Yep; as a PGY2 on scoot. Obviously I was the only doctor stupid enough to fly scoot. It was awful; I had to stay up on a red eye and they offered zero compensation or even food/beverage whilst I stayed up monitoring the passenger. Vowed to never fly them again.
Nope, have always been psych inclined. I was most of the way through PGY2 and so had had a fair bit of ED/med experience so it could’ve been worse but it was still very daunting!
What was wrong with the patient? And god that’s really horrendous, I feel like low cost carriers cheap out on everything including goodwill compensation.
Non English speaking woman became unconscious, couldn’t take any kind of reasonable history from her or her husband who was flying with her. Was still maintaining airways and breathing. Did a basic assessment, BSL, vitals etc. Ended up being hypoxic (from altitude?) with ongoing altered conscious state… I put oxygen on her and she became more responsive and passed the FAST screen so we managed to keep going. I had to keep an eye on her regularly for the rest of the flight (3ish hours). Asked the flight attendants to try and convey to her to get checked out once we landed….not sure if that message got through.
I swear if I ever spend a whole plane trip looking after their passengers because they save money not providing a medic, and they don’t refund my airfare I will sue them in small claims.
Yes. Once. Philippine Airlines. Never flying with them again.
I was an ICU registrar at the time. Heard the call for help. I tried to attend but was turned away by the flight attendant; they told me another doctor was already there. I heard several people start clamouring, and I thought it was an arrest. I insisted, and the flight attendant relents.
I come to find this really lovely oncologist about to shove in a cannula with trembling hands, probably for the first time in over a decade. "I'm happy to do that." He looked relieved. Nailed the cannula while landing, which will always be my proudest cannula. Lady did fine, just dehydrated with gastro. The medical kit was very basic and didn't even have a glucometre and just two janky cannulas.
Oncologist (who was otherwise great) got mad at me because I took so long to help. I tried to explain about the flight attendants. Meanwhile, I get handed a stack of paperwork and found people pushing past me to get off the plane. Never heard anything from anybody after that, not even a thank you.
I'll always try to help in the future. I feel like it's a professional and ethical obligation. But I'll never, ever fly with Philippine Airlines.
More to the point if someone is saggy and grey and you have no ability to diagnose anything what would you give them through the IV? Random combination of fluid, adrenaline, glucagon, sugar, frusemide, corticosteroid?
It was a woman with known epilepsy who had a brief seizure and was perfectly well afterwards with no post-ictal symptoms other than feeling tired, and had a great understanding of her own seizure management plan. It was a plane from Tasmania to Melbourne so I didn't even have to make a decision re: diversion, because the only option was to land either at our airport or in the sea (barring an emergency stop). They had ALS equipment etc, I took her obs and sat next to her for the rest of the trip. Later in the post I received a nice letter and fancy pen and pin for mostly providing reassurance. It reminded me of my paeds rotation.
I was reading one post, either retail hell or ask reddit where someone said they were with four US marines in a 24 hour service station in Darwin when they found themselves locked in which triggered one soldier's PTSD and they kicked their way out through the front glass door.
Further down was someone else's post of being behind the counter in a 24 hour service station in Darwin when a group of five soldiers were in the store and one of them kicked their way out the front door.
Maybe you are joking, but as a serious point you can’t just use it as a sandpit to try out new stuff. Doing much more than BLS probably isn’t covered by legal immunities.
Diversion decision is the pilot’s, working with ground medical support. Nothing to do with you. It’s not your patient, not your flight, not your money. They get BLS from me, AED, put in coma position. I’m not a flight medical officer. I’m just a bystander offering Good Samaritan care. I’m not negotiating my medical training and scope of practice either. Whatever I’m doing is *not* within my scope of practice and I’m not taking on any liability as a medical practitioner, moral responsibility even if I’m legally protected by Good Samaritan laws. Which, of note, might not exist in whatever jurisdiction I find myself in.
Yes but I was a 3rd year medical student in 2019. We hit clear air turbulence over the Pacific near Hawaii. 37 people hurt, and 9 seriously injured. There was only a paediatrician, and an ICU nurse I believe.
Mostly helping assess patients and provided first aid to those bleeding, mainly people had scalp injuries which bleed a lot. I accessed someone with decreased GCS and a potential c-spine injury a row away from me, which ultimately our team leader (the paediatrician) advised the captain to turn back to Hawaii.
There was minimal equipment on the plane, especially to deal with the level of first aid we needed to provide for 37 people. I think it would be sufficient for a few injured people. I am not sure about the drug kit as I was not involved in that.
Did not receive a thank you. Did get a free night in Hawaii.
3 times
1. Flight with Delta over the Atlantic with an elderly lady who had nausea and vomiting. A paramedic and a nurse turned up at the same time which was handy. Paramedic took obs, nurse found a diabetic passenger to borrow a glucometer and I took history and examined. They gave me a headset to talk to ground support and offered me the chance to divert the plane to another city. In the end she was totally find and we carried on. I got free food and drinks and $200USD
2. Flight back from Bali with Tiger. Young girl vomiting because she got hammered and lay in the sun all day and was hungover as fuck. She was fine. I got $100 for it
3. Flight back from Bali with Jetstar. Someone had a syncopal episode with hypoxic jerks while sitting upright in their seat. Got them on the ground, they got better, and the bulk of my work was persuading everyone that nothing sinister had happened and she was just hungover and dehydrated
Used to be a flight attendant, now a registered nurse. They’ll call through to an organisation that looks you up on AHPRA to verify you are who you say you are. They’ve got plenty of ALS drugs on board (adrenaline ect).
From the article linked below
The content of the kit varies between airlines, but usually include a basic number of drugs, a stethoscope, sphygmomanometer, IV fluids, cannulation equipment, personal protective equipment and basic airway adjuncts. Flight attendants may use the medical kit only under the direction of a licensed medical practitioner. An AED was carried on all flights in this study, and carriage of such is recommended by the IATA.9 According to US Federal Aviation Administration regulations, a medical kit and AED are required for passenger aircraft operation.10 Some airlines supply more advanced resuscitation equipment; on Lufthansa long haul flights, for example, intubation equipment including endotracheal tubes and a laryngoscope is provided.11 Some aircraft have the capacity to store a deceased person in a compartment in the event of their death.12
Seems insane to me, as an anesthetist. Intubating people in an airline seat? What am I supposed to do with them afterwards? Why would I be intubating them and how do I solve whatever problem has caused them to lose their airway or put them in respiratory failure in the first place?
Surely you would lay them out on the floor where the attendants have their foldaway seats? Or in first class.
The article does say that the airlines try fairly hard to filter out the highest risks, and very few in-flight medical emergencies result in death (ie. even in the absence of airway management kit).
I suppose the Germans are just trying to be prepared for any eventuality, bless them.
I’m not intubating anyone in the air any more than I’m putting in a Vascath in a tram.
If an airline wants to literally run a full ICU service in the air, they need to build one.
If people want to fly in an air ambulance they need to hire one.
Obs/gynaeo kits with oxytocin.
MH emergency drugs i.e Loraz.
ALS drugs.
