Medical Emergencies at 40,000 Feet: Airline systems are woefully underprepared to deal with these situations

  • Posted by a hidden member.
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    Apr 05, 2013 1:33 PM GMT
    Troubling.

    http://www.theatlantic.com/health/archive/2013/04/medical-emergencies-at-40-000-feet/274623/
  • SomeSiciliano...

    Posts: 543

    Apr 05, 2013 4:21 PM GMT

    From the standpoint of someone who works in the industry, there is nothing here that pilots, F/As, dispatchers & ops personnel and management are not already aware. In my 13 year flying career I have been involved in over 40 medical emergencies and only 3 aircraft emergencies (preparing the passengers for a possible evacuation). Allot of the problems rest in the nature intercontinental operations, over oceans or uninhabited land with poor ground communication. Second is the physical nature of the tubes that get people from A to B. Unused space = lost revenue...smaller lavs are being installed,(or removed), so they can add seats. The bigger problem is legal nuance. For example:

    - No one has ever died on my airline's aircraft. They "take on the appearance of death". .
    - Crew can not accept the help of trained medical professionals without seeing documentation and credentials.
    - ALLOT of 'air servers' and 'coke can poppers' are RN's, EMTs, Physician Assistants and even retired doctors. No matter how advanced your medical training, the only medical care sanctioned by the airline are the very basic procedures outlined in the operating manual.
    - The laws & processes applicable to medical situations depends on the jurisdiction the plane lands. About ten years ago we had an elderly passenger "take on the appearance of death" en route to Nagoya. Everyone was detained on the aircraft until Japanese officials determined the time and cause of death.
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    Apr 05, 2013 7:07 PM GMT
    Step 1. Descend to 3 kilometers. (10,000 ft)
    Step 2. Slow to 241 KPH (150 MPH)
    Step 3. Open door.
    Step 4. Boot out source of medical emergency.
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    Apr 05, 2013 8:56 PM GMT
    ^^^
    Preferably over an elementary school playground...icon_wink.gif
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    Apr 05, 2013 9:09 PM GMT
    rickmenbashi saidStep 1. Descend to 3 kilometers. (10,000 ft)
    Step 2. Slow to 241 KPH (150 MPH)
    Step 3. Open door.
    Step 4. Boot out source of medical emergency.

    turbobilly said^^^
    Preferably over an elementary school playground...icon_wink.gif
    +1
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    Apr 05, 2013 9:14 PM GMT
    Oh, forgot, is mandatory that those "taking on the appearance of death" be costumed as Santa Claus before evacuation. (with thanks to Larkin) icon_wink.gif
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    Apr 05, 2013 9:14 PM GMT
    @OP: You can't see this or me. icon_smile.gif
    You're too negative for my liking.
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    Apr 05, 2013 9:16 PM GMT
    I travel for a living - 3 weeks a month. Since January 1, I've been on 24 different flights. I log a lot of time in a pressurized metal tube. My observations:

    1 - I think people expect way too much out of an air carrier. It's a transport method, that's it.
    2 - Unless every airline started flying an RN (that's what FA's were at the very beginning!), our litigious society would not take well to an airline employee providing care.

    Even DOCTORS have to be cautious when acting as a Good Samaritan. An excerpt from this article http://www.aafp.org/fpm/2008/0400/p37.htmlsums up what is covered under Good Samaritan laws:

    **In most states, there is no legal obligation to provide Good Samaritan care.
    **If aid is given, it need be stabilization only.

    For international travel, as SomeSicilianoGuy notes, the law is applied based on the jurisdiction the aircraft is based and, in most cases, whose airspace the aircraft is in. Australian law compels a medical responder to act. US law does not.

    3 - Air carriers do provide basic tools - FAA requires AEDs be onboard larger aircraft (do you have a flight attendant aboard? then there's an AED onboard too.), First Aid kits, and Emergency Medical kits - plus radio relay to 24/7 medical support on the ground. Short of removing the aft lav and putting in an operating suite, I'm not sure what more they can do?

    4 - Air travel contains inherent risk. So does driving, walking down the street, and snatching a drag queen's wig while she's performing. Part of the deal is accepting the risk - albeit small - when you take on the activity.
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    Apr 05, 2013 9:53 PM GMT
    I think prevention is more important here. Anybody with a chronic condition should ask their doctors: "Am I safe to fly?" I've personally ruined the vacations of several of my patients because simply they were in no condition to fly when they saw me.
    Of course you'll still have emergencies, but preventable ones would be fewer.

