The IDHS should contact the flight surgeon when a patient has an unexplained pulse greater than what heart rate (BPM)?

• A. 110 BPM
• B. 120 BPM
• C. 130 BPM
• D. 140 BPM

Answer: (B)

Unexplained tachycardia in a patient requires escalation to ensure flight safety. When the pulse rate rises above 120 beats per minute without an obvious, benign cause, the proper step is to contact the flight surgeon. At altitude and under flight stresses, even modest dysrhythmias or rapid heart rates can signal underlying issues that could compromise performance or safety, such as dehydration, fever, anemia, infection, hypoxia, arrhythmias, or volume status problems. The flight surgeon can evaluate the patient, order appropriate tests (like an ECG or labs), and decide whether the patient is fit for flight, needs treatment, or should be grounded until the tachycardia is resolved. If there is a clear, benign cause (exercise, anxiety, fever, pain) and it’s resolving, escalation may not be necessary, but unexplained tachycardia beyond the 120 BPM threshold should prompt consultation.