Air travel

Additional risks to skin integrity occur during air travel. Skin breakdown during travel can be more difficult to manage. This section provides advice on how to minimise the risk of skin damage during air travel.

Boarding the aircraft

• Communication: Inform the airline of the needs of the person when booking the flight. Ask for an aisle seat with removable armrests, check hoist and assistance availability.
• Time: People requiring assistance are first to board the aircraft and the last to disembark, consider the extra time required when planning the trip.
• Transfers: Several transfers may be required, which can be difficult to manage due to unfamiliar environments. Ask for assistance from airline staff as necessary.
• Wheelchair access: Airline wheelchairs are narrow and will not provide adequate postural support or pressure care. Airline chairs should only be used to access the aircraft, not for waiting to board the flight. Advise the airline staff of the need to remain in the person’s own wheelchair until boarding. The wheelchair will then be stored under the aircraft during the flight. Ensure any loose or removable fittings are secured.
• Cushion: To reduce the risk of loss or damage, the cushion should be carried onto the plane, even if the individual does not intend to sit on it during the flight

During the flight

• Cushion: Depending on the individual and flight duration, it may be advisable to use a pressure redistribution cushion during the flight. Inflation of an air cushion may need to be adjusted with changes in altitude, even within a pressurised cabin. Bring the cushion pump onboard and wait until the aircraft reaches cruising altitude to make adjustments. Pressure inside the cushion will increase on the ascent and decrease on the descent, so it will be necessary to readjust the cushion inflation once the aircraft has landed.
• Pressure relief: Even if using a cushion, pressure should be redistributed by lifting or leaning on a regular basis. Leaning forwards is a useful way of redistributing pressure.
• Oedema: Air travel can increase the risk of oedema in the legs and feet. Loosen leg straps or shoelaces and consider the need for compression stockings, in conjunction with elevating the feet as able.
• Hydration: Ensure adequate hydration to maintain skin integrity.
• Continence plan: Consider how the bowel and bladder will be managed during travel, including how the timing of the flight might impact bowel routines, diet and medications. Depending on the length of the flight, an indwelling catheter could be considered.