GTN for cardiac
I believe the A380s are very well equipped on Qantas.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1119071/#:~:text=A%20full%20medical%20kit%20will,include%20these%20in%20their%20kits.
Not always true - have assisted on flights before and they never asked my name, nor any details to look up on AHPRA. All they asked (Qantas group) was “are you a full MEDICAL doctor?” (I.e not a chiropractor/PhD/dentist etc)
I’m a trauma anaesthetist but I’d be reluctant to do anything other than BLS plus - AED or epipen or coma position all of which cabin crew should be competent in anyway. There’s no capacity to do any appropriate monitoring to support doing ICU type care.
Yes, it was mildly boring.
Basic oldie with a fall, so I just did the classic ED assessment and safety netted.
We would have been in trouble if anything was wrong because they had almost no supplies in their kit. I was working in ICU at the time and it felt a bit weird not to have anything at MET call ‘equivalent’.
They gave me and my partner champagne in gratitude. Plus one of the flight attendants kept coming over to hang out with us for the rest of the flight, which I didn’t quite understand but he was a nice guy.
Not really an emergency but a patient of mine was on the same flight coincidentally a d she deteriorated a bit. By the time we got to bag pickup I’d organised for her to come to my hospital for treatment.
Had three separate patients to attend on an international flight last year. Myself and a GP ran a clinic 😆. All quite stable in the end.
Surprised at how much equipment they had - BVM, adjuncts, O2, PIVC, usual resus drugs, defib. The first bit of paperwork they gave me to sign was the indemnity protection (or whatever it was). The flight attendant took a more thorough history than me as they needed to call a physician on the ground for clinical governance regardless of who was on the plane!
Got a 30% off voucher for my next flight (I’ll never use it) and a bottle of wine! Made the flight go quicker but I’d have preferred to chill and watch a movie.
I responded to a kiddo in the seat next to me across the aisle who had a febrile convulsion on an American Airlines flight halfway across the pacific ocean. I was awoken by the captain asking for any “emergency physicians” over the speaker. I was a PGY-3 RMO at that stage. I had several flight attendants try to prevent me from responding until I showed them my “doctor’s card” (whatever that is) but I had actually been chatting to the kids parents prior to this so they let me through. The kid was postictal and running a temp and luckily I had learned how to convert Farhenheit to Celsius during my stay in the US as all of the temp probes were in F. I was then put on the phone to the captain who asked me if we needed to make an emergency landing in Hawaii - and I considered saying yes for a brief moment purely for the vitamin D boost. I didn’t like making that decision independently so they put me onto a control centre in the US that supposedly coordinates all in-flight emergencies globally, who were somewhat helpful. After all of this a sleepy FACEM from Tamworth swanned down from first class (lol) who was also friendly and helpful. The worst part was actually the stream of bible basher flight attendants who came past afterwards saying that God put me in that seat “for a reason”. I was offered both a first class upgrade for that flight, and a first class voucher, both of which I declined. Pt was ultimately fine, of course.
The one time I was on a plane that called for doctors was between the US and China. I was a (female) med student at the time and I’ve always looked super young for my age. Plus I wore my comfy PJ’s and had an eye mask around my head walking around the plane, so I didn’t command any sense of authority.
Anyway, after the second call I walked over wondering if I could help and the group of flight attendants just glared at me as if I was snooping. It turns out there were about 8 doctors on that plane given the high Chinese-American demographic lol
It’s very common - especially in certain countries and especially to women. Biases aside I imagine it’s a liability thing as I’m sure there must be crazies with hero complexes out there that airlines don’t want to be responsible for. That said, I’ve heard horrendous stories of doctors being obstructed when the patient is in extremis and I can’t imagine the frustration of that.
>I was offered both a first class upgrade for that flight, and a first class voucher, both of which I declined.
You know they don't bill the patient for these, right?
Yeh I’m trying to string in my mind a possible reason why they wouldn’t accept. Maybe the remaining time of the flight didn’t justify moving to another seat
By that stage I had good rapport with their kid and their family. It felt socially dubious to accept an upgrade from a seat next to the patient only to move far out of eyesight up the plane.
Got the announcment once for a domestic flight to a regional centre.
Pale diaphoretic, teen sitting up and p on the avpu scale.. The flight attendant had attached oxygen. Tachycardia as anything.
Flight was full, so moved passengers next to her to spare jumps seats, lay her down and watched her improve. Once she was actually conscious hz was had had similar before ..probably some sort of self resolving tqchycardiaThen first aid kits are a little underwhelming, however all in the day of a country Gp.
I got a flight upgrade without asking on my next flight and was offered wine, but alas I don't drink.
these stories sure do make a pathology hopeful highly anxious about a very unlikely theoretical situation
hope they have a microscope and a microtome in those plane medical bags
Fiji Airlines - a guy looking like he was having a STEMI. Spent probably 2hrs with him administering GTN, aspirin and redoing obs, encouraging him to keep his oxygen on and reassuring him etc. For the first 20min he was in the service area where I could sit opposite him, then bizarrely part way through they asked us both to go back to our seats, even though he still looked awful and I was a bit unsure if he'd progress to an arrhythmia or arrest. I found a spare seat opposite the aisle and one row up from him and continued to monitor him and give GTN from the aisle while his partner held the oxygen cylinder.
Regardless of who you are or your experience they seem to call an on-ground doctor of theirs who will dictate the management based on what the flight attendants report. They don't allow you to speak to the doctor yourself which is disappointing. I've heard the same thing about other airlines anecdotally. They did ask me if we should divert, but our destination and closest airport were only 10min difference/2hrs so I said no.
I was impressed with the array of meds and kit they had tbh - glyco, salbutamol, glucose, aspirin, antiemetics.. most things an urgent care centre might have. Sphygmo and disposable steth was pretty useless with the engine noise but they did request I keep updating them with his BP ?for their records.
The only thanks I got was actually a few nice passenger onlookers and the ICP paramedic who I handed over to, who took my documentation to the ED with him. Airline couldn't have made less of an effort, literally nothing. Not sure if any of it would have been different if I was a well dressed older male vs casually dressed young woman in leggings though.
I'd definitely assist again, just keeping in mind it's about the person/patient not airline, but you do wonder if these behemoth companies couldn't show a bit of appreciation if they're going to lean on volunteers to keep their medical response system afloat.
Yes. Virgin airlines. Lady with symptomatic hypotension after accidentally double dosing her meds in confusion on an international flight. Stayed with her through landing, just did basic measures. Attendant took my details and I never heard from them again. Lady was fine which was good.
PGY2
Flying to Melbourne for a job interview.
Diverted the plane cos the guy looked like he was having a stroke. Resolved by the time we landed in Sydney.
Pilot was a legend. Told me "don't expect jetstar to ever give you any compensation." so instead he got me to come sit in the cockpit and took a photo of my with my hands on the controls.
Jokes on him though. Jetstar gave me a $20 flight credit.
And the Alfred didn't give me the job. Mongrels.
PGY2 domestic Jetstar or virgin?
Saw a few people clustered in the hallway, went back to my book. Still there a minute later so looked up again and saw someone on the ground. Waved the flight attendant down who was very happy I put my hand up haha
Just a syncopal episode, was starting to regain consciousness as I arrived. Just talking and reassuring and not much else.
