19103_aa

In my experiences with DL (and formerly NW), they have asked for help. I am always clear about my role and ask the patient and/or family member if they consent to my volunteering to help them with limited resources and knowledge about their situation. In a few instances, I've told the pilot we need priority landing and an ambulance at the gate. It's amazing how quickly they can get on the ground. In all circumstances I've been asked to complete an incident report and receive 5,000 miles a few days later. The crew members helping me have always been unusually outstanding, very versed with terminology and procedures and know their med carts in and out.

Recommendations for lay passengers:
Have a card with your current diagnoses, medications, and allergies, and an emergency contact in your wallet. This helps a great deal in completing necessary paperwork.

sbjnyc

I'm an actuary but claim ignorance on these statistics. However I think it would be helpful if the FAA not only published mortality but morbidity (ie number of incidents requiring a healthcare professional) statistics so they can assess methods to improve inflight outcomes (ie what helps and what doesn't). Based on what's been said here it seems the airlines keep detailed information on inflight medical emergencies so this should be possible. I'll assume that the airlines already consult with healthcare providers to determine the medical supplies that should be kept on board (if they don't then they should).

Someone had implied that a few drinks on a flight could impair their medical judgement (apologies if I misunderstood). I wonder if it is feasible for airlines to compile a list of qualified healthcare providers (volunteers of course) so the airlines know in advance if any are aboard a particular flight. This way the airlines can request that one be a "designated driver" so to speak.

NOLAnwGOLD

So I was recently on LAX-JFK the day before Thanksgiving and shortly after takeoff, on mid-60s pax was found unresponsive by her fellow seatmates....there was a lot of immediate chaos which drew my attention from my laptop to what was going on and we had to get her out from the window seat to start CPR (she was pulseless). Thankfully we got her back quickly and despite her second unresponsive, pulseless episode (I advised landing the plane on this second episode), UPMC overruled me and wanted her to stay laying with oxygen for 20 minutes, which turned out she was fine until we landed in NYC. With the help of a guy who does live animal research, watched her while she slept on the floor of the galley to make sure she didn't stop breathing for the rest of the flight.

The FAs were very nice, they funnels a sandwich, cocktail (which I only got a sip of before she went down again) and whatever food I wanted after the first episode. The credit card reader has multiple functions including doing voucher and mile compensation for problems on the flight including for medical assistance. The FA chooses between $50-150 transportation credit vouchers, which you get a receipt and about a month later you get the voucher credited to your account.

Pre-merger on NW, I had three AMS-MSP flights in a row which I had to help out. Each time I got a certificate for 5000 miles that the FAs had. Once, I got moved up to WBC.

Certainly I'm happy to help out and so far everyone has walked off the airplane and all us pax didn't have to divert.

bfxfd

That is really surprising. I am only an EMT-B but in my experience when a patient goes pulseless it is reason for a rush and if available Advanced life support to begin since there is not much us basic guys can do. I would think UPMC would have agreed with you because of the liability factor, kind of hard to explain why they did not recommend that the plane divert especially after a a second medical emergency.


Also one of the guys I am a volunteer firefighter with is also an FDNY Medic who was telling me about a flight he was on from NRT to NYC when a man had a heart attack. As an ALS provider the crew gave him the drug bag and he was able to get the guy back and I believe they made a divert to LAX or other west coast airport can't remember, but they moved him to BE while a doctor kept watch. He also was telling me that there were only enough drugs to do one code which may have been a factor in forcing a diversion.

aubreyfromwheaton

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skchin

Please thank your friend for being a good Samaritan.

DrPSB

Agreed - that is a pretty incredible story. Perhaps there wasn't a closer airport to divert to.

I was reading through this topic because I just had an episode on my flight from Tokyo to Chicago where we responded to a passenger with shortness of breath. I agree with the comments that we have an ethical obligation to provide assistance to passengers in distress. I'd also say a short note from the airline saying thank you for spending four plus hours with an ill passenger and helping avoid a diversion would probably be a nice gesture and not out of place, although also not really expected.

skyvanman

My father has an MD (he doesn't practice) and often he is the only one on the plane who is trained to help. Every time he is offered something by the crew, even if it is just a bag of Biscoffs. On KLM the crew and station manager at LAX basically offered him anything. Pretty sure they were quite glad they didn't ha ve to land somewhere in between AMS and LAX. In the ened he got me a bunch of Delft Houses!

emma dog

Before I get into a long explanation, here's disclosure time. I'm an Anesthesiologist and was in the military. I've responded to multiple in flight medical emergencies and after a friend got caught up in one where the passenger died and the family threatened to sue everyone involved (though it was a heart attack and supplies were limited since this was circa 1997 on a domestic UA flight), we had a long discussion with the JAG. Since that time I've kept up and had curbside discussions with lawyer friends since my frequent flying increases the odds I'm involved in medical emergencies.

