LOWER LIMB PHYSIOLOGY DURING AIRCRAFT TRANSPORTATION

Abstract

In 1991 15% of the UK population that travelled abroad required medical assistance. We have been treating more patients with lower limb injuries requiring repatriation via aircraft. Recommendations from Airlines were unavailable. 357 Consultants replied to a questionnaire about transportation of patients with a lower limb injury wearing a plaster cast. There was no consensus on safe transportation of these patients. No scientific data is available on the dynamics of transportation of patients with lower limb trauma. In order to assess the safest method of transportation an experiment was conducted. Ethical committee approval was granted. Five volunteers wearing above leg plaster casts were placed in a decompression chamber. The effects on anterior compartment pressures, Doppler venous return, ambient pressure between plaster and skin were assessed in different positions with and without plasters being split. In the normal population we have shown a trebling of intracompartmental pressures from an average of under 10mmHg to 30mmHg. Intracompartmental pressures are more raised with 90 degrees of hip flexion rather than 45 degrees. We recommend patients be transferred with their legs at 45 degrees to the ground with a split plaster cast.