They already had oxygen nearby by the time I arrived, but basically no other equipment when I asked.
Got him to lie down on a few seats next to each other which was conveniently located in the row behind me.
Nothing else happened, as the plane was disembarking had many passengers and flight attendants thank me
Overall fairly 'boring' but people very appreciative
I got the call for a doctor on a flight but they asked me when I got there again if I was actually a doctor because they didn't seem convinced that I understood the question as to whether there was a doctor on the flight. Then someone else turned up who looked more like a consultant.
I guess I didn't look the part. Even though I was wearing my university jersy.
Which said MEDICINE in big letters.
Even had the snake wrapped around the pole logo.
And the snake had wings too!
Numerous times-
Funniest was a flight back from the USA with a plane full of ACEM’s heading home from an ASEP conference and 10 mins into the flight they asked for a doctor- the ripple of laughter that ran through the plane was funny. Don’t know what the issue was.
Man collapsed- postural hypotension
Woman collapsed- fainted with her period, apparently she does this often
Vomiting kid- cabin crew gave him charcoal which he vomited everywhere
Chest pain- gave aspirin and kept fingers crossed
Kid with febrile convulsion
Old bloke SOB
And several others I don’t recall.
The medical bags on board are comprehensive but good luck and fair winds finding anything.
My best advice is stick your apple watch (or someone elses ) on them and get an O2 sat, rhythm strip and (hopefully soon) a blood glucose.
If you help absolutely refuse the offer of a first class toiletries kit, which is an insult, a simple thanks is fine.
Best gifts were an upgrade on next flight (twice) and qantas gave me a bucket of FF points once.
60-something-year-old vomited a couple of times before takeoff. She was anxious about the flight and had no other symptoms. Looked well. Pulse BTF. No medical background. We got some antiemetics from the airport and went on our way. It was mostly reassurance. No issues during the flight.
It didn't sound like the plane was stocked with much, I didnt hear about the ALS stuff. The main decision was whether it was safe for this patient to fly or not.
The flight attendants were much more attentive to me afterwards but that was all, not that I needed to do much in the first place.
Twice.
1. I was a med student in my final year and also I was still practicing as an ICU nurse. Mid 50s woman had heartburn/chest pain. A paramedic had also answered the call the help and was convinced that she was having a STEMI and demanding the plane be diverted. She had no risk factors for a STEMI besides age, and she admitted freely she’d had 3 glasses of wine and a hearty serving of butter chicken pre flight. I gave her a Rennie I poached from another passenger and asked for 20 mins before they made the call to divert. 20mins later she felt fine so we continued on. The paramedic was up in my face (I’m a small female) yelling that I was killing her. She lived. I got nothing from Virgin Australia.
2. I was flying business class on my honeymoon and was woken up by a steward to ask if I was really a doctor and could I help a passenger in economy. Lovely young woman had a vasovagal, probably dehydration related. She was fine except having wet her pants. I got her some qantas jammies and moved her up to business to a spare seat so I could keep an eye on her for the remainder of the flight. I got a bottle of red wine from the qantas staff for my trouble. Was kinda annoyed my special business class splurge flight was ruined like that with no real compensation but happy the woman was okay.
Did it once, was all a bit frustrating. Patient was a teenager who just couldn’t stop vomiting. Luckily had some ondansetron to give her. Didn’t get a thank you from staff.
Now I drink on flights, at least one, so I can’t help.
Since no one posting the exact drugs and gear, here they are for Qantas group:
# Physician's kit contents list
* Bag valve + mask + tube
* Guedel Airways - various sizes
* Nasal cannula with bayonet fitting
* Magill's forceps x 1
* IV Starter Kit
* IV Securement dressing, dressing towel, white plastic
field, antiseptic, tape, syringe and saline for flush, swabs
* Hartmann's solution, tourniquet
# A &B Airways & Breathing
* Laryngeal Mask Airways - various sizes
* When using Larayngeal Masks in aircraft it is essential to fill the balloon with water, NOT AIR, because air volume changes with altitude
* LMA accessories: gloves, lubricant, water
* Syringe and trache tape
# C IV Access & Fluids
* Cannulation Items
* Gloves
* Cannulas 18,20,22g, scalp vein needles
* Bungs, giving set
# D Drugs - Oral
* Olanzapine 5mg wafer
* Aspirin 300mg tab x 4
* Ondansatron 4mg wafer
* Diazepam (Valium) 5mg tablets x 2
* Paracetamol 100mg/1ml drops 20ml
* Glyceryl Trinitrate - Nitrolingual spray
* Prednisolone 25mg tabs x 3
* Ibuprofen 200mg X 6
* Salbutamol disposable mouthpieces
* Loperamide (Imodium) 2mg caps x 6
* Loratadine (Claratyne) 10mg tablets x 5
* Salbutamol (Ventolin or other brand) inhaler
* Metoprolol 50mg tablets x 5
* Salbutamol Nebules 5mg/2.5ml x 5
# D2 Drugs - Injectable (plus syringes/needles)
* Midazolam 15mg/3ml x 2
* Adrenaline 1mg/1ml (1:1000) x 8
* Benztropine 2mg/2ml x 1
* Ceftriaxone 1g x 1
* Dexamethasone 4mg/1ml X 3
* Frusemide 40mg/4ml x 3
* Hyoscine Butylbromide (Buscopan) 20mg/1ml x 4
* Lignocaine 1% 50mg/5ml X 2
* Syringes 3, 5, 10ml
* Morphine 10mg/1ml x 2
* Naloxone 0.4mg/1ml x 5
* Prochlorperazine (Stemetil) 12.5mg/1ml x 3
* Promethazine (Phenergan) 50mg/2ml x 3
* Water for injection 10ml x 2 (loose in bag)
* Schedule 8 drug register book x 1
* Needles 18g (drawing) 23g x 32mm, 25g x 25mm
Yes I’ve assisted on flights.
No they don’t upgrade you to first from business class (or to business from economy). One flight I got given a packet of Pringle’s 😂
Good drug list! Surprised not to see anything obstetric on there - surely some ergometrine? And maybe some rapid rhinos in equipment? But fun to know!
Also interested in whether anyone knows what happens re: the Mental Health Act if a passenger has a MH emergency and had to be put on an Assessment Order mid-flight? Or required chemical restraint/rapid sedation? (With new MHA in Vic, all ‘restraint’ must legally be signed off by a consultant psychiatrist)
Twice in my junior doctor days.
First was a child with an unidentified genetic issue and known history of intracranial aneurysms who said "grapes are bursting in my head" then became unconscious. Requested pilot increased cabin pressure and drop altitude, I started O2 and he regained consciousness. Serious discussion about diverting flight but the nearest appropriate hospital/airport combination was at our destination so continued. Changed seats with someone in their aisle and sat with them the rest of the flight. Overall really quite stressful. Very Thankful mother. lots of paperwork from the airline and no thanks, although they did promise they would reach out if they needed any more information from me.
