Table 8 Late/subsequent medical protocol

A late or subsequent presentation relates to first consultations with medical staff that take place a few days, weeks or even months following the fume event. The medical approach is not dissimilar to that recommended for earlier presentations, in that a detailed clinical history of the events and symptoms experienced at the time of the fume event and those since need to be recorded and a formal physical examination pertinent to the presenting symptomatology undertaken.

The recommendations below should be taken as a guide:

 Medical history of event

  • As for Immediate post-flight (see Table 6).

 Clinical examination and general investigations as applicable

  • As for Immediate post-flight (see Table 6).

  • Referral for specialist consultation should be considered as appropriate.

Further discussion regarding special investigations appears in the sections below. It is important to understand that in some cases it will be necessary to undertake the investigation in all people who have been affected by a fume event, while in other situations an investigation may be undertaken based on clinical indication. In general terms, it is always important to consider whether a test undertaken will assist in diagnosis or management. Negative tests are as useful, in many circumstances, as tests that are positive. Cost and availability may need to be considered in some cases.