Asthma case-based scenario

Keen to pursue a career in aviation, 20-year old Jessie began a Bachelor of Aviation before attending her initial aircrew medical. Jessie was confident she would receive a clean bill of health.

In her younger years, Jessie suffered from asthma and ended up in hospital a few times for treatment. As she grew older, Jessie’s symptoms reduced. She now uses her inhaler so rarely that she thought she had 'grown out' of the condition.

It was a surprise to Jesse when she eventually learned that she was still at risk of asthma attacks.

Visiting the DAME

Jessie went to a Designated Aviation Medical Examiner (DAME) for her initial aircrew medical certificate application.

She found the assessment straightforward but was not expecting so many questions about her asthma.

Asthma can cause major problems for pilots due to:

  • reduced oxygen environment at altitude
  • low ambient temperatures at altitude
  • potential for exposure to airborne chemicals
  • the need to occasionally use breathing apparatus.

Developing an action plan

The DAME examined Jessie, listened to her chest and performed a lung function test called a spirometry.

Jessie’s test showed her lungs were not in the best condition due to the asthma. This surprised both Jessie and the DAME.

The DAME referred Jessie to a respiratory physician who performed more tests and examinations. These confirmed Jessie remained at risk of acute asthma attacks.

The specialist recommended an asthma action plan. The plan teaches Jessie how to manage her condition both when she is well and when she is ill.

A month later, the specialist repeated some of the tests and reported back to the DAME. Jessie had achieved optimum lung function and was at a low risk of suffering an acute attack.

‘Going for my aviation medicals not only let me see how impaired my lungs were it put me back on the path to optimum health,’ Jessie said.

Cleared for flying

With the new reports, the Aviation Medicine (AvMed) doctor issued a medical certificate. It came with the provisions that Jessie must:

  • maintain her asthma action plan
  • provide an annual asthma management report from her general practitioner or respiratory physician
  • always have a reliever inhaler on hand when flying, in case of emergency
  • notify her DAME or CASA if her condition or treatment changes. In particular, if she receives a regimen of oral steroids or needs hospital treatment which are markers of unstable asthma.

The new asthma action plan saw Jessie’s lung health restored and she could launch her flight career as planned.

'It is amazing how much better I feel now,' Jessie said. 'My sporting performance has even improved. It made me realise my asthma symptoms had been slowly creeping up on me for years.'

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