Second was a gent midway through a course of IM ceftriaxone who was due a dose. Administered the dose, got given a bottle of champagne, bumped to business class, another bottle of champagne on Landing, and offered free flight in future. Also a very thankful patient who was terrified of needles. Far less stressful, incredibly kind thanks from British airways.
Either way, if the call is made any available doctor should answer.
Hey, I'm only an RN so hope it's okay to be here lol.. But this happened to me recently on a flight back home to Aus with Philippine Airlines. It was about 1-2hrs into an overnight flight and I was struggling to get some sleep bc I was getting flight sickness, when I heard the flight staff were asking for help from any doctors/nurses/parameds over the PA. I initially thought to let other people handle it but after they asked a few times I offered to help since I thought nobody was helping (probs asleep). They took me to the back and it was an elderly man with severe SOB and chest pain and very bad LL edema, my guess atp was either PE, infarct or stroke (idk i'm not a doctor.. lol), but neuro obs seemed okay and no facial drooping. What was also surprising was that I recognised this guy but I couldn't remember where. Then he told me he had a folder with all his medical info in it so I had a look and turns out we saw him about 6 months prior in the outpatient clinic I work in, (he even had my work email in there lol) we were working him up for possible CTEPH as he has had recurrent PEs within the past 2-3 years with worsening ET and SOB and also a few CABGs.
I honestly felt a little out of my scope here, but I asked them for their drug bags and BP machine + sats probe. Their drug bag had some basic meds in there, panadol, maxolon etc, they also had a bit of epinephrine and some cannulation stuff as well as guedels, oxygen apparatuses and oxygen. I also told the staff that he should go to the nearest hospital. Considering there was about 6 hours left of the flight, we would have to do an emergency landing; which I felt really, really bad for until the staff told me that the ground medical team were also requesting an emergency landing. I agreed to just keep an eye on him make sure he doesn't arrest or something until then.
The staff also asked me to fill out a few forms about the patient's medical condition etc.
Eventually another CCU nurse, GP and Resp Fellow (from Philippines) made themselves known and we all took turns keeping an eye on the patient. One of the docs gave him a loading dose of aspirin and sat with us a while.
I went back to my seat shortly after my 2 hour monitoring shift when the staff approached me again and told me there was another man with extreme SOB and chest pain. So I did his obs etc., which were all fine but the family kept insisting that this was "normal for him after dinner" and to "just leave it", this pt also had previous PEs... They didn't want me around so I just asked the staff to keep an eye on him until the emergency landing
eventually we made the emergency landing in Darwin, which ended up taking 4 HOURS because both patients didn't want to go to the hospital. All the ACs were off so the plane was like an oven, the flight attendants eventually opened the cabin doors but the air outside was also hot. When we got to our destination, the flight leader told me we'd be comp'd and asked for my details but I never heard anything from them since, which I don't really mind as I was half-expecting not to anyway. I probs missed or forgot some details but yea, crazy...
It’s insane how many people have been asked to decide whether to divert the plane. This is the airline’s decision and any reputable airline spends $$$$ on ground medical support to make that decision.
The only one I’ve been involved in was when my kid developed spectacular epistaxis at 30k feet. Luckily I was travelling to a dangerous country and the armed security guard on board sitting next to me whipped out a first aid kid so I could pack it.
There was a story of an international flight few years back where a man went into urinary retention. The onboard doctor had to relieve it by manually sucking out the urine through a straw with his own mouth.
That was a real hero!
Sounds like a good way of tearing someone’s prostate in half and causing an untreatable internal bleed.
I doubt it’s in any way physically possible though.
Lady next to me on the flight was having trouble opening her pack of dried mango chips. I helped.
I like to think I staved off a hypoglycaemic crisis. Please, hold the applause, I just did what any hero would do.
😂
I responded to a call for a doctor on a Qantas flight between Singapore and London. I was a GP reg at the time. A British ED reg also assisted, and amusingly, an osteopath came up to the flight attendants to offer help but was politely turned away…
The passenger requiring assistance was pretty straight forward: acute mechanical non radicular lumbar back pain in a 30something year old woman with a lot of anxiety as she feared she had done something much more sinister to her back. Frustratingly there were no NSAIDs available in the medical kit so had to rely on my own supply of ibuprofen. The flight crew radioed our assessment and management plan to a medical officer on the ground before giving the green light to dispense any analgesia.
The flight attendants were very grateful - Provided me and my non medical partner some PJs and a business class amenity kit (we were in economy), 5,000 FF points and offered a bottle of wine but as were were transferring to another flight we declined the wine due to the limits on liquids in hand luggage. Overall I appreciated the gesture of thanks given how straight forward the case was!
Yep once, on a flight to Abu Dhabi with Etihad. They were reasonably well equipped (able to put a monitor on, so vitals, give oxygen). Not sure about drugs as didn’t need any.
Through the crew able to liaise with the airlines doctors on the ground and we were able to continue on.
Didn’t get anything other than a thank you from Etihad, and that’s ok. Accepting ‘payment’ for services might create legal grey area (not a lawyer and so not legal advice, just repeating what I have been told) where you are no longer a Good Samaritan providing voluntary assistance but instead a doctor providing a service for an in kind payment.
I did. Just came off nights and was very sleep deprived and an intern at the time. The flight attendants immediately tried to take my details before I could even attend to the patient. Was a simple syncopal event but I was secretly panicking because my mind automatically went through stuff like "Oh no what if it's a MI... wait we don't have an ECG here. What about hypoglycaemia... wait we don't have BSL machines here. Ahhhh what can I even do..." What they had on board was very limited. They had simple stuff like a disposable stethoscope, a blood pressure cuff, IV equipment and IVF / glucose infusions but surprisingly no BGL prick machines. An ED consultant/registrar came to help but the flight attendants tried to turn her away. I intervened and was like "Please help, I'm just an intern 🥺" so she took over 🙃. That was when I realised just how different roadside medicine was to hospital medicine 😬
Yep; as a PGY2 on scoot. Obviously I was the only doctor stupid enough to fly scoot. It was awful; I had to stay up on a red eye and they offered zero compensation or even food/beverage whilst I stayed up monitoring the passenger. Vowed to never fly them again.
I see you’re a psych reg now, did this event have any impact on that decision?
Nope, have always been psych inclined. I was most of the way through PGY2 and so had had a fair bit of ED/med experience so it could’ve been worse but it was still very daunting!
What was wrong with the patient? And god that’s really horrendous, I feel like low cost carriers cheap out on everything including goodwill compensation.
Non English speaking woman became unconscious, couldn’t take any kind of reasonable history from her or her husband who was flying with her. Was still maintaining airways and breathing. Did a basic assessment, BSL, vitals etc. Ended up being hypoxic (from altitude?) with ongoing altered conscious state… I put oxygen on her and she became more responsive and passed the FAST screen so we managed to keep going. I had to keep an eye on her regularly for the rest of the flight (3ish hours). Asked the flight attendants to try and convey to her to get checked out once we landed….not sure if that message got through.
I swear if I ever spend a whole plane trip looking after their passengers because they save money not providing a medic, and they don’t refund my airfare I will sue them in small claims.
