Air Travel and Venous Thrombosis
There is reasonable evidence that the risk of venous thromboembolism (VTE) is increased following a flight of over 4 to 8 hours. The risk is further increased if the person has thrombophillia or is on the oral contraceptive.
The following management is suggested:
- Is the traveller at increased risk for VTE?
- previous history of VTE
- active cancer
- recent surgery on the lower extremities
- If yes to any of the above:
- Avoid excess alcohol and sedatives when travelling and actively maintain hydration.
- Class 1 (20 to 30 mmHg) compression stockings (e.g. Venosan® Flight socks) to improve venous return. These are available from:
- Papanui Pharmacy, 478 Papanui Road, Christchurch.
- Unichem Crisps Pharmacy, 283 Wairakei Road, Bryndwr, Christchurch.
- Silverstream Kaiapoi Pharmacy, 10/42 Silverstream Boulevard, Kaiapoi.
- Single dose, weight adjusted low molecular weight heparin sub-cut immediately before take off, e.g. enoxaparin sub-cut 1 mg/kg with a cap at 100 mg, assuming normal renal function. This option must be funded by the patient.
- Aspirin has not been shown to be effective in this situation.
- Periodic (3-hourly) in-flight mobilisation.
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These patients are not usually seen in Haematology Outpatients and the above advice should be given to the general practitioner so they can inform the traveller and give any treatment that they and the patient agree upon.
Topic Code: 5202
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