Guidance for medical examiners when assessing a patient for either a general topic or condition – Asthma.
Aeromedical implications (partial / total incapacitating features / hypoxia / hypobaria)
Effect of aviation on condition
- Hypoxia
- Cold triggers
- Chemicals
- Use of breathing apparatus
Effect of condition on aviation
- Overt incapacitation with acute attack
- Subtle with uncontrolled poorly controlled
- Distraction due to treatment and symptoms
Approach to medical certification
Based on the condition
- Respiratory function [FER>70%; Reversibility post bronchodilator FVC and FEV1 less than 12%; PaO2 on air >95%]
Based on treatment
- Not oral steroids / theophylline
Demonstrated stability
- Absence of symptoms
- No hospital admissions - 12M
- No requirement for prednisone or other oral/IV steroids in 12M
Risk assessment protocol - information required
New cases
- Confirmed diagnosis
- Clinical status
- progress
- reliever use
- preventative therapy
- exacerbations (precipitating factors / frequency / severity / steroid use / hospitalisation)
- Investigations conducted
- Spirometry pre and post bronchodilator (mandatory within past 3M)
- Challenge test (if undertaken)
- Other tests and interventions previously undertaken
- Management
- treatment
- side-effects
- monitoring /peak flow diary
- Follow-up plan
- Previous specialist reports if available.
Renewal
- Clinical status
- progress
- reliever use
- preventative therapy
- exacerbations (precipitating factors / frequency / severity / steroid use / hospitalisation)
- Investigations conducted
- Spirometry pre and post bronchodilator (mandatory within past 3M)
- Management
- treatment
- side-effects
- monitoring /peak flow diary
- Follow-up plan.
Indicative outcomes
Asthma which is well-controlled (including using inhaled preventer therapy) may be eligible for any class of medical certificate. Unstable asthma and relevant triggers will need individual consideration.
Favourable
- Stable asthma
- Inhaled preventers
- Inhaled bronchodilators
Unfavourable
- Exacerbation in dry air
- Unstable
- Steroid requirement (oral)
Pilot and controller information
- Any flare-up must be reported to the DAME
- Doses of prednisolone over 10mg (or equivalent) are safety relevant and not acceptable
- A reliever inhaler (eg Salbutamol) must be kept readily available for use when flying
Feedback
We value your feedback.
Disclaimer
The clinical practice guidelines is provided by way of guidance only and subject to the clinical practice guidelines disclaimer.