Airplane Medical Reporting System Questioned

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ARTICLE: FAA and Airlines Should Standardize In-Flight Medical Emergency Protocol and Reporting

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Have you ever been on a flight when an in-flight medical emergency happened? While most of the flights we take are uneventful, the likelihood that in-flight medical emergency will take place will go up with the baby boomer generation living longer and air travel continuing to grow. The FAA does not require that air carriers report in-flight medical emergencies.

The first question to ask is what would the FAA do with the data or stated more pointedly, would knowing the frequency and type of in-flight medical emergencies create a basis for standardizing procedures and medical kit contents? Another critical question would be the quality of the data which the airline personnel would be able to produce. In most cases an on-board medical event is treated as maintaining the status of the passenger/patient until the individual can be turned over to emergency medical personnel.

European airlines reported 10,000 in-flight medical emergencies over a 5 year period from 2005-2010; yet each airline has its own reporting system and protocol. Ninety percent of the US air carriers call MedAire, a global emergency response center that provides real-time medical assistance to pilots and flight attendants. In 2011, MedAire received 22,594 calls for service, which the company claims represents about one medical event for every 30,000 passengers.

While emergency medical kits are mandated by the FAA and EASA to contain medications and equipment, actual kits vary by airline. The FAA mandates that flight attendant training includes CPR and the use of automated external defibrillators, but they do not have (nor does the FAA require) standard curriculum or testing.

Separately, physicians on a flight assisting in an emergency are likely to be unfamiliar with emergency medical kits. Equally problematic, the contents of those kits may be inadequate and poorly organized. Finally, flight crews are unaware of how best to assist the physicians.

Oddly, the approaches that the FAA, NTSB and the industry have taken to improve flight safety have not been extended to passengers who become seriously ill during flights.

If we apply a Safety Management Systems SMS) approach to the problem, here are 4 things that an SMS analysis would likely produce and should be done:

  1. FAA – create a standardized reporting system with mandatory reporting of each medical emergency. Knowing the type and frequency of in-flight medical emergencies will improve the process and protocols for treatment of passengers who become ill in-flight. You can’t address the problem unless you know the facts – think SMS!
  2. FAA – Obtain inputs from medical experts and create the optimal standardized medical kit and revise the kit contents periodically based on the data that is collected. Perhaps working with the AMA, Red Cross and organizations with knowledge of  emergency medicine protocols will create better coordination and equipment.
  3. FAA – Standardize in-flight medical emergency training and procedures for flight attendants.
  4. ICAO/FAA – Standardize flight crew communication with ground medical support when there are no health care professionals on the flight. This is especially important for International flights and air carriers where ground medical support services may vary.

The success of the FAA and the airline industry in improving flight safety indicates that implementing an in-flight medical reporting program and standardizing the emergency medical kits and flight attendant training should be part of the operators overall SMS and safety program and will certainly improve the survival chances of passengers who become ill or get injured.

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2 Comments on "Airplane Medical Reporting System Questioned"

  1. Jennifer Keenan | November 28, 2012 at 12:24 pm | Reply

    Does this mean that the medical system for pilots and contollers will be challenged as well? This is not an avoidance of the issue I hope.

  2. The post was recommending that the FAA should require air carriers report in-flight medical emergencies in standardized format. If implemented it would determine the scope and nature of the in-flight medical emergencies and in turn help ensure that the on-board medical kits and related procedures are consistent/standard to address the types of medical emergencies that take place in flight. The FAA has a responsibility to ensure the safety of the traveling public and they do a great job of that – we are suggesting that the system safety/SMS approach be extended to in flight medical emergencies. There was no intent to challenge pilot, flight crew or controller medical requirements.

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