Just When You Thought It Was Safe ...
In-flight medical emergencies, I am told, have been occurring more frequently over the years due to the rising number of air travelers, the aging of the US and European populations, and the increasing mobility of people with acute and chronic illnesses. Clinicians may suddenly find themselves in a difficult environment, in front of many onlookers, managing conditions they do not normally treat, with unfamiliar equipment.
After returning home, I found some good advice in an article in the New England Journal of Medicine. Should you find yourself in a situation similar to mine, Gendreau and DeJohn4 suggest that you:
1. Identify yourself to the cabin crew and explain your qualifications.
2. Ask the patient for permission before taking a complete history and performing a thorough physical exam.
3. If necessary, use an interpreter.
4. If the patient is in critical condition, request diversion to the nearest airport.
5. Cooperate with the on-ground medical staff.
6. Keep a detailed written medical record of your patient encounter.
7. Perform only treatments you are qualified to administer.4,5
Since that time, I have wondered how many stories like this are out there and thought it would be interesting to ask Clinician Reviews’ readers to share their experiences. So, this editorial is a call to you: If you have a story like this, whether it took place on an airplane or the golf course, while you were fishing or attending an athletic event, please share it with us. Limit your story to about 1,000 words and send it to PAEditor@qhc.com. Perhaps we can publish some of your responses on our Web site.
Or if you just want to comment on this editorial, we would also love to hear from you.
REFERENCES
1. Chandra A, Conry S. Be prepared for in-flight medical emergencies. ACEP [American College of Emergency Physicians] News (August 2010). www.acep.org/content.spx?id=49206. Accessed October 17, 2011.
2. Lyznicki JM, Williams MA, Deitchman SD, Howe JP 3rd; Council on Scientific Affairs, American Medical Association. Inflight medical emergencies. Aviat Space Environ Med. 2000; 71(8):832-838.
3. Delaune EF 3rd, Lucas RH, Illig P. In-flight medical events and aircraft diversions: one airline’s experience. Aviat Space Environ Med. 2003;74(1):62-68.
4. Gendreau MA, DeJohn C. Responding to medical events during commercial airline flights. N Engl J Med. 2002;346(14):1067-1073.
5. Newson-Smith MS. Passenger doctors in civil airliners: obligations, duties and standards of care. Aviat Space Environ Med. 1997; 68(12):1134-1138.
