Medical Handbook For Pilots Chapter 20 – The Flying passenger

Passengers come in all sizes, shapes, and temperaments. It is not uncommon for a pilot to take up a friend who is ordinarily calm and relaxed, only to find that he becomes completely unnerved and panicky during some incidental flight mishap.

All of us operate at two levels: the rational and the emotional. Our daily activities are regulated by the rational forces-logic, knowledge, experience, and goal-seeking. But under this exterior, strong emotions lie dormant-fear, anger, and love, for example. Fear, or more accurately, anxiety, is the emotion most often encountered in flying. Many passengers have some vague, weakly formulated anxiety about “what might happen up there.” Then, if some minor mishap occurs, they experience a natural “fight-or-flight” response (the instinctive reaction of a human being to danger).

Obviously, though, they have no suitable object at hand to fight, and flight (in the sense of escape) is out of the question. So the anxious passenger tries to appear calm while enduring inner torment and tension. His nervousness may be apparent in chain-smoking, heavy perspiring, rambling conversation, stony silence, or other peculiar behavior. Strangely enough, his very effort to conceal his fear and combat his growing tension just leads to greater anxiety.

If you are carrying several passengers, one of them can quickly infect the others with his anxiety. And a group of panicky passengers can be a threat to safe flight. Bear in mind that others may not be as confident in the air as you, and take precautions to minimize their discomfort and worry. Keep flight maneuvers smooth and professional. Avoid sudden control movements, uncertainty in selecting your course or destination, requests for radio assistance, or any behavior which might undermine your passengers’ faith in your skill and self-confidence.

All the medical problems discussed previously in this handbook apply to passengers as well as to pilots. The remedial steps suggested for you as the pilot should be the same for your passengers, and should be taken before any difficulty magnifies itself. However, a few medical situations apply solely to passengers.

Before allowing a pregnant woman to fly in your aircraft (especially if she has a history of miscarriages), have her check with her physician. The decreased pressure at altitude may be inadvisable. If a passenger has brought an infant along, the baby should either be made to cry or be given a bottle during descent to keep the eustachian tubes open.

If a passenger shows signs of airsickness during flight, encourage him to look out the window at a fixed, definite object; the horizon, faraway clouds, or a distant object on the ground is suitable. The commonly available motion sickness medications are also useful for relieving the discomfort. Persons who are bothered with nasal congestion associated with altitude may obtain effective remedies from their physician or pharmacist.

If you are transporting a sick person, keep in mind the effects of altitude on his particular condition. Those with a history of cardiovascular or pulmonary problems should be very closely observed. Bowel obstructions may become aggravated by the expansion of trapped gas. Some types of hernia may worsen for the same reason.

Your own confidence and control of the aircraft, along with an awareness of your passengers’ needs, will help ensure a relaxed and safe flight for everyone.