Or, in the case of a ruptured aortic aneurysm, if you're attending a meeting in the U.S. State Department just blocks from GWU Hospital.

Yes. I'm a doctor.
http://s3.amazonaws.com/files.poster...BopRwLCp5Vw%3D

While in my current life I am the "other kind of doctor", I have been a paramedic in a former life. In 13 years of regular flying and close to MM, I had a dozen or so calls for medical assistance and actively helped in five. One on the ground before take off, four in the air. On all occasions there also was at least one MD on board. They usually are quite happy to see an EMT. Most MDs, even ER docs, are used to an organized environment. EMTs learn to deal with environmental constrains. I can (well could in the past) put an i.v. in crouching down or intubate while lying on the floor. This comes in handy in the confined space of an aircraft.

It usually is good teamwork, as I can be the eyes and hands, while the MD can run though the program. The only problem I ran into are private practice physicians who have not seen an medical emergency since internship. They usually hesitate as they even do not recognize the contents of the med kit. But there is always the radio back up.

On all occasions when I had to fill out the medical incidence report form I got a voucher booklet (NW, KLM, 5000 miles, $50 off, etc.). For the on ground incident, where the flight had to be delayed to get the passenger safely off the aircraft, I woke up to find a bottle of champagne in trhe empty seat next to me, wrapped in a trash bin liner for me to take home (DTW-AMS in J) and a handshake thank you from the purser.

So far I have dodged the bullet for a really severe emergency, which would have led to diverting the aircraft.
The "funniest" one was while sitting in F having dinner I heard a loud bang from just behind. Sitting at the window I could not see. My seat neighbor turned around to have a peak turned back and said in the most bored voice: "Someone just died" and nonchalantly continued with dinner. I guess she was quite surprised as I jumped over her without much warning. Fortunately, it was only a syncope, the most frequent new medical condition for in-flight incidents. The guy collapsed and hit the lav door with a loud bang.

For anybody interested here is a link to a two page article
"Emergencies in the air"
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1726905/
listing the various causes.

The following article is a pretty good description of:
"Management of In-flight Medical Emergencies"
http://journals.lww.com/anesthesiolo...encies.27.aspx

Safe travels.

It's good Dovster isn't a Doctor!



What was the loud bang?

The guy collapsing and crashing into the lav door.

Expedited landings into ATL for medical emergencies make for some nervous pax -- who are NOT in medical need.

I endured a corkscrew landing approach into Hartsfield just last week. He put it down an instant after the last hard bank. We'd been advised of possibly "violent" moves. The captain headed straight to the gate and we waited no more than 3 minutes for the gurney and medical techs. The woman was unconscious.

All in all, very well-handled. Very weird vectoring, of course.

From a historical standpoint, does anyone know how having a medical emergency in a plane today compares with even the best available care 25, 50, 100, or 200 years ago? I'd guess a heart attack on a plane with a defib would be better than any heart attack just 10 years ago?

This was also my experience about a year ago. BTW, I must be a black cat or something. I have heard the call for doctors at least 4 times on board an aircraft and I don't fly nearly as much as the rest of you. Unfortunately, I am little help in these situations, having let my CPR license lapse. I did volunteer my first class seat in the MSP to ATL incident when the physician attending to the patient asked for one. But, the FA turned it down. They couldn't move me and the toddler to the exit row where the ill passenger was sitting.

I CAN pass on a thank you to all of you who have helped, though.

It was much better a few hundred years ago. Aztec Airlines used to pull out the last four rows of Y and install an operating room, complete with flt surgeon and a couple nurses. :rolleyes::D

Uh, I think your guess that it is far better today is a good one. ;)

I guess it depends on what you will call "best available care". Having an heart attack while visiting your uncle in the hospital, you have very short ways. Having a heart attack at 30.000"...

If you thinking "pre-hospital care in the field" forget 200, 100 and even 50 years ago. In the 1960s scoop-and-run was still the prevalent ambulance service approach. And even if you got a heart attack in a hospital, there were no clot busters or radiological intervention.

