There are two main factors we consider when assessing a patient’s fitness for air travel:

Reduced atmospheric pressure: cabin air pressure changes greatly during 15-30 minutes after take-off and before landing, and gas expansion and contraction can cause pain and pressure effects.
Reduction in oxygen tension: the cabin is at a pressure equivalent to an altitude of 6,000ft to 8,000ft and oxygen partial pressure is approximately 20% less than on the ground.

Any medical condition that would render a passenger unable to complete the flight safely, without requiring extraordinary medical assistance during the flight, is considered unacceptable for air travel.

Conditions usually considered unacceptable for air travel

We assess each individual case on its own merits, and take into account whether the passenger is accompanied by a medical escort. However, as a general guide the following conditions are usually considered unacceptable for air travel:

Severe cases of anaemia
Severe cases of either middle ear infections (otitis media) or sinusitis
Acute, contagious or communicable diseases
Those suffering from congestive cardiac failure or other cyanotic conditions which aren’t fully controlled
Uncomplicated myocardial infarctions (MI) within two weeks of onset, or complicated MIs within six weeks of onset
Those suffering from severe respiratory diseases or recent pneumothorax
Those with gastrointestinal lesions which may cause hematemesis, melaena or intestinal obstruction
Post-operative cases:
- Within 10 days of simple abdominal operations
- Within 21 days of chest or invasive eye surgery (not including laser surgery)
Jaw or jawbone fractures with fixed wiring of the jaw (unless medically escorted)
Unstable mental illnesses without escort and suitable medication for the journey
Uncontrolled seizures (unless medically escorted)
Uncomplicated single pregnancies beyond the end of the 36th week or multiple pregnancies beyond end of the 32nd week
Infants within seven days of birth
Those who have introduced air to body cavities for diagnostic or therapeutic purposes within the previous seven days

Notes on other specific items

Allergies: passengers don’t need to complete this form to request a special meal for their flight. (Please note we can’t guarantee peanut-free meals.) However if the passenger has a life threatening food allergy that may require treatment in-flight – particularly if they react to the presence of traces of food in the air – this form should be completed.

Asthma: medication for asthma must be carried in cabin baggage. As nebulisers require their own power source, spacer devices used with an inhaler are an effective onboard alternative.

Escorts: medical escorts should ensure that they have all appropriate items for the proper care of their patient, and are responsible for attending to all aspects of their patient’s needs. Due to food handling regulations, cabin staff can’t assist with these needs.

Fractures: all new long bone fractures and full leg casts require a medical certificate. Casts must be at least 48 hours old. Plasters should be split for fresh injuries (48 hours or less), which could swell inside the cast on a long flight. Unfortunately extra legroom for leg elevation isn’t possible in Economy Class; however, an aisle seat can be reserved. Please state whether the injury is on the passenger’s left or right.

Inflight care: please note we don’t provide nursing attendants; our cabin crew are only trained in first aid.

Lung or heart disease: cardiopulmonary disease which causes dyspnoea on walking more than 100m on a flat surface, or has required oxygen in hospital or at home (or in flight previously) may require supplementary oxygen. The aircraft oxygen is for emergency use only. Serious cardiopulmonary cases as well as those requesting continuous oxygen, a stretcher, or an incubator should enclose a recent detailed medical report with the medical certificate. (A copy of a specialist or hospital referral should be sufficient.)

Physical disabilities: if the passenger only requires a wheelchair as far as the aircraft door there is no need to complete this form. Note: Civil Aviation Rules require all passengers to be able to use the aircraft seat with the seatback in the upright position.

Special meals: special diets for religious or other medical reasons can be ordered directly with a travel agent or by using Manage a booking.

Terminal illnesses: passengers in the advanced stages of terminal illness will normally require a medical or nursing escort.

Part 1 Medical Information Form (MEDIF)