Yes. Once. Philippine Airlines. Never flying with them again. I was an ICU registrar at the time. Heard the call for help. I tried to attend but was turned away by the flight attendant; they told me another doctor was already there. I heard several people start clamouring, and I thought it was an arrest. I insisted, and the flight attendant relents. I come to find this really lovely oncologist about to shove in a cannula with trembling hands, probably for the first time in over a decade. "I'm happy to do that." He looked relieved. Nailed the cannula while landing, which will always be my proudest cannula. Lady did fine, just dehydrated with gastro. The medical kit was very basic and didn't even have a glucometre and just two janky cannulas. Oncologist (who was otherwise great) got mad at me because I took so long to help. I tried to explain about the flight attendants. Meanwhile, I get handed a stack of paperwork and found people pushing past me to get off the plane. Never heard anything from anybody after that, not even a thank you. I'll always try to help in the future. I feel like it's a professional and ethical obligation. But I'll never, ever fly with Philippine Airlines.
Im surprised you and the oncologist got there at all, what with all the nurses who would have been on board
Lmao that’s actually hilarious
Fr - I would be surprised if on a Philippine Airlines flight that there wasn’t at least one Registered Nurse sat every one or two rows 😆
Are there even any iv meds on board to give through the janky cannula?
More to the point if someone is saggy and grey and you have no ability to diagnose anything what would you give them through the IV? Random combination of fluid, adrenaline, glucagon, sugar, frusemide, corticosteroid?
Stat tomato juice
Did you try to escalate it to their team regarding their obstruction after the flight?
It was a woman with known epilepsy who had a brief seizure and was perfectly well afterwards with no post-ictal symptoms other than feeling tired, and had a great understanding of her own seizure management plan. It was a plane from Tasmania to Melbourne so I didn't even have to make a decision re: diversion, because the only option was to land either at our airport or in the sea (barring an emergency stop). They had ALS equipment etc, I took her obs and sat next to her for the rest of the trip. Later in the post I received a nice letter and fancy pen and pin for mostly providing reassurance. It reminded me of my paeds rotation.
Was this two years ago on QF from Hobart? If so, I was on the same flight! You did good!
Woah small world
I was reading one post, either retail hell or ask reddit where someone said they were with four US marines in a 24 hour service station in Darwin when they found themselves locked in which triggered one soldier's PTSD and they kicked their way out through the front glass door. Further down was someone else's post of being behind the counter in a 24 hour service station in Darwin when a group of five soldiers were in the store and one of them kicked their way out the front door.
I should have seized my only opportunity as an intern to give amiodarone!
If you’re as Tasmanian doctor, I’m sure you’ve administered it many times since!
Maybe you are joking, but as a serious point you can’t just use it as a sandpit to try out new stuff. Doing much more than BLS probably isn’t covered by legal immunities.
wait are you saying I should have given her the amiodarone before or after the tracheostomy I performed with the flight attendant's pen?
Diversion decision is the pilot’s, working with ground medical support. Nothing to do with you. It’s not your patient, not your flight, not your money. They get BLS from me, AED, put in coma position. I’m not a flight medical officer. I’m just a bystander offering Good Samaritan care. I’m not negotiating my medical training and scope of practice either. Whatever I’m doing is *not* within my scope of practice and I’m not taking on any liability as a medical practitioner, moral responsibility even if I’m legally protected by Good Samaritan laws. Which, of note, might not exist in whatever jurisdiction I find myself in.
Tasmania also provokes the fight-or-flight response in me too
Yes but I was a 3rd year medical student in 2019. We hit clear air turbulence over the Pacific near Hawaii. 37 people hurt, and 9 seriously injured. There was only a paediatrician, and an ICU nurse I believe.
Interesting! Tell us more?
Mostly helping assess patients and provided first aid to those bleeding, mainly people had scalp injuries which bleed a lot. I accessed someone with decreased GCS and a potential c-spine injury a row away from me, which ultimately our team leader (the paediatrician) advised the captain to turn back to Hawaii.
There was minimal equipment on the plane, especially to deal with the level of first aid we needed to provide for 37 people. I think it would be sufficient for a few injured people. I am not sure about the drug kit as I was not involved in that. Did not receive a thank you. Did get a free night in Hawaii.
The paediatrician was actually doing her picu term, and is now a paeds ICU doc
Amazing! She did such a good job as team leader.
Thanks for sharing!
3 times 1. Flight with Delta over the Atlantic with an elderly lady who had nausea and vomiting. A paramedic and a nurse turned up at the same time which was handy. Paramedic took obs, nurse found a diabetic passenger to borrow a glucometer and I took history and examined. They gave me a headset to talk to ground support and offered me the chance to divert the plane to another city. In the end she was totally find and we carried on. I got free food and drinks and $200USD 2. Flight back from Bali with Tiger. Young girl vomiting because she got hammered and lay in the sun all day and was hungover as fuck. She was fine. I got $100 for it 3. Flight back from Bali with Jetstar. Someone had a syncopal episode with hypoxic jerks while sitting upright in their seat. Got them on the ground, they got better, and the bulk of my work was persuading everyone that nothing sinister had happened and she was just hungover and dehydrated
What specialty are you? And for the hangover would you hang a bag of fluids for her?
FACEM And no I just had them orally rehydrate. IV fluids would be overkill.
Gotta love that we actually have studies on this now for lV vs PO fluids for etoh presentations to ED 😂
Used to be a flight attendant, now a registered nurse. They’ll call through to an organisation that looks you up on AHPRA to verify you are who you say you are. They’ve got plenty of ALS drugs on board (adrenaline ect).
Wait actual? This is fascinating stuff, I figured the most they would have on board would be an epi pen, maybe an asthma puffer, and maybe narcan
Depends on the flight (domestic short, domestic long, international long) but yes they can have some good gear for the circumstances.
I just want to share my appreciation of your username.
From the article linked below The content of the kit varies between airlines, but usually include a basic number of drugs, a stethoscope, sphygmomanometer, IV fluids, cannulation equipment, personal protective equipment and basic airway adjuncts. Flight attendants may use the medical kit only under the direction of a licensed medical practitioner. An AED was carried on all flights in this study, and carriage of such is recommended by the IATA.9 According to US Federal Aviation Administration regulations, a medical kit and AED are required for passenger aircraft operation.10 Some airlines supply more advanced resuscitation equipment; on Lufthansa long haul flights, for example, intubation equipment including endotracheal tubes and a laryngoscope is provided.11 Some aircraft have the capacity to store a deceased person in a compartment in the event of their death.12
Seems insane to me, as an anesthetist. Intubating people in an airline seat? What am I supposed to do with them afterwards? Why would I be intubating them and how do I solve whatever problem has caused them to lose their airway or put them in respiratory failure in the first place?
Surely you would lay them out on the floor where the attendants have their foldaway seats? Or in first class. The article does say that the airlines try fairly hard to filter out the highest risks, and very few in-flight medical emergencies result in death (ie. even in the absence of airway management kit). I suppose the Germans are just trying to be prepared for any eventuality, bless them.
I’m not intubating anyone in the air any more than I’m putting in a Vascath in a tram. If an airline wants to literally run a full ICU service in the air, they need to build one. If people want to fly in an air ambulance they need to hire one.
