INFLIGHT MEDICAL EMERGENCIES

By Dr. Burnell Cardron Photographs and Images Courtesy Of Pro-headshots and Island Queen Marketing

How would you deal with a medical emergency when flying? Most times when we fly, it is usually uneventful, but there may also be times when emergencies arise. How we handle them can be potentially lifesaving. Air travel is associated with an array of potential stressors on the physical and psychological well-being of travellers. Altitude changes, particularly fluctuations in cabin pressure, can affect susceptible airline passengers. Research shows that one in every 600 flights result in a medical emergency of some sort.

The more common emergencies we see in order of frequency are light-headedness or fainting, respiratory issues, nausea or vomiting, cardiac symptoms and seizures. The least common are lacerations, cardiac arrest, ear pain, obstetrical or gynaecological symptoms, and headaches. Even though emergencies like cardiac arrest and obstetric problems are less common, these are usually emergencies that would likely result in the plane diverting or changing course to facilitate the urgent transfer of that person to the nearest hospital.

Who usually responds to a medical crisis inflight?

Studies have shown that one in three medical emergencies is usually resolved while still inflight. This is most likely since, in a lot of cases, there may be medical personnel onboard who can assist persons who fall ill. Most times, physician passengers respond to inflight crisis, next are nurse passengers and least commonly may be EMT passengers, if present. Physicians who decide to volunteer should have knowledge about the most common inflight medical incidents, know what is available in onboard emergency medical kits, be able to coordinate their therapy with the flight crew and remote resources, and provide care within their scope of practice. However, if no medical personnel are present in critical situations, the most qualified person may be the one who decided to take up that Basic Life Support or CPR course.

Who can be affected when flying at certain altitudes?

Recent decades have seen an increase in the ease and accessibility of air travel, resulting in the rise and diversity of aircraft passengers. Typically, the average person is usually able to ascend to a height of 7,800 feet without difficulty. However, persons with cardiac or pulmonary co-morbidities are more vulnerable to changes in altitude and are at a considerably higher risk of developing symptoms resulting from low levels of oxygen in their bodies when climbing to higher altitudes. On observation, they may appear to have shortness of breath at rest, cough, weakness, drowsiness, anxiety, or agitation, or even develop bluish discolorations. Persons with chronic medical conditions should be screened by their primary care providers prior to air travel to determine their ability to endure the flight environment. Those with significant pulmonary or cardiovascular disease should be counselled to avoid air travel when possible or travel with supplemental oxygen that may be recommended by their physician.

When inflight medical incidents occur, emergency physicians are ideally suited to respond given the breadth of their training, knowledge, and leadership experience. While there are no studies on pre-flight medical screening of passengers, many sources advise primary care providers to screen patients for these disorders and provide advice prior to commercial air travel.

What should be available for use in an emergency?

Ideally, airlines, especially larger aircrafts, should be equipped with an automatic external defibrillator (AED) and an enhanced emergency medical kit. The use of an external defibrillator and CPR can be lifesaving for someone suffering a cardiac arrest. Flight attendants should be AED and CPR certified every two years. AED use within a commercial flight environment has been validated as safe and effective. There should also be access to certain medications used in the emergency treatment of a patient inflight, which should be included in the standard emergency medical kit.

Finally, always remember to contact emergency medical personnel on the ground, so they can ensure a team is awaiting the arrival of the aircraft to transport any ill passengers to the nearest available medical facility. UA

Pompey Medical is located at #85 Robinson Road, Nassau, Bahamas, open Monday to Friday, 9 a.m. to 5 p.m. and Saturdays 9 a.m. to 3 p.m. We cater to well and sick visits, COVID-19 Rapid Antigen and RT-PCR testing, IV treatments, minor surgical procedures and consultations to name a few. We also accept major insurances and National Health Insurance (NHI) to all qualified persons.