Long Haul Flight advice

The risk of DVT and Pulmonary embolism (PE) is greater in individuals:
Over 40 years of age.
With a past or family history of VTE.
With malignancy.
With certain blood diseases.
Being treated for heart failure.
With chronic venous insufficiency.
Following recent surgery, especially to the hip or knee.
With thrombophilia (a hereditary or aquired tendency to clotting)

The risk of DVT and PE is more common in women who are:
Pregnant.
In the first 6 weeks after having a baby.
Taking the contraceptive pill.
On hormone replacement therapy.

These groups make up 90-95% of all people who develop VTE

Advice for all long-haul air travellers

Be comfortable in your seat.
Drink plenty of water.
Be sensible about alcohol, as excess leads to dehydration and immobility.
Bend and straighten the legs, feet and toes every half-hour while seated.
Press the balls of feet down hard on the floor or foot-rest to increase the blood flow in the legs and reduce clotting in the vessels.
Use upper body and breathing exercises to further improve circulation.
Take occasional short walks (when in-flight advice suggests this is safe).
At stopovers, where possible, get off the plane and walk about.
Avoid taking sleeping pills, which will increase immobility.

Advice for travellers with additional risk factors

Travellers with:
             A past or family history of VTE.
             Thrombophilia.
             Cancer, or a history of treatment for cancer.
             A history of major surgery, especially to the hip or knee, within the last three months.
             A previous stroke.
Should discuss additional preventive measures with their family doctor in advance of travel, particularly for flights of over four hours' duration.

We would recommend the following measures alone or in combination:-

Well-fitting elastic below-knee compression stockings.
Low-dose aspirin (75-150 mg daily for three days before and on day of travel). But do not take aspirin if you have a history of allergy to aspirin or if you have an ulcer or if you are already on warfarin.
Low molecular weight heparin on day of travel (pre-flight) and the day after at high-risk      thromboprophylaxis doses (5,000 units dalteparin, 40 mg enoxaparin or 4,500 units   tinzaparin once daily). Current airline security measures are likely to require a medical letter endorsing the need for this, and the airline should be notified in advance of the individual's requirement to carry a syringe and needle in their hand luggage. Low molecular weight heparin is not required if already on warfarin