    I once saw a young guy on a plane who had severe abdominal pain. It was pretty clear to me he had appendicitis. None of the crew even showed me the medical kit, and I didn't know that they were supposed to have a BP cuff in there. I estimated his BP with feeling his radial pulse which was bounding. They offered him some tylenol and I told them to keep him NPO (since he was going to need surgery as soon as he got off the plan).
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    Apr 07, 2013 8:33 AM GMT
    COBulldog74 saidAir carriers do provide basic tools - FAA requires AEDs be onboard larger aircraft (do you have a flight attendant aboard? then there's an AED onboard too.), First Aid kits, and Emergency Medical kits - plus radio relay to 24/7 medical support on the ground. Short of removing the aft lav and putting in an operating suite, I'm not sure what more they can do?


    Exactly. It seems airlines are eminently prepared for medical emergencies, within the bounds of what is reasonable and practicable, in the circs.
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    Apr 07, 2013 9:02 AM GMT
    Yeah I agree with previous posters.. what more can they do?

    Even if you do have a doctor on board, what can they really do? Repeatedly check vitals like the doctor in the article? Do CPR with no ACLS?

    They are limited to first aid measures just like any basic EMT.

    I can't think of a practical way to prevent people with serious illness from flying in the first place. It seems like a practical risk any person has to take. If they decide to fly knowing they are ill, then it is on them and not the airline.


  • GQjock

    Posts: 11649

    Apr 07, 2013 1:02 PM GMT
    Medical Emergencies will happen
    and there are places and times where getting or being brought to optimum medical care is not an option

    We cannot have airborne ER's on every airplane
    But there should be sufficient knowledge of critical care by the crew to help stabilize someone in need
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    Apr 07, 2013 1:08 PM GMT
    Some airlines will require medical clearance before flying if you have certain medical conditions, and prohibit flying under some circumstances...

    As mentioned...how far can you go. Some passengers maybe should ask themselves...should I be flying ??
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    Apr 07, 2013 2:57 PM GMT
    Bodycontactau saidSome airlines will require medical clearance before flying if you have certain medical conditions, and prohibit flying under some circumstances...

    As mentioned...how far can you go. Some passengers maybe should ask themselves...should I be flying ??


    Which airlines are you referring to? I've flown almost all US airlines and Lufthansa and I've never experienced or seen a medical clearance form.
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    Apr 07, 2013 3:22 PM GMT
    Having been trained to deal with many medical emergencies (on a repeated basis), I have to say that the only people who are "well prepared" to deal with such situations are EMTs or ER medical doctors/nurses. Medical emergencies are really nerve wrecking and no one should expect a partially trained individual to handle it well. Why should they? It's not their job.
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    Apr 08, 2013 7:55 PM GMT
    COBulldog74 saidI travel for a living - 3 weeks a month. Since January 1, I've been on 24 different flights. I log a lot of time in a pressurized metal tube. My observations:

    1 - I think people expect way too much out of an air carrier. It's a transport method, that's it.
    2 - Unless every airline started flying an RN (that's what FA's were at the very beginning!), our litigious society would not take well to an airline employee providing care.

    Even DOCTORS have to be cautious when acting as a Good Samaritan. An excerpt from this article http://www.aafp.org/fpm/2008/0400/p37.htmlsums up what is covered under Good Samaritan laws:

    **In most states, there is no legal obligation to provide Good Samaritan care.
    **If aid is given, it need be stabilization only.

    For international travel, as SomeSicilianoGuy notes, the law is applied based on the jurisdiction the aircraft is based and, in most cases, whose airspace the aircraft is in. Australian law compels a medical responder to act. US law does not.

    3 - Air carriers do provide basic tools - FAA requires AEDs be onboard larger aircraft (do you have a flight attendant aboard? then there's an AED onboard too.), First Aid kits, and Emergency Medical kits - plus radio relay to 24/7 medical support on the ground. Short of removing the aft lav and putting in an operating suite, I'm not sure what more they can do?

    4 - Air travel contains inherent risk. So does driving, walking down the street, and snatching a drag queen's wig while she's performing. Part of the deal is accepting the risk - albeit small - when you take on the activity.


    I wish all our passengers would be as understanding as you are !!
    You bloody deserve a gold medal icon_biggrin.gif
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    Apr 08, 2013 8:03 PM GMT
    This story is a crock.

    "I never take sedatives on flights because I feel like on almost every other international flight they ask if there's a doctor on board."

    Bullshit.

    I've been on many international flights, and not once have I witnessed a medical emergency.
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    Apr 08, 2013 8:12 PM GMT
    I fly quite a bit and there have actually been several occasions where there has been a medical emergency on my flight. However, when an announcement has been made, there's always been a doctor, nurse, EMT or other professional on board that's been able to lend a hand. I don't know if that's the law of averages or the person in need of help on each flight has just been very fortunate.