Although I claim no expertise in this area, this is a summary of the "best evidence-based advice" endorsed by the American college of chest physicians[1] and supported by European publications[2][3] for the prevention of venous thromboembolism (clots in the veins) for long distance air travel {this is defined as travelling >6 hours}.
Please note that this is "general advice" and provided for educational purposes only and if you feel that you are at a higher risk of developing venous clots, you should consult your family physician for further advice. Please also note that there are probably many other things people do/dont but if they are not listed below then there is probably no evidence that they work!
Strong recommendations [for everybody]
1. Avoid constrictive clothing around the waist or legs
2. Avoid dehydration: ensure you take in plenty of fluids [eg water] during the flight [although alcohol is also a liquid, it is NOT recommended!!!]
3. Do frequent calf muscle stretching/exercises and frequently get up and move around the plane.
Weaker recommendations [only for travellers with an increased risk of thrombosis eg obesity, previous thrombosis, increasing age etc]
4. Consider wearing below-knee graduated compression stockings/socks eg T.E.D. stockings during the flight. These are available from pharmacies BUT must be measured/sized correctly for your legs to provide the correct compression pressure. They do work [1][2][3]!
5. Some travellers at a higher risk may require a single injection of heparin (LMW) before travelling. This renders the blood "less clottable" for ~24 hours. This requirement for heparin injection needs to be discussed with/advised by your family physician/practitioner.
The use of aspirin for the prevention of thrombosis in long distance travel is NOT recommended by either references below as there is no evidence that it works/justifies the risks.
References [for those who want more in-depth medical information, some may need subscription]:
[1] http://www.chestjournal.org/cgi/content/full/126/3_suppl/338S
[2] http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2141.2005.05617.x
[3] http://ebm.bmjjournals.com/cgi/content/extract/11/2/55
How do you recognise a deep vein thrombosis (DVT)?
Seek professional help if you get: lower leg (calf) swelling/warmth especially if only on one side [a bit of ankle swelling on both sides straight after a flight is normal and usually disappears after a few hours]; calf pain; Both of these may also develop a few days after a long flight [ wikipedia].
What is a pulmonary embolism?
This is a condition where an artery in the lungs gets blocked by a blood clot that has broken off from a larger clot eg in the leg. [ wikipedia]
Seek immediate professional advice if you suddenly feel:
short of breath
get chest pain
feel extremely unwell
The above may also develop a few days after a long flight.
Marios - 5B4WN/G0WWW
Please note that this is "general advice" and provided for educational purposes only and if you feel that you are at a higher risk of developing venous clots, you should consult your family physician for further advice. Please also note that there are probably many other things people do/dont but if they are not listed below then there is probably no evidence that they work!
Strong recommendations [for everybody]
1. Avoid constrictive clothing around the waist or legs
2. Avoid dehydration: ensure you take in plenty of fluids [eg water] during the flight [although alcohol is also a liquid, it is NOT recommended!!!]
3. Do frequent calf muscle stretching/exercises and frequently get up and move around the plane.
Weaker recommendations [only for travellers with an increased risk of thrombosis eg obesity, previous thrombosis, increasing age etc]
4. Consider wearing below-knee graduated compression stockings/socks eg T.E.D. stockings during the flight. These are available from pharmacies BUT must be measured/sized correctly for your legs to provide the correct compression pressure. They do work [1][2][3]!
5. Some travellers at a higher risk may require a single injection of heparin (LMW) before travelling. This renders the blood "less clottable" for ~24 hours. This requirement for heparin injection needs to be discussed with/advised by your family physician/practitioner.
The use of aspirin for the prevention of thrombosis in long distance travel is NOT recommended by either references below as there is no evidence that it works/justifies the risks.
References [for those who want more in-depth medical information, some may need subscription]:
[1] http://www.chestjournal.org/cgi/content/full/126/3_suppl/338S
[2] http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2141.2005.05617.x
[3] http://ebm.bmjjournals.com/cgi/content/extract/11/2/55
How do you recognise a deep vein thrombosis (DVT)?
Seek professional help if you get: lower leg (calf) swelling/warmth especially if only on one side [a bit of ankle swelling on both sides straight after a flight is normal and usually disappears after a few hours]; calf pain; Both of these may also develop a few days after a long flight [ wikipedia].
What is a pulmonary embolism?
This is a condition where an artery in the lungs gets blocked by a blood clot that has broken off from a larger clot eg in the leg. [ wikipedia]
Seek immediate professional advice if you suddenly feel:
short of breath
get chest pain
feel extremely unwell
The above may also develop a few days after a long flight.
Marios - 5B4WN/G0WWW
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