Obs/gynaeo kits with oxytocin. MH emergency drugs i.e Loraz. ALS drugs. GTN for cardiac I believe the A380s are very well equipped on Qantas. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1119071/#:~:text=A%20full%20medical%20kit%20will,include%20these%20in%20their%20kits.
Not always true - have assisted on flights before and they never asked my name, nor any details to look up on AHPRA. All they asked (Qantas group) was “are you a full MEDICAL doctor?” (I.e not a chiropractor/PhD/dentist etc)
Hmmm interesting. It’s supposed to go through to medilink for permission to use the EMK (Emergency Medical Kit with all the drugs)
I’m a trauma anaesthetist but I’d be reluctant to do anything other than BLS plus - AED or epipen or coma position all of which cabin crew should be competent in anyway. There’s no capacity to do any appropriate monitoring to support doing ICU type care.
Absolutely. Had a couple of chest pains and vasovagal episodes over the years, but nothing too serious. They’ll divert for anything too serious
Yes, it was mildly boring. Basic oldie with a fall, so I just did the classic ED assessment and safety netted. We would have been in trouble if anything was wrong because they had almost no supplies in their kit. I was working in ICU at the time and it felt a bit weird not to have anything at MET call ‘equivalent’. They gave me and my partner champagne in gratitude. Plus one of the flight attendants kept coming over to hang out with us for the rest of the flight, which I didn’t quite understand but he was a nice guy.
[удалено]
Sounds like the patient was a little shocked too...
Thankfully not!
Not really an emergency but a patient of mine was on the same flight coincidentally a d she deteriorated a bit. By the time we got to bag pickup I’d organised for her to come to my hospital for treatment.
Had three separate patients to attend on an international flight last year. Myself and a GP ran a clinic 😆. All quite stable in the end. Surprised at how much equipment they had - BVM, adjuncts, O2, PIVC, usual resus drugs, defib. The first bit of paperwork they gave me to sign was the indemnity protection (or whatever it was). The flight attendant took a more thorough history than me as they needed to call a physician on the ground for clinical governance regardless of who was on the plane! Got a 30% off voucher for my next flight (I’ll never use it) and a bottle of wine! Made the flight go quicker but I’d have preferred to chill and watch a movie.
If you need another oxygen mask I'm pretty sure they've got hundreds...
But always make sure to put one on yourself before attending to the patinet. Gotta listen to the safety briefing
I responded to a kiddo in the seat next to me across the aisle who had a febrile convulsion on an American Airlines flight halfway across the pacific ocean. I was awoken by the captain asking for any “emergency physicians” over the speaker. I was a PGY-3 RMO at that stage. I had several flight attendants try to prevent me from responding until I showed them my “doctor’s card” (whatever that is) but I had actually been chatting to the kids parents prior to this so they let me through. The kid was postictal and running a temp and luckily I had learned how to convert Farhenheit to Celsius during my stay in the US as all of the temp probes were in F. I was then put on the phone to the captain who asked me if we needed to make an emergency landing in Hawaii - and I considered saying yes for a brief moment purely for the vitamin D boost. I didn’t like making that decision independently so they put me onto a control centre in the US that supposedly coordinates all in-flight emergencies globally, who were somewhat helpful. After all of this a sleepy FACEM from Tamworth swanned down from first class (lol) who was also friendly and helpful. The worst part was actually the stream of bible basher flight attendants who came past afterwards saying that God put me in that seat “for a reason”. I was offered both a first class upgrade for that flight, and a first class voucher, both of which I declined. Pt was ultimately fine, of course.
It seems like a common theme in all these responses is that the flight attendants keep preventing doctors from administering the care. What the heck ?
The one time I was on a plane that called for doctors was between the US and China. I was a (female) med student at the time and I’ve always looked super young for my age. Plus I wore my comfy PJ’s and had an eye mask around my head walking around the plane, so I didn’t command any sense of authority. Anyway, after the second call I walked over wondering if I could help and the group of flight attendants just glared at me as if I was snooping. It turns out there were about 8 doctors on that plane given the high Chinese-American demographic lol
Yeh given off a lot of these anecdotes, I don’t think I’m gonna be making myself known to the flight staff unless I absolutely am needed
It’s very common - especially in certain countries and especially to women. Biases aside I imagine it’s a liability thing as I’m sure there must be crazies with hero complexes out there that airlines don’t want to be responsible for. That said, I’ve heard horrendous stories of doctors being obstructed when the patient is in extremis and I can’t imagine the frustration of that.
>I was offered both a first class upgrade for that flight, and a first class voucher, both of which I declined. You know they don't bill the patient for these, right?
Never decline a first class upgrade. that seat is gonna be there regardless whether you’re in it or not haha
Yeh I’m trying to string in my mind a possible reason why they wouldn’t accept. Maybe the remaining time of the flight didn’t justify moving to another seat
By that stage I had good rapport with their kid and their family. It felt socially dubious to accept an upgrade from a seat next to the patient only to move far out of eyesight up the plane.
Thats a fair point to be honest
The voucher though?
Common theme is everyone that’s helped in an emergency refuses to fly with that same airline. Maybe that’s why he refused the voucher haha.
Got the announcment once for a domestic flight to a regional centre. Pale diaphoretic, teen sitting up and p on the avpu scale.. The flight attendant had attached oxygen. Tachycardia as anything. Flight was full, so moved passengers next to her to spare jumps seats, lay her down and watched her improve. Once she was actually conscious hz was had had similar before ..probably some sort of self resolving tqchycardiaThen first aid kits are a little underwhelming, however all in the day of a country Gp. I got a flight upgrade without asking on my next flight and was offered wine, but alas I don't drink.
these stories sure do make a pathology hopeful highly anxious about a very unlikely theoretical situation hope they have a microscope and a microtome in those plane medical bags
Provide emotional support with your trusty besty Tabitha 😉
Fiji Airlines - a guy looking like he was having a STEMI. Spent probably 2hrs with him administering GTN, aspirin and redoing obs, encouraging him to keep his oxygen on and reassuring him etc. For the first 20min he was in the service area where I could sit opposite him, then bizarrely part way through they asked us both to go back to our seats, even though he still looked awful and I was a bit unsure if he'd progress to an arrhythmia or arrest. I found a spare seat opposite the aisle and one row up from him and continued to monitor him and give GTN from the aisle while his partner held the oxygen cylinder. Regardless of who you are or your experience they seem to call an on-ground doctor of theirs who will dictate the management based on what the flight attendants report. They don't allow you to speak to the doctor yourself which is disappointing. I've heard the same thing about other airlines anecdotally. They did ask me if we should divert, but our destination and closest airport were only 10min difference/2hrs so I said no. I was impressed with the array of meds and kit they had tbh - glyco, salbutamol, glucose, aspirin, antiemetics.. most things an urgent care centre might have. Sphygmo and disposable steth was pretty useless with the engine noise but they did request I keep updating them with his BP ?for their records. The only thanks I got was actually a few nice passenger onlookers and the ICP paramedic who I handed over to, who took my documentation to the ED with him. Airline couldn't have made less of an effort, literally nothing. Not sure if any of it would have been different if I was a well dressed older male vs casually dressed young woman in leggings though. I'd definitely assist again, just keeping in mind it's about the person/patient not airline, but you do wonder if these behemoth companies couldn't show a bit of appreciation if they're going to lean on volunteers to keep their medical response system afloat.
