parachute jump

Question

One of my patients who presents a respiratory failure (FEV1 between 22 and 31%), with hypoxemia and hypercapnia has received for his birthday a parachute jump. He was dreaming about it since a long time. He needs a medical certificate.
I think it is not reasonable because of situation fragility to do this kind of exercise.
Which attitude do you have?
Doctor S Ramel

Answer

Hello Sophie,
Indeed, it seems not reasonable.
To do a parachute jump involves to stay at 4000 meters altitude for several minutes. The template of a medical certificate attesting a non-contraindication indicates to stay for a minimum of 20 minutes. During this time, the patient has to tolerate hypoxia and cold. Then the descent is fast: 50 seconds later, the altitude is at 1000 meters and 5 minutes later at ground. Past history of pneumothorax and cystic fibrosis frequent sinonasal obstruction are equally a problem considering traumatisation of rapid altitude difference.
The parachute opening is responsible of a shock which is not extremely brutal because the sail is opening during 200 meters to be more soft. Indeed, osteoporosis is a contraindication and the presence of a portacath too.

All the best
Dr Isabelle Danner-Boucher

04.03.2013