Nav: Home

'Is there a doctor on board?' A guide to managing in-flight medical emergencies

February 26, 2018

A new article in CMAJ (Canadian Medical Association Journal) practical tips for physicians on airplanes who may step in to help in a medical emergency.

"Hearing the call go out for a doctor onboard at 36 000 feet can be anxiety-provoking for any physician," says Dr. Alun Ackery, an emergency physician at St. Michael's Hospital and the University of Toronto. "If the health professional offers their expertise, they may have to manage an unfamiliar clinical scenario, in a foreign and limited environment without knowledge of the available resources. This article provides practical tips to inform physicians about what to expect if they are in this situation."

The article reviews the policies and procedures of Canada's two major airlines, Air Canada and WestJet Airlines Ltd. and literally unpacks the medical equipment found onboard these carriers in a video to help health care professionals understand what they might encounter during an in-flight medical emergency and what resources are available to help with treatment.

An estimated 2.75 billion passengers worldwide fly each year on commercial airlines, with 133.4 million fliers in Canada in 2015, a 27% increase over 2009. The increased number of passengers is one reason for an increase in in-flight medical emergencies. Another reason is longer flights, which subject people to stressors, such as lower oxygen humidity levels, for a longer period of time.

There are no standardized methods for identifying in-flight emergencies making it difficult to find reliable incidence rates. Estimates range from one medical emergency per every 604 flights (16 events per one million passengers) to one per 7700 passengers. The top five causes of medical emergencies are lightheadedness/loss of consciousness (37.4%), respiratory symptoms (12.1%), nausea or vomiting (9.5%), cardiac symptoms (7.7%) and seizures (5.8%).

Physicians are the primary responders in 40% to 50% of in-flight emergencies, nurses and paramedics in 5% to 25% and flight attendants alone in almost half (45%) of incidents. The authors suggest that in complex medical situations, a team-based approach, assigning clear roles and responsibilities to use the skills of other health care professionals, is valuable. Flight attendants should be involved as key resources who know the aircraft, emergency procedures and can liaise with the cockpit and ground communications staff for telemedicine support and potential emergency landings.

"The incidence of in-flight medical emergencies continues to rise and it is likely that many physicians will hear a call to attend to a fellow passenger. Knowing what to expect may help physicians be better prepared the next time that fateful call goes out at 36 000 feet," says Dr. Ackery.

Watch the authors unpack in-flight medical kits from Air Canada and WestJet Airlines Ltd. in a video https://youtu.be/h5iKxHO5oVY.

Researchers from St. Michael's Hospital, the University of Toronto, Air Canada, WestJet Airlines Ltd. and ORNGE Air Ambulance collaborated on the article.

""Is there a doctor on board?": Practical recommendations for management of in-flight medical emergencies" is published February 26, 2018.

Video link pre-embargo: https://youtu.be/h5iKxHO5oVY

Canadian Medical Association Journal

Related Physicians Articles:

Physicians call for an end to conversion therapy
Historically, conversion therapies have used electroshock therapy, chemical drugs, hormone administrations and even surgery.
Racial bias associated with burnout among resident physicians
Symptoms of physician burnout appear to be associated with greater bias toward black people in this study of nearly 3,400 second-year resident physicians in the United States who identified as nonblack.
Survey finds physicians struggle with their own self-care
Despite believing that self-care is a vitally important part of health and overall well-being, many physicians overlook their own self-care, according to a new survey released today, conducted by The Harris Poll on behalf of Samueli Integrative Health Programs.
Less burnout seen among US physicians, Stanford researcher says
The epidemic levels of physicians reporting burnout dropped modestly in 2017, according to a study by researchers at the Stanford University School of Medicine, the Mayo Clinic and the American Medical Association.
Payments to physicians may increase opioid prescribing
US doctors who receive direct payments from opioid manufacturers tend to prescribe more opioids than doctors who receive no such payments, according to new research published by Addiction.
Is marketing of opioids to physicians associated with overdose deaths?
This study examined the association between pharmaceutical company marketing of opioids to physicians and subsequent death from prescription opioid overdoses across US counties.
Nearly half of resident physicians report burnout
Resident physician burnout in the US is widespread, with the highest rates concentrated in certain specialties, according to research from Mayo Clinic, OHSU and collaborators.
Burnout and scope of practice in new family physicians
Among physicians, family physicians report some of the highest levels of burnout.
Majority of US physicians say they're burned out or depressed
This release concerns the first-ever Medscape National Report on Physician Burnout and Depression.
More than five percent of family physicians did not attempt recertification
More than five percent of family physicians did not attempt recertification.
More Physicians News and Physicians Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: Reinvention
Change is hard, but it's also an opportunity to discover and reimagine what you thought you knew. From our economy, to music, to even ourselves–this hour TED speakers explore the power of reinvention. Guests include OK Go lead singer Damian Kulash Jr., former college gymnastics coach Valorie Kondos Field, Stockton Mayor Michael Tubbs, and entrepreneur Nick Hanauer.
Now Playing: Science for the People

#562 Superbug to Bedside
By now we're all good and scared about antibiotic resistance, one of the many things coming to get us all. But there's good news, sort of. News antibiotics are coming out! How do they get tested? What does that kind of a trial look like and how does it happen? Host Bethany Brookeshire talks with Matt McCarthy, author of "Superbugs: The Race to Stop an Epidemic", about the ins and outs of testing a new antibiotic in the hospital.
Now Playing: Radiolab

Dispatch 6: Strange Times
Covid has disrupted the most basic routines of our days and nights. But in the middle of a conversation about how to fight the virus, we find a place impervious to the stalled plans and frenetic demands of the outside world. It's a very different kind of front line, where urgent work means moving slow, and time is marked out in tiny pre-planned steps. Then, on a walk through the woods, we consider how the tempo of our lives affects our minds and discover how the beats of biology shape our bodies. This episode was produced with help from Molly Webster and Tracie Hunte. Support Radiolab today at Radiolab.org/donate.