Abstract 13 - Recommendations For Managing In-Flight Medical Emergencies

“Is There A Doctor On Board?”: Practical Recommendations For Managing In-Flight Medical Emergencies Kodama, D., et al, Can Med Assoc J 190(8):E217, February 26, 2018

SUMMARY

• Airplane emergencies have gotten a lot of media attention lately with headlines reading, “Is there a doctor aboard? Airlines hope not.”
• Doctors on a plane are much more likely to suggest diversion of the flight compared to ground dispatch or the pilot.
• Recently there was the case of a patient who sued United Continental Holdings after they ignored an onboard doctor’s recommendation to divert the flight and kept going resulting, per the patient, in prolonged hospitalization.
• If you do answer the call, this article provides a lot of good information regarding the scenario:

○       You are protected from liability – the Good Samaritan law applies even in the friendly skies.

○       The most common complaint is syncope/ presyncope followed by chest pain.

○       Vital signs are affected by cabin environment (e.g O2 sat around 90%).

○       The loud baseline noise makes it nearly impossible to use a stethoscope reliably.

○       The inflight emergency kit is designed to have most meds in IM format and are kept in pre-dosed vials to make administration as easy as possible.

○       Expect there to be epinephrine, atropine, normal saline, nitroglycerin, aspirin, oral analgesics, benzodiazepine, metered-dose inhalers (MDIs), among other things--all are typically really well labeled with instructions for use.

○       You will communicate with the pilot and likely ground support, though in the end although you can make a recommendation on whether or not to divert the flight, the pilot will ultimately make the call.

PMID: 29483330 

EDITOR’S COMMENTARY: This is a great, quick article about basics for management of an in-flight medical emergency. While they list some of the medications and scenarios you may encounter, we’d love to hear your stories.

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