Airsickness

Airsickness
Classification and external resources
Specialty	emergency medicine
ICD-10	T75.3
ICD-9-CM	994.6

Airsickness is a sensation which is induced by air travel.^[1] It is a specific form of motion sickness, and is considered a normal response in healthy individuals. Airsickness occurs when the central nervous system receives conflicting messages from the body (including the inner ear, eyes and muscles) affecting balance and equilibrium.

The inner ear is particularly important in the maintenance of balance and equilibrium because it contains sensors for both angular (rotational) and linear motion. Airsickness is usually a combination of spatial disorientation, nausea and vomiting.^[2]

Symptoms

Common symptoms of airsickness include:

Nausea, vomiting, vertigo, loss of appetite, cold sweating, skin pallor, difficulty concentrating, confusion, drowsiness, headache, and increased fatigue.^[1] Severe airsickness may cause a person to become completely incapacitated.^[1]^[2]

Susceptibility

The following factors increase some people's susceptibility to airsickness:

Fatigue, stress, and anxiety, are some factors that can increase susceptibility to motion sickness of any type.
The use of alcohol, drugs, and medications may also contribute to airsickness.
Additionally, airsickness is more common in women (especially during menstruation or pregnancy), young children, and individuals prone to other types of motion sickness.^[3]
Although airsickness is uncommon among experienced pilots, it does occur with some frequency in student pilots.^[2]

Prevention

Travelers who are susceptible to motion sickness can minimize symptoms by:

Choosing a window seat with a view of the ground or of lower clouds, such that motion can be detected. This will not work if the plane is flown in the clouds for a long duration.
Choosing seats with the smoothest ride in regards to pitch (the seats over the wings in an airplane). (This may not be sufficient for sensitive individuals who need to see ground movement)^[1]
Sitting facing forward while focusing on distant objects rather than trying to read or look at something inside the airplane.
Eating dry crackers, olives or suck on a lemon, to dry out the mouth, lessening nausea.
Drinking a carbonated beverage.

Treatment

Medication

Medications that may alleviate the symptoms of airsickness^[1] include:

meclozine (Antivert, Bonine)
dimenhydrinate (Dramamine)^[4]
diphenhydramine (Benadryl)
scopolamine (available in both patch and oral form).^[5]

Pilots who are susceptible to airsickness should not take anti-motion sickness medications (prescription or over-the-counter).^[1]^[2] These medications can make one drowsy or affect brain functions in other ways.

Non-pharmacologic remedies

A method to increase pilot resistance to airsickness consists of repetitive exposure to the flying conditions that initially resulted in airsickness. In other words, repeated exposure to the flight environment decreases an individual’s susceptibility to subsequent airsickness.^[1] Recently, several devices have been introduced that are intended to reduce motion sickness through stimulation of various body parts (usually the wrist).^[6]

Natural remedies

There are numerous alternative remedies for motion sickness. One such is ginger, but it is ineffective.^[7]

References

1 2 3 4 5 6 7 Benson AJ (2002). "35". Motion Sickness. In: Medical Aspects of Harsh Environments 2. Washington, DC: Borden Institute. Retrieved 2008-05-09.
1 2 3 4 Antunano, Melchor J., M.D. Medical Facts for Pilots (pdf) Federal Aviation Administration, Civil Aerospace Medical Institute. Publication: AM-400-03/1.
↑ Hain, Timothy C., M.D. (2006) Motion Sickness.
↑ Weinstein SE, Stern RM (October 1997). "Comparison of marezine and dramamine in preventing symptoms of motion sickness". Aviat Space Environ Med 68 (10): 890–4. PMID 9327113.
↑ Spinks AB, Wasiak J, Villanueva EV, Bernath V (2007). Wasiak, Jason, ed. "Scopolamine (hyoscine) for preventing and treating motion sickness". Cochrane Database Syst Rev (3): CD002851. doi:10.1002/14651858.CD002851.pub3. PMID 17636710.
↑ Bertolucci LE, DiDario B (December 1995). "Efficacy of a portable acustimulation device in controlling seasickness". Aviat Space Environ Med 66 (12): 1155–8. PMID 8747609.
↑ Brainard A, Gresham C (2014). "Prevention and treatment of motion sickness". Am Fam Physician 90 (1): 41–6. PMID 25077501.

Consequences of external causes (T66–T78, 990–995)

Temperature/radiation	elevated temperature Hyperthermia Heat syncope reduced temperature Hypothermia Immersion foot syndromes Trench foot Tropical immersion foot Warm water immersion foot Chilblains Frostbite Aerosol burn Cold intolerance Acrocyanosis Erythrocyanosis crurum radiation Radiation poisoning Radiation burn Chronic radiation keratosis Eosinophilic, polymorphic, and pruritic eruption associated with radiotherapy Radiation acne Radiation cancer Radiation recall reaction Radiation-induced erythema multiforme Radiation-induced hypertrophic scar Radiation-induced keloid Radiation-induced morphea

Air	Hypoxia/Asphyxia Barotrauma Aerosinusitis Decompression sickness High altitude Altitude sickness Chronic mountain sickness HAPE HACE

Food	Starvation

Maltreatment	Physical abuse Sexual abuse Psychological abuse

Travel	Motion sickness Seasickness Airsickness Space adaptation syndrome

Adverse effect	Hypersensitivity Anaphylaxis Angioedema Allergy Arthus reaction Adverse drug reaction

Other	Electric shock Drowning Lightning injury

Ungrouped skin conditions resulting from physical factors	Dermatosis neglecta Pinch mark Pseudoverrucous papules and nodules Sclerosing lymphangiitis Tropical anhidrotic asthenia UV-sensitive syndrome environmental skin conditions Electrical burn frictional/traumatic/sports Black heel and palm Equestrian perniosis Jogger's nipple Pulling boat hands Runner's rump Surfer's knots Tennis toe Vibration white finger Weathering nodule of ear Wrestler's ear Coral cut Painful fat herniation Uranium dermatosis iv use Skin pop scar Skin track Slap mark Pseudoacanthosis nigricans Narcotic dermopathy

Motion sickness

Types	Airsickness Seasickness Simulator sickness Ski sickness Space adaptation syndrome Virtual reality sickness

Medicine Treatment	Dramamine Bonine Marezine Promethazine Transdermscop

Related	Bárány chair Sickness bag

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