Clinical aviation medicine: safe travel by air.

Commercial air travel has increased dramatically in the last 25 years, which has resulted in an increased number of passengers travelling. In 1995, approximately 1.4 billion passengers flew. There are very few contra-indications to flying in commercial jet aircraft and even passengers with medical conditions travel regularly without incident. To avoid in-flight emergencies which potentially have implications for the patient's medical condition and the operation of the flight it is essential to assess significant medical conditions prior to travel. With appropriate assessment by a physician who has an understanding of the aviation environment and its potential interaction with the patient's medical condition, the majority of passengers may be carried. If a medial emergency occurs in flight the medical practitioner may have a role to play when asked by the crew, whose training has recently been augmented by many airlines to include the use of self diagnosing defibrillators. This team approach is important and is of benefit to the patient; it may avoid disruption to the flight.