25 years ago the paramedic system was pretty much in place in the big US population centers. Within minutes you have an EMT arriving with a fire truck and the paramedic unit is close behind. In an aircraft, if a medical professional is on board, they are not far away either. The med kit in US aircraft is limited but can be used for the management of the most common medical emergencies. The main issue is the time from 30.000" to the ER. If you have a heart attack or stroke, time is tissue. The earlier the blockage can be resolved the more tissue can be saved.
Keep in mind that the main function of EMTs is to stabilize you for transport to the ER and not to "cure" you.

That said, if you have a hypoglycemic diabetic who accidentally overdosed on insulin, you have that person stabilized and even "cured" within minutes. They still need to be checked in an ER, but there is no further threat.

To summarize, if you have the right people on board who know how to use the med kit, this can amount to pretty standard pre-hospital care. The challenge is in getting you to the ER ASAP. Hence the weird vectoring mentioned before.

I have responded to calls for a doctor three times.

The first two times were on NW. No one else responded. I don't remember many details about the medical emergencies, but one of them was a 40ish male who simply had a fear of flying and had hyperventilated himself into a cold sweat and lightheadedness.

Both of those times I was patched through to Mayo Clinic, even though it seemed unnecessary. I suspect I was talking to an internal medicine resident on call.

In both cases, the sum total of equipment was oxygen, a BP cuff, and a stethoscope. I think this was in the pre-difibrillator days. There was so much aircraft noise that it was very hard to take the BP and to listen to the chest. In both cases the captain asked me if I felt that we needed to divert. In both cases I answered negatively. I do feel that he would have diverted if I had recommended doing so.

In answer to an earlier poster, of course the physician-pax has no authority to force an aircraft diversion. However, can you imagine the situation in which the doctor recommended a diversion, the captain refused, and there was a preventable bad outcome? The lawyers would have a feeding frenzy.

In both cases, I did have to fill out a very short form. Oh, and early into both incidents, the lead FA asked if and where I was licensed (answer: "no, but I did stay at the Holiday Inn Express last night" :p--not really).

About six weeks after each of these incidents, I was surprised to find a nice letter of thanks from NW, accompanied by a $100 voucher.

The third incident occurred a few months ago on DL. There were several physicians and nurses on board, and I ended up going back to my seat unneeded.

DLFan2 I have only one thing to say to you:
yIn nI' yISIQ 'ej yIchep
Or in case your Klingon is as rusty as my Latin:
Sit tibi vita longa et omnia bona

Most planes now have a full medical kit that includes child birth equipment, ivs and fluids, intubation equipment, some drugs including lasix and narcotics and I have seen chest tube placement kits.

As a special forces trained medic, I have done many procedures over 40 years on airplanes and was made a flying colonel the second time.

On most planes, the doc can recommend to the pilot who can recommend to ground about being diverted - I think ground / "the company" still has the final decision -- but hard to overrule pilot or doc on plane.

A lot of docs still don't come forward as even with good samaritan rules, they can still be sued. There was a doc from NY who was sued several years ago. Made the papers, don't know final

More requirements
 

I think the regulations should be that the pursuer and at least another FA have extensive training in CPR/AED and can perform the same functions and administer the same medicine an MD can with authorization from the Medical Advice Nurse. I think they should not leave it up to passengers having medical background.

Its just like on a school campus there is a nurse same with a cruise ship so why shouldn't be the same for airplanes. In fact it would be nice to have a WiFi enabled AED that sends the EKG over Wifi to the Medical Advice center or hospital. The Medical Advice Center is like calling 911 as they work with the diversion process and can get EMTs to meet the plane. When the pilot declares and Easy Victor Medical situation all parties are notified including Delta's operations department.

It amazes me why doesn't the FAA require a specific level of more than basic CPR/AED/First Aid especially on flights over the water. You can't always have a medical professional onboard. Like they said on Rescue 911you can stand there and watch the patient die or you can take courses through the American Red Cross. In all the job descriptions for a flight attendant they don't list CPR as one of the requirements. I think this should be required for applying to such jobs that deals with the public.

I think the physician's role during medical emergencies is to determine whether the patient can wait the duration of the flight or make emergency landing.
Up in the cabin, you can't do much anyway other than supportive treatments or defibrilate the patient if there's no pulse.
Personally, if I have any doubt about the patient not being able to finish the flight, I'll recommend the pilot to divert for landing.