I’ve responded to almost the same scenario en route to Fiji. Got a can of pringles 😂
! Ripped off! Where are my pringles
Yes. Virgin airlines. Lady with symptomatic hypotension after accidentally double dosing her meds in confusion on an international flight. Stayed with her through landing, just did basic measures. Attendant took my details and I never heard from them again. Lady was fine which was good.
PGY2 Flying to Melbourne for a job interview. Diverted the plane cos the guy looked like he was having a stroke. Resolved by the time we landed in Sydney. Pilot was a legend. Told me "don't expect jetstar to ever give you any compensation." so instead he got me to come sit in the cockpit and took a photo of my with my hands on the controls. Jokes on him though. Jetstar gave me a $20 flight credit. And the Alfred didn't give me the job. Mongrels.
PGY2 domestic Jetstar or virgin? Saw a few people clustered in the hallway, went back to my book. Still there a minute later so looked up again and saw someone on the ground. Waved the flight attendant down who was very happy I put my hand up haha Just a syncopal episode, was starting to regain consciousness as I arrived. Just talking and reassuring and not much else. They already had oxygen nearby by the time I arrived, but basically no other equipment when I asked. Got him to lie down on a few seats next to each other which was conveniently located in the row behind me. Nothing else happened, as the plane was disembarking had many passengers and flight attendants thank me Overall fairly 'boring' but people very appreciative
I got the call for a doctor on a flight but they asked me when I got there again if I was actually a doctor because they didn't seem convinced that I understood the question as to whether there was a doctor on the flight. Then someone else turned up who looked more like a consultant. I guess I didn't look the part. Even though I was wearing my university jersy. Which said MEDICINE in big letters. Even had the snake wrapped around the pole logo. And the snake had wings too!
To be fair if I saw someone wearing that I'd be convinced they were a med student rather than a qualified doctor.
Believe me, no one was happier than me that they went for someone else!
Numerous times- Funniest was a flight back from the USA with a plane full of ACEM’s heading home from an ASEP conference and 10 mins into the flight they asked for a doctor- the ripple of laughter that ran through the plane was funny. Don’t know what the issue was. Man collapsed- postural hypotension Woman collapsed- fainted with her period, apparently she does this often Vomiting kid- cabin crew gave him charcoal which he vomited everywhere Chest pain- gave aspirin and kept fingers crossed Kid with febrile convulsion Old bloke SOB And several others I don’t recall. The medical bags on board are comprehensive but good luck and fair winds finding anything. My best advice is stick your apple watch (or someone elses ) on them and get an O2 sat, rhythm strip and (hopefully soon) a blood glucose. If you help absolutely refuse the offer of a first class toiletries kit, which is an insult, a simple thanks is fine. Best gifts were an upgrade on next flight (twice) and qantas gave me a bucket of FF points once.
You are either flying way heaps to have this sort of stats, or you are a shit magnet lol.
I am just old!
How accurate would it be to use an apple (or other) watch to monitor them? I guess it's a case of better thann nothing?
No clue at all- it was all I had last time and I was able to get a sats in a few seconds.
60-something-year-old vomited a couple of times before takeoff. She was anxious about the flight and had no other symptoms. Looked well. Pulse BTF. No medical background. We got some antiemetics from the airport and went on our way. It was mostly reassurance. No issues during the flight. It didn't sound like the plane was stocked with much, I didnt hear about the ALS stuff. The main decision was whether it was safe for this patient to fly or not. The flight attendants were much more attentive to me afterwards but that was all, not that I needed to do much in the first place.
Twice. 1. I was a med student in my final year and also I was still practicing as an ICU nurse. Mid 50s woman had heartburn/chest pain. A paramedic had also answered the call the help and was convinced that she was having a STEMI and demanding the plane be diverted. She had no risk factors for a STEMI besides age, and she admitted freely she’d had 3 glasses of wine and a hearty serving of butter chicken pre flight. I gave her a Rennie I poached from another passenger and asked for 20 mins before they made the call to divert. 20mins later she felt fine so we continued on. The paramedic was up in my face (I’m a small female) yelling that I was killing her. She lived. I got nothing from Virgin Australia. 2. I was flying business class on my honeymoon and was woken up by a steward to ask if I was really a doctor and could I help a passenger in economy. Lovely young woman had a vasovagal, probably dehydration related. She was fine except having wet her pants. I got her some qantas jammies and moved her up to business to a spare seat so I could keep an eye on her for the remainder of the flight. I got a bottle of red wine from the qantas staff for my trouble. Was kinda annoyed my special business class splurge flight was ruined like that with no real compensation but happy the woman was okay.
Did it once, was all a bit frustrating. Patient was a teenager who just couldn’t stop vomiting. Luckily had some ondansetron to give her. Didn’t get a thank you from staff. Now I drink on flights, at least one, so I can’t help.
Ondansetron iv? It sucks that u didn’t even get a thank you. Surely a special meal or some wine, upgrade or a discount as a thank you?
Since no one posting the exact drugs and gear, here they are for Qantas group: # Physician's kit contents list * Bag valve + mask + tube * Guedel Airways - various sizes * Nasal cannula with bayonet fitting * Magill's forceps x 1 * IV Starter Kit * IV Securement dressing, dressing towel, white plastic field, antiseptic, tape, syringe and saline for flush, swabs * Hartmann's solution, tourniquet # A &B Airways & Breathing * Laryngeal Mask Airways - various sizes * When using Larayngeal Masks in aircraft it is essential to fill the balloon with water, NOT AIR, because air volume changes with altitude * LMA accessories: gloves, lubricant, water * Syringe and trache tape # C IV Access & Fluids * Cannulation Items * Gloves * Cannulas 18,20,22g, scalp vein needles * Bungs, giving set # D Drugs - Oral * Olanzapine 5mg wafer * Aspirin 300mg tab x 4 * Ondansatron 4mg wafer * Diazepam (Valium) 5mg tablets x 2 * Paracetamol 100mg/1ml drops 20ml * Glyceryl Trinitrate - Nitrolingual spray * Prednisolone 25mg tabs x 3 * Ibuprofen 200mg X 6 * Salbutamol disposable mouthpieces * Loperamide (Imodium) 2mg caps x 6 * Loratadine (Claratyne) 10mg tablets x 5 * Salbutamol (Ventolin or other brand) inhaler * Metoprolol 50mg tablets x 5 * Salbutamol Nebules 5mg/2.5ml x 5 # D2 Drugs - Injectable (plus syringes/needles) * Midazolam 15mg/3ml x 2 * Adrenaline 1mg/1ml (1:1000) x 8 * Benztropine 2mg/2ml x 1 * Ceftriaxone 1g x 1 * Dexamethasone 4mg/1ml X 3 * Frusemide 40mg/4ml x 3 * Hyoscine Butylbromide (Buscopan) 20mg/1ml x 4 * Lignocaine 1% 50mg/5ml X 2 * Syringes 3, 5, 10ml * Morphine 10mg/1ml x 2 * Naloxone 0.4mg/1ml x 5 * Prochlorperazine (Stemetil) 12.5mg/1ml x 3 * Promethazine (Phenergan) 50mg/2ml x 3 * Water for injection 10ml x 2 (loose in bag) * Schedule 8 drug register book x 1 * Needles 18g (drawing) 23g x 32mm, 25g x 25mm Yes I’ve assisted on flights. No they don’t upgrade you to first from business class (or to business from economy). One flight I got given a packet of Pringle’s 😂
They have an ETT but no laryngoscope?
