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Responding to a medical emergency in flight

Responding to a medical emergency in flight

Old Oct 29, 2023, 2:12 pm
  #1  
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Responding to a medical emergency in flight

Over the years, I have probably responded to about half a dozen such events (both Dom and Int) - probably about 1/2 with passengers having pretty significant problems
- never involved in a diversion, although on a FRA-ORD, I felt that the circumstances warranted an emergent landing in ORD as that would have been better for the pass than diverting somewhere else with potentially limited access to his needed.... and often wondered how that decision is made (I know of an interesting story about that which was shared with me....)

I have found that UA (vs some of the other airlines in which this issue has come up) is much better prepared - but I still sense there is a long way to go
.... and, to be blunt, as a professional taking a huge risk (not to mention the disruption in my flying experience), I have mixed feelings about the "thank you" response from UA

I know this can be a hot topic for healthcare providers who travel (and not just doctors) but also for passengers (a recent diversion to ORD that is making the rounds on the blogs prompted this thought) as well as the "patient/passenger"

hence, maybe we can discuss some thoughts and experiences?

-m
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Old Oct 29, 2023, 2:17 pm
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I always wondered if there is ever any follow up "thank you" by the airline [UA here] in these kinds of incidents. Is there?
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Old Oct 29, 2023, 2:23 pm
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Originally Posted by mfirst
(I know of an interesting story about that which was shared with me....)

....

hence, maybe we can discuss some thoughts and experiences?
So... start the thread...

Originally Posted by mfirst
a professional taking a huge risk (not to mention the disruption in my flying experience)
If you're more interested in yourself than helping people, don't respond when they call for a doc.

Originally Posted by mfirst
I have mixed feelings about the "thank you" response from UA
Act not expecting one at all.
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Old Oct 29, 2023, 2:26 pm
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Originally Posted by mfirst
Over the years, I have probably responded to about half a dozen such events (both Dom and Int) - probably about 1/2 with passengers having pretty significant problems
- never involved in a diversion, although on a FRA-ORD, I felt that the circumstances warranted an emergent landing in ORD as that would have been better for the pass than diverting somewhere else with potentially limited access to his needed.... and often wondered how that decision is made (I know of an interesting story about that which was shared with me....)

I have found that UA (vs some of the other airlines in which this issue has come up) is much better prepared - but I still sense there is a long way to go
.... and, to be blunt, as a professional taking a huge risk (not to mention the disruption in my flying experience), I have mixed feelings about the "thank you" response from UA

I know this can be a hot topic for healthcare providers who travel (and not just doctors) but also for passengers (a recent diversion to ORD that is making the rounds on the blogs prompted this thought) as well as the "patient/passenger"

hence, maybe we can discuss some thoughts and experiences?

-m
I have been reluctantly involved in a few over the years. I generally only answer after the third request. Not much in terms of feedback or thanks from United. Once though I got a call a day later from corporate office thanking me and saying that they will remember my efforts (how I have no clue). Never once did I get feedback on how the sick person did. The captain generally I have found to be very responsive and they are deferent to one's professional opinion. They seem to be in touch though with a medical team on the ground which is giving advice also on what to do with a sick passenger. Sometimes that the advice could be questionable like once they were telling me to give strong antiplatelet (blood thinning) medication for a passenger having a neurological event in which my clinical diagnosis was a possible bleed in the brain (and a blood thinner would have made it worse).

The liability issue is a big one. Because the captain sometimes has asked if the medical condition is such that ir needs immediate attention (ie diversion) or can it wait till reach the destination. Of course whatever answer one gives can have implications for the sick person or the airline. Personally, I prefer to have my noise canceling headphones on and not hear any of the announcements!
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Old Oct 29, 2023, 2:37 pm
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Originally Posted by mduell
If you're more interested in yourself than helping people, don't respond when they call for a doc.

Well, no doctor here, but I can fully understand how this puts a medical professional in an extremely difficult position.
Between their professional oath and the potential ramifications, it can't be an easy decision.
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Old Oct 29, 2023, 2:43 pm
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Originally Posted by mduell
So... start the thread...



If you're more interested in yourself than helping people, don't respond when they call for a doc.



Act not expecting one at all.
A bit harsh. I know several people who do not and would not respond to the call. It's a big ask and not the right context to offer professional assistance.
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Old Oct 29, 2023, 2:51 pm
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Originally Posted by mduell
So... start the thread...



If you're more interested in yourself than helping people, don't respond when they call for a doc.



Act not expecting one at all.
Ummm... wow, that seems a tad unnecessary (and that is coming from someone that frequently gets himself in trouble for "harsh" responses)

Regards
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Old Oct 29, 2023, 3:13 pm
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I've been on a handful of flights over the years where the FAs page for a doctor and only had one flight where we received an expedited approach. While aboard IAD-DEN in 2011 on the 757, an individual fell in the aisle and it sounded as though he was unconscious. We got an expedited approach into DEN and landed approx 35-40 minutes early so he could be removed by medics.

In terms of UA being prepared, that's good to hear, though I hope it also translates to decent medical supplies. My girlfriend flew WN this weekend (I know ) and said they had very minimal medical supplies aboard when she assisted with a patient having a medical issue.

