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Is there a doctor on the plane? Probably

U. PITTSBURGH (US) — In-flight medical emergencies are relatively uncommon and when they do occur, fellow passengers or flight attendants take care of the situation with help from medical professionals on the ground.

A new study examined records of in-flight medical calls from five domestic and international airlines to the University of Pittsburgh’s STAT-MD Communications Center, a 24-hour medical service directed by physicians, between January 1, 2008, through October 31, 2010.

Although not required to by the Federal Aviation Administration, many airlines use a medical communications facility to consult with doctors on the ground. The center handled 11,920 in-flight medical calls during the study period. The most common in-flight problems reported were syncope (fainting) or near-syncope, respiratory symptoms, nausea or vomiting, and cardiac symptoms.

Physician passengers provided medical assistance in nearly half of those calls. Other medical professionals, including nurses and emergency medical technicians, provided help in another 28 percent of the calls. Flights were diverted to alternate destinations because of medical concerns in only 7.3 percent of the incidents.

Most of the passengers who were treated in-flight had favorable outcomes. According to data for nearly 11,000 of those patients, 25.8 percent were transported to a hospital by emergency medical services; 8.6 percent were admitted, and 0.3 percent died, either on board the aircraft or upon transport to the hospital. The most common causes for admission to a hospital were stroke, respiratory, and cardiac symptoms.

Published in the New England Journal of Medicine, the study found that most calls could be managed by the flight attendants, who are trained in emergency protocols and have access to an FAA-required emergency medical kit, along with medical volunteers in the majority of cases.

In these cases, ground-based physician consultants provided additional guidance, including use of specific medications in the kit, and assisting the pilot and crew in making decisions regarding need for diversion of the aircraft.

“We wanted to provide a description of the type of emergencies commonly treated on an aircraft, identify the outcomes of these patients, and provide an understanding of  the treatment capabilities available on the aircraft in the medical kit and through experts on the ground,” says Christian Martin-Gill, assistant professor of emergency medicine.

Physicians and others obtain a basic knowledge and awareness of the resources available to them in this unfamiliar and cramped setting to be effective volunteers during an in-flight emergency, the study suggests.

“Commercial air travel is generally safe, and in-flight deaths are rare,” Martin-Gill says. “We hope to look more closely at the most common conditions and which ones require follow-up care so we can better tailor treatment recommendations for passengers.”

The National Institutes of Health funded the study.

Source: University of Pittsburgh

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