time)
Considerations
- Medication should be carried onboard
- Attendant should be considered if any risk of deterioration with the stress of travel
- Alcohol avoidance should be encouraged
ATRAF is not required if all criteria are met
- Mild asymptomatic asthma
- No recent hospitalizations for asthma
- Travel with medications in carry-on
ATRAF is not required if all criteria are met
- ≥11 days after surgery without complication
- No pneumothorax on x-ray
ATRAF is not required if all criteria are met
- O2 sats >93%
- Able to walk >50m or 2 flights of stairs with minimal symptoms
- No other cardiac or remarkable health issues
Considerations
Moderate COPD may require inflight O2
ATRAF is not required if all criteria are met
- Asymptomatic
- Hgb >90g/L
- No large effusions on CXR
Considerations
Large hemoptysis, regardless of diagnosis, is contraindicated for flight
Considerations
For patient whose O2 requirement is ≤4 L/minute at rest, guidelines advise increasing the O2 flow by 1 to 2 L/minute while in flight
ATRAF is not required if all criteria are met
Fully resolved and symptom free
Considerations
Consider supplemental O2 in cases of recent episode, elderly passengers, or longer flights
ATRAF is not required if all criteria are met
14 days after full inflation confirmed by CXR
Considerations
Consideration may be given to those with a non-traumatic pneumothorax 7 days after inflation confirmed by CXR
ATRAF is not required if all criteria are met
- NYHA Class I
- Stable Medications
Considerations
For all other cases, an ATRAF is recommended
ATRAF is not required if all criteria are met
Stable requiring ventilation only with air
ATRAF is not required if all criteria are met
- Submit ATRAF if a buffer zone is required.
Considerations
- We are unable to guarantee an allergen-free environment as our aircraft are open to the public
- Recommend travel with medications including epinephrine autoinjector (for anaphylaxis) in carry-on. Patient must be able to self-administer or an attendant must accompany the patient.
Considerations
Travel during contagious stage of the illness is contraindicated
Considerations
- Travel plans should be reviewed by nuclear medicine department
- Individual risk assessments may be required including dose rate estimate in microSV per hour at 0.5m
- All cases need documentation for security radiation detection purposes
ATRAF is not required if all criteria are met
- >24 hours following uncomplicated scuba diving
- >72 hours if multiple dives in the three days prior to travel
Considerations
Decompression illness will generally require 3-7 days after treatment after consultation with treating physician
Considerations
- Individual assessment of cases must occur
- Consideration must be given to mobility, lung function, bowel and urinary function, pain control
- Attendant may be required
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