I know LH offers their "Doctor on Board" program which offers folks some miles and other goodies for assisting with a medical emergency. I'm not a Doctor, but I don't think I'd be too concerned with getting some sort of gift for helping somebody experiencing a medical emergency. One would hope the satisfaction of helping somebody through a potentially life threatening emergency would be all the thanks needed.
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Old Oct 29, 2023, 3:29 pm
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Originally Posted by fumje
A bit harsh. I know several people who do not and would not respond to the call. It's a big ask and not the right context to offer professional assistance.
That's fine, don't respond, it's the providers choice. Don't need to make a big deal about not acting.

Originally Posted by narvik
Well, no doctor here, but I can fully understand how this puts a medical professional in an extremely difficult position.
Between their professional oath and the potential ramifications, it can't be an easy decision.
If they have a bright line obligation to respond, then they should do that. If they don't, they should exercise their choice without expectation of a thank you from the airline.

Last edited by mduell; Oct 29, 2023 at 3:37 pm
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Old Oct 29, 2023, 3:30 pm
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Originally Posted by ani90
I have been reluctantly involved in a few over the years. I generally only answer after the third request. Not much in terms of feedback or thanks from United. Once though I got a call a day later from corporate office thanking me and saying that they will remember my efforts (how I have no clue). Never once did I get feedback on how the sick person did. The captain generally I have found to be very responsive and they are deferent to one's professional opinion. They seem to be in touch though with a medical team on the ground which is giving advice also on what to do with a sick passenger. Sometimes that the advice could be questionable like once they were telling me to give strong antiplatelet (blood thinning) medication for a passenger having a neurological event in which my clinical diagnosis was a possible bleed in the brain (and a blood thinner would have made it worse).

The liability issue is a big one. Because the captain sometimes has asked if the medical condition is such that ir needs immediate attention (ie diversion) or can it wait till reach the destination. Of course whatever answer one gives can have implications for the sick person or the airline. Personally, I prefer to have my noise canceling headphones on and not hear any of the announcements!
would not the 1998 Aviation MedicalAssistance Act (AMAA) shield at least US carrier flights from liability for good Samaritan type assistance?
PL 105-170 sec. 5(b) LIABILITY OF INDIVIDUALS.An individual shall not be liable
for damages in any action brought in a Federal or State court
arising out of the acts or omissions of the individual in providing
or attempting to provide assistance in the case of an in-flight
medical emergency unless the individual, while rendering such
assistance, is guilty of gross negligence or willful misconduct.
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Old Oct 29, 2023, 3:32 pm
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Originally Posted by mduell
That's fine, don't respond, it's the providers choice. Don't need to make a big deal about not acting.
Not making any kind of deal about it there are valid, non-selfish reasons to not respond, that's all.
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Old Oct 29, 2023, 3:37 pm
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In early September, LHR-IAD, there was some medical emergency in the far back cabin shortly before landing. We were all told to remain seated while 3 medics came on board (1L) and walked to the far back. After a few minutes, the purser clapped her hands and told those of us in business (J) that we could get up and quickly get off.

The passengers in PE and further back remained seated, as the FAs back there did not clap their hands and tell the PE/E+ passengers to start getting off. As I got off (I was in row 3), I looked to the back and the medics were still in the far back.

It struck me as a bit strange to allow the J passengers to get off while the medics were still on the plane, but I guess it could be done quickly enough while they were still stabilizing or treating the passenger in E-.
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Old Oct 29, 2023, 3:38 pm
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Originally Posted by fumje
Not making any kind of deal about it there are valid, non-selfish reasons to not respond, that's all.
Agree 100% -- and we don't need to differentiate them here.
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Old Oct 29, 2023, 3:52 pm
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Originally Posted by prestonh
would not the 1998 Aviation MedicalAssistance Act (AMAA) shield at least US carrier flights from liability for good Samaritan type assistance?
It is not as simple as that though. The act does not protect against negligent practice. For example if a doctor does something that is against the standard of care that results in harm to the patient then it wont be indemnified by this act. Most doctors these days are heavily specialized so may not necessarily be up to date on areas of medicine outside their expertise so can provide care or opinion that is negligent or not standard in good faith truly thinking they are doing the right thing for the sick person.

Also the act does not indemnify against the condition of the doctor - if you have say you had three glasses of wine or took an ambien, and went to help because you were the only doctor available, then you are liable for for actions and not exempt by the act and can be sued successfully for providing (bad) medical care under influenceof drugs or alcohol. If you gave medical care outside scope of your expertise - for example you are a psychiatrist and then tried to administer a drug or treatment you have no training to do (like use a coat hanger to drain a pneumothorax as a doctor famously did years ago) then you can certainly be sued if things go wrong. Also I don't know for sure the jurisdiction issues assuming the flight originated and was diverted to a non US airport.

True there are practically no cases of doctors or nurses being successfully sued for inflight good Samaritan acts but it doesn't mean it cant happen. I don't think anyone wants to be that index case.

Last edited by ani90; Oct 29, 2023 at 4:00 pm
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Old Oct 29, 2023, 4:14 pm
  #15  
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Originally Posted by mduell
If you're more interested in yourself than helping people, don't respond when they call for a doc.
Totally uncalled for. In our litigious society, a licensed physician has to be extremely careful becoming involved with a situation outside their specialty.
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