Medical air transport to Morocco: commercial flight, stretcher or air ambulance, which option for which patient?

What flying changes for the body

Airliners are pressurised, but the pressure in the cabin corresponds to that of a moderate mountain altitude. For a healthy passenger, the slight drop in blood oxygen has no consequence. For a patient with lung or heart disease, severe anaemia or sickle cell disease, it may be poorly tolerated and justify oxygen during the flight.

Lower pressure also makes gas trapped in the body expand. This is why an undrained pneumothorax, some recent abdominal, chest, skull or eye surgery, or a recent diving accident require specific medical advice before any flight, or even a delay. The length of the journey, immobility and dehydration also increase the risk of deep vein thrombosis in some patients.

Option 1: commercial flight without assistance

A stable, independent patient whose condition is unlikely to deteriorate during the journey can travel like an ordinary passenger. A wheelchair at the airport, a suitable seat or a non-medical companion may be enough. They travel with their medical file, their treatments in the cabin and their prescriptions.

Option 2: commercial flight with a medical escort

When the patient is stable but needs monitoring or simple care during the journey, a doctor or nurse can accompany them on a scheduled flight, with the necessary equipment and medicines. If oxygen is required, the oxygen or portable concentrators accepted by the airline must be used, according to its rules. The airline generally asks for a medical form completed by the doctor and gives its approval before boarding.

Option 3: stretcher on a commercial flight

A patient who cannot remain seated during the flight can, on some routes and some aircraft, travel lying on a stretcher installed in the cabin, in place of several rows of seats, with a medical escort. This option depends on the airline, the aircraft, availability and booking times; it is not possible everywhere. It suits a stable patient who does not need intensive care during the journey.

Option 4: air ambulance

An air ambulance is an aircraft dedicated to the patient’s transport, equipped like a small intensive care unit, with a medical team on board. It is indicated when the patient needs continuous monitoring, ventilation or continuous infusion of medicines, or when their condition is at risk of deteriorating and requires immediate intervention. It also offers a flexibility of timing and airports that scheduled flights do not. It is the heaviest and most expensive option, reserved for situations that justify it.

Ground journeys are part of the transport

Whatever the aircraft, the patient must reach the airport and then the receiving facility. An ambulance, with medical staff if needed, covers these legs. Transport is planned bed to bed: the level of care must not drop during transfers between vehicles, formalities or waiting times.

How is the decision made?

The doctors who know the patient and the transport team consider in particular:

• respiratory and circulatory stability and the risk of deterioration during the journey;
• the need for oxygen, ventilation, infusions or continuous monitoring;
• the patient’s ability to remain seated and move about;
• flight-related contraindications: trapped gas, recent surgery, severe anaemia;
• the total length of the journey, including stopovers and ground transfers;
• acceptance by the airline when the flight is commercial.

Frequently asked questions