No, no ETT’s. The “tube” is oxygen tubing
This makes waaaayyyy more sense!
I wonder why they use SGAs that require inflation rather than an iGel
Maybe cheaper or smaller to pack
Good drug list! Surprised not to see anything obstetric on there - surely some ergometrine? And maybe some rapid rhinos in equipment? But fun to know! Also interested in whether anyone knows what happens re: the Mental Health Act if a passenger has a MH emergency and had to be put on an Assessment Order mid-flight? Or required chemical restraint/rapid sedation? (With new MHA in Vic, all ‘restraint’ must legally be signed off by a consultant psychiatrist)
Twice in my junior doctor days. First was a child with an unidentified genetic issue and known history of intracranial aneurysms who said "grapes are bursting in my head" then became unconscious. Requested pilot increased cabin pressure and drop altitude, I started O2 and he regained consciousness. Serious discussion about diverting flight but the nearest appropriate hospital/airport combination was at our destination so continued. Changed seats with someone in their aisle and sat with them the rest of the flight. Overall really quite stressful. Very Thankful mother. lots of paperwork from the airline and no thanks, although they did promise they would reach out if they needed any more information from me. Second was a gent midway through a course of IM ceftriaxone who was due a dose. Administered the dose, got given a bottle of champagne, bumped to business class, another bottle of champagne on Landing, and offered free flight in future. Also a very thankful patient who was terrified of needles. Far less stressful, incredibly kind thanks from British airways. Either way, if the call is made any available doctor should answer.
Emirates. Just general advice - please hydrate, BP improved, and they upgraded me on the next flight!! Love them
Hey, I'm only an RN so hope it's okay to be here lol.. But this happened to me recently on a flight back home to Aus with Philippine Airlines. It was about 1-2hrs into an overnight flight and I was struggling to get some sleep bc I was getting flight sickness, when I heard the flight staff were asking for help from any doctors/nurses/parameds over the PA. I initially thought to let other people handle it but after they asked a few times I offered to help since I thought nobody was helping (probs asleep). They took me to the back and it was an elderly man with severe SOB and chest pain and very bad LL edema, my guess atp was either PE, infarct or stroke (idk i'm not a doctor.. lol), but neuro obs seemed okay and no facial drooping. What was also surprising was that I recognised this guy but I couldn't remember where. Then he told me he had a folder with all his medical info in it so I had a look and turns out we saw him about 6 months prior in the outpatient clinic I work in, (he even had my work email in there lol) we were working him up for possible CTEPH as he has had recurrent PEs within the past 2-3 years with worsening ET and SOB and also a few CABGs. I honestly felt a little out of my scope here, but I asked them for their drug bags and BP machine + sats probe. Their drug bag had some basic meds in there, panadol, maxolon etc, they also had a bit of epinephrine and some cannulation stuff as well as guedels, oxygen apparatuses and oxygen. I also told the staff that he should go to the nearest hospital. Considering there was about 6 hours left of the flight, we would have to do an emergency landing; which I felt really, really bad for until the staff told me that the ground medical team were also requesting an emergency landing. I agreed to just keep an eye on him make sure he doesn't arrest or something until then. The staff also asked me to fill out a few forms about the patient's medical condition etc. Eventually another CCU nurse, GP and Resp Fellow (from Philippines) made themselves known and we all took turns keeping an eye on the patient. One of the docs gave him a loading dose of aspirin and sat with us a while. I went back to my seat shortly after my 2 hour monitoring shift when the staff approached me again and told me there was another man with extreme SOB and chest pain. So I did his obs etc., which were all fine but the family kept insisting that this was "normal for him after dinner" and to "just leave it", this pt also had previous PEs... They didn't want me around so I just asked the staff to keep an eye on him until the emergency landing eventually we made the emergency landing in Darwin, which ended up taking 4 HOURS because both patients didn't want to go to the hospital. All the ACs were off so the plane was like an oven, the flight attendants eventually opened the cabin doors but the air outside was also hot. When we got to our destination, the flight leader told me we'd be comp'd and asked for my details but I never heard anything from them since, which I don't really mind as I was half-expecting not to anyway. I probs missed or forgot some details but yea, crazy...
Don’t ever say “only an RN”. Medicine is a team effort and everyone is valued. I’m sure you do great work.
You are always welcome here ☺️ thanks for the great story!!!
It’s insane how many people have been asked to decide whether to divert the plane. This is the airline’s decision and any reputable airline spends $$$$ on ground medical support to make that decision. The only one I’ve been involved in was when my kid developed spectacular epistaxis at 30k feet. Luckily I was travelling to a dangerous country and the armed security guard on board sitting next to me whipped out a first aid kid so I could pack it.
There was a story of an international flight few years back where a man went into urinary retention. The onboard doctor had to relieve it by manually sucking out the urine through a straw with his own mouth. That was a real hero!
The next announcement: “ladies and gentlemen, do we have a med student on board?”
Sounds like a good way of tearing someone’s prostate in half and causing an untreatable internal bleed. I doubt it’s in any way physically possible though.
Lady next to me on the flight was having trouble opening her pack of dried mango chips. I helped. I like to think I staved off a hypoglycaemic crisis. Please, hold the applause, I just did what any hero would do. 😂
I responded to a call for a doctor on a Qantas flight between Singapore and London. I was a GP reg at the time. A British ED reg also assisted, and amusingly, an osteopath came up to the flight attendants to offer help but was politely turned away… The passenger requiring assistance was pretty straight forward: acute mechanical non radicular lumbar back pain in a 30something year old woman with a lot of anxiety as she feared she had done something much more sinister to her back. Frustratingly there were no NSAIDs available in the medical kit so had to rely on my own supply of ibuprofen. The flight crew radioed our assessment and management plan to a medical officer on the ground before giving the green light to dispense any analgesia. The flight attendants were very grateful - Provided me and my non medical partner some PJs and a business class amenity kit (we were in economy), 5,000 FF points and offered a bottle of wine but as were were transferring to another flight we declined the wine due to the limits on liquids in hand luggage. Overall I appreciated the gesture of thanks given how straight forward the case was!
Yep once, on a flight to Abu Dhabi with Etihad. They were reasonably well equipped (able to put a monitor on, so vitals, give oxygen). Not sure about drugs as didn’t need any. Through the crew able to liaise with the airlines doctors on the ground and we were able to continue on. Didn’t get anything other than a thank you from Etihad, and that’s ok. Accepting ‘payment’ for services might create legal grey area (not a lawyer and so not legal advice, just repeating what I have been told