Writer offers a bad diagnosis
FAA, ICAO and AMA provide expert Air Medical Kit advice
Instruments, devices and Rx on board varies
Opinion: Medical distress on planes is rising—but what each airline keeps handy, and how flight crews are trained to respond, varies wildly
by Blair Bigham
Mar 2, 2018
“’Ladies and gentlemen, I’m sorry to disturb your sleep—but if there is a doctor on board, would you please identify yourself to a flight attendant?’ As a resident doctor in the emergency department, calls like that are what I live for. It sounds strange, for sure—but emergencies are what I train for, and I was nothing but eager to put my honed skills to work on board an airplane. But then came the fear. I was at 38,000 feet, somewhere between two continents, and I was alone: no nurses, no CT scanners, no pharmacists. I am, at best, a highly educated first aider in a long, metal tube racing towards the rising sun at 500 miles an hour. And when I arrived at the rear galley, my fears were confirmed when I was handed a “medical kit” the size of a shoebox, containing a handful of medications and a blood-pressure cuff so old it belonged in a museum.”
Blair Bingham’s introductory paragraph got my attention; the author is a “resident doctor” but then refers to himself as “I am, at best, a highly educated first aider.” He then wrote: “’medical kit’ the size of a shoebox, containing a handful of medications and a blood-pressure cuff so old it belonged in a museum;’” so, research about the status of on board medical kits was launched.
- there are about 60,000 inflight medical emergencies,
- about 16 for every one million passengers
- about 20,000 of these consulted with ground-based medical support consultants on contract to the airlines (e.g. MedAire and STAT-MD)
- health care providers have been available and have responded in upwards of 80 percent of in-flight medical events.
- Most were minor in nature, involving fainting or an upset stomach.
- about 6oo planes were diverted for medical reasons and about 100 people died onboard.
[NOTE; these numbers were accumulated from a number of different articles on different years; so, the figures are approximate for macro comparison purposes.]
First and foremost, the science of on board medicine is advancing quickly, particularly as to the equipment which can be included in a medical kit and which can be used, safely, by the flight crew plus the more-than-occasional physician. From a policy planning stand point, what should be included in these medical resources is subject to constant change.
Given the variables of available personnel and equipment, the care will range from barely adequate to almost good. The Aerospace Medical Association provides the regulatory bodies and the airlines with their recommendations of what should be on board; the most recent standard was published in 2016.
The good news is that the emergency kits have regulatory requirements and are supplemented by the AMA guide as well as outside consultants. Many airlines also rely on real time medical experts on the ground, who can assist the flight crew and even medical professionals who are passengers.
This is not to say that the metal tube in the sky is a mini-hospital, but a lot of thought has been given to what should be on board in terms of equipment and medicines, how to respond to in flight problems and to obtain expert medical advice,
 Blair Bigham is a Toronto-based multimedia journalist, scientist and resident emergency physician. He was a Global Journalism Fellow at the Munk School of Global Affairs. His work has appeared in the Toronto Star, the Globe and Mail, the New England Journal of Medicine and the Canadian Medical Association Journal, amongst others, and he frequently appears on CBC Radio.
He has worked in health care settings on five continents and has responded to emergencies in urban, rural, and remote settings on helicopters, boats, and vehicles that could generously be described as pick-up trucks. (source: http://blairbigham.com/
Rotor wing critical care transport
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