Template Letters | Flying with Medical Equipment
This letter is an example of an appeal to an airline company for a patient to get special permission to fly with medical equipment. It is intended to be sent by a medical professional on behalf of the patient. The patient should keep an original signed copy for their records. Please replace all [bolded] words with the appropriate language.
[PRINT ON MEDICAL CENTER OR INSTITUTION LETTERHEAD]
[DATE]
To Whom It May Concern:
[Patient Name (DOB)] is a patient of mine who suffers from pulmonary hypertension (PH). PH is a condition characterized by increased blood pressure in the pulmonary artery. PH is grouped into five clinical classifications as defined by the World Health Organization (WHO) World Symposium on PH[1]:
· WHO Group 1 PH: Pulmonary Arterial Hypertension (PAH)
· WHO Group 2 PH: PH due to Left Heart Disease
· WHO Group 3 PH: PH due to Chronic Lung Disease and/or Hypoxia
· WHO Group 4 PH: Chronic Thromboembolic Pulmonary Hypertension
· WHO Group 5 PH: PH with Unclear, Multifactorial Mechanisms
When PAH occurs in the absence of a known cause, it is referred to as idiopathic pulmonary arterial hypertension (IPAH). IPAH is extremely rare, occurring in about one person per million population per year.[2],[3] PAH can also occur in association with other diseases and exposures, including historical anorexigen exposure, methamphetamine use, collagen vascular diseases, HIV infection, portal hypertension, and congenital heart diseases (PAH). PAH affects the vessels in the lungs, causing narrowing of the vessels and increased pressure within the vessels.
Patients may experience symptoms such as shortness of breath, dyspnea on exertion, and chest pain. It is a progressive and debilitating disease for which there is no cure. As the disease progresses, the blood vessels continue to lose elasticity, begin to scar, and the pressure in the pulmonary artery increases. This makes it extremely difficult for the right side of the heart to pump, and often results in a dilated and enlarged right heart which may later lead to heart failure.
In order to treat pulmonary hypertension, patients must be on a host of medications. [PATIENT NAME] is on a continuous intravenous infusion of a medication called [INSERT NAME OF TREATMENT]. This medication is administered using a portable pump via a central line in [HIS OR HER] chest. Any interruption in the medication delivery could result in a life threatening pulmonary hypertension crisis. [PATIENT NAME] must carry all of his medication supplies with him on board the plane. This includes extra infusion pumps, cassettes, syringes, needles, medication vials, scissors, clamps, medical dressings and other supplies.
[PATIENT NAME] is in stable condition to fly. [PATIENT NAME] must have all of his medical supplies for his [INTROVENOUS OR SUBQ] medication as well all of his oral medications with him on board the plane in the event his luggage is lost. This patient and his family are responsible for preparing and administrating the medication, programming the pump, and caring for the central line.
[PATIENT NAME] will require supplemental oxygen at 2 liters/minute via nasal cannula during the entire duration of the flight.
If you have any questions or need more information, please do not hesitate to contact me.
Sincerely,
[YOUR NAME], [DATE]
[SIGNATURE]
[Print Name]
[Address]
[Phone NUMBER] [Fax NUMBER]
[1] Simonneau G, et al. J Am Coll Cardiol. 2013;62(25_S): doi:10.1016/j.jacc.2013.10.029
[2] Humbert M, et al. Am J Respir Crit Care Med. 2006;173(9):1023-1030
[3] Escribano-Subias P, et al. Eur Respir J. 2012;40(3):596-603