First off, every state has different laws. Some have strong protections for "good Samaritans" and others lack them entirely. A lawsuit can be filed against you in any state the plane departs from, lands in, or even flies over. There is no federal jurisdiction protecting a respondent from a lawsuit being filed for medical malpractice.

In a medical malpractice lawsuit, you need to prove four elements in order to establish the case: duty to the patient, breach of duty, injury, and damages.

To begin with, on an airplane, there is question of whether or not there is duty to the patient. With few exceptions, no healthcare provider on an airplane "owes" someone having an emergency. Ethically, yes... they should do their best to help out. But legally, with the exception (I believe) of NY state, trained bystanders have no obligation to help out. As soon as you raise your hand, however, you now have duty to help to the best of your ability.

Breach of duty means that you failed to conform to a reasonable standard of care. This is INCREDIBLY difficult to prove on an airplane. I don't have testing equipment, I don't have X-rays or EKG. I don't have the ability to ventilate the patient. I don't have sterile instruments. Even the stethoscopes and blood pressure cuffs are marginal. While airplane kits are 1,000,000 times better today than they were in the 1990s, they're still a poor substitute. It would be difficult to prove a breach of duty in this environment. The only real possibility would be something like someone complaining of severe chest pain and telling the pilot to continue flying despite all signs saying land. But beyond that, it's hard to imagine a breach.

Injury again is hard to prove. Meaning, with the exception of the chest pain and failing to act, it's hard to prove that a healthcare provider proving basic life support on a plane caused your injury. It's as likely that the 30 minutes it takes to land and the additional 30 minutes to reach a hospital also lead to your injury. So, tying your injury to the breach of duty is a challenge.

Finally, damages are easy. Perhaps the easiest part of the claim. But without breach and injury, it's hard to get your damages.

So... coming around to nidem's post. It's simply not true that accepting compensation removes you from Good Samaritan laws. It's all state dependent. Some states may have this incorporated into their laws, but not all of them. In addition, some states still allow a lawsuit to be filed despite Good Samaritan laws which require hours of depositions and significant expense which is also reportable to the National Practitioner Data Bank. That being said, regardless of individual state laws and one's acceptance of compensation, it's very unlikely a plaintiff would prevail in a med mal case against a first responder on an airplane.

The biggest reason I believe people don't seek compensation from people on airplanes is the difficulty of collecting. In order to collect, you have to be an approved provider in someone's insurance... which is rather unlikely unless you both happen to live in the same state. In addition, what are you going to do... take the injured to collections for failure to pay? Seems pretty tacky. In my experiences, both UA and AA have sent me a variety of thank you letters, miles, and gift certificates. All have been appreciated and I've kept the personal thank you letters sent me because they seem to mean the most.

Again, not necessarily true and is dependent on each individual state laws. Common sense says if someone has an MI midway on a transcon from JFK to LAX, you would be sued in MO or maybe NY or CA. Turns out it can be filed in NY, NJ, PA, WV, OH, IN, IL, MO, NE, CO, NM, AZ, NV, and CA. A truly aggressive plaintiff will pick the most advantageous state and start there.

W/R/T malpractice coverage, my understanding of my policy is that they will cover me in emergency situations as long as I'm not completely off my rocker... they won't cover me on humanitarian trips but they would cover "unscheduled" services.

jimg20

I am a current fire fighter and former paramedic, and I have responded to several requests. My wife who is a nurse has also responded. No, we are not looking for any compensation. That is not why we do this. We have gotten atta boy letters and some miles tossed into our accounts. We are far more satisfied by the best outcome for the patients.

We have had contact with MDs on the ground. I had a seizure patient on the old NWA. We could have easily made it to MEM, but the MDs decided that we should set it down in SGF. My only regret is that NWA would not hold my connection for a few minutes and forced me to hang out in MEM 4+ hours. By the way, we had a very sophisicated medical bag as our disposal. The FAs were also great.

I had a need to come in and out of SGF at that time and asked about our patient the next week. He was checked out at the local hospital and sent on his way the same day.