Practice Policy on Sedatives for Flying and Medical Procedures

We are unable to prescribe sedatives, such as diazepam, for any procedure or scan being undertaken outside the practice. This includes MRI scans, dental procedures and fear of flying.

If you feel you need sedation for a procedure or scan, please speak to the team undertaking the procedure or scan, as they are responsible for providing this if needed. All our local NHS hospitals have formal procedures in place for sedation during procedures, so you should not be directed to your GP for this.

Why We Do Not Prescribe Sedatives for External Procedures:

• Lack of Regular Involvement and Training: GPs are not regularly involved, skilled, trained, or appraised in sedation skills. Providing too little sedation won’t help you, and providing too much sedation can make you too sleepy, which could lead to the procedure being cancelled. Excessive sedation can also dangerously affect your breathing. After taking a sedative for a procedure or scan, you will need to be closely monitored to keep you safe.
• Unpredictable Effects of Diazepam: Although diazepam makes most people sleepy, in some rare situations, it can have the opposite effect and make people aggressive or agitated. Diazepam can also cause disinhibition, leading you to behave in a way that you would not normally. These effects can impact on your safety and in some instances can get you in trouble with the law.
• Timing of Sedation: Scans and hospital procedures are often delayed. Therefore, the team performing the procedure or scan should provide the sedation to ensure you become sleepy and relaxed at the right time.
• Impair your Ability to Concentrate: Diazepam is a sedative, which means it makes you more sleepy and more relaxed. If there is an emergency during a flight or procedure, this may impair your ability to concentrate, follow vital instructions and react to the situation. This could have serious safety consequences for you and those around you.
• Risk of Developing DVT: Sedative drugs can make you fall asleep, however when you do sleep it is an unnatural form of sleep called non-REM sleep. This means your body does not move around as much as during natural sleep and can increase your risk of developing a blood clot in the leg (DVT) or lung (pulmonary embolism). Blood clots are dangerous, and in some circumstances can be fatal. This risk is even higher for those on flights over 4 hours.
• Need for Regular Monitoring: Sedated patients should be regularly monitored. There has been a case where a GP-prescribed sedative was used, the patient wasn’t monitored, and subsequently had a respiratory arrest in an MRI machine.
• Guidelines from the Royal College of Radiologists: The Royal College of Radiologists’ guidelines on sedation for imaging make no mention of GP involvement or prescribing and stress the importance of experienced, well-trained staff being involved and the need for monitoring of sedated patients.
• Legal Risk for GP: According to prescribing guidelines for doctors (BNF) benzodiazepines (including diazepam) are contraindicated (not allowed) in patients with phobia. Your doctor would have to take a significant legal risk to prescribe against these guidelines, and risk losing their job. They are only licensed short term for a crisis in generalised anxiety. If this is the case, you should be getting proper support and care for your mental health.
• Illegal in Some Other Countries: Diazepam, and other similar drugs are illegal in several countries. They may be confiscated, or worse you may find yourself in trouble with the police.
• Implications of Diazepam Use: Diazepam stays in your system for quite a while after taking it. If your job requires random drug testing, you may fail this after taking diazepam. We appreciate that anxiety can be very debilitating, and we urge patients to see us for support with their mental health.

We appreciate a fear of flying is very real and very frightening. A better approach to tackle this is to take a fear of flying course run by the airlines listed below.

Easy Jet www.fearlessflyer.easyjet.com

British Airways www.flyingwithconfidence.com

Feel free to show this policy to your hospital team or dentist.

Thank you for your understanding.

Bramblehaies Surgery