Motion Sickness Prediction in Aeromedical Evacuation of Patients with Ebola

INTRODUCTION: Aeromedical evacuation of patients affected by severe infectious diseases inside an aircraft transit isolator (ATI) system is at potential risk of motion sickness (MS). A test flight was then conducted to quantify this risk during the transfer of an Ebola patient from West Africa to Italy. CASE REPORT: A mannequin was inserted inside an ATI and instrumented to provide acceleration parameters throughout the test flight. The analysis of the data predicted a MS incidence of about 2% for a 6-h flight, so the decision to use anti-MS drugs only in selected cases was taken (i.e., those with positive past history of MS, gastrointestinal disorders, or residual carsickness due to previous ambulance run). On this basis, an actual aeromedical evacuation of an Ebola patient was successfully performed without the use of any anti-MS drugs. DISCUSSION: During aeromedical evacuation with ATI systems, the patient's risk of MS should be evaluated on an individual basis and calibrated according to the specific exposure to motion evoked by the flight platform used. Due to the possible onset of untoward effects, prevention with anti-MS drugs in these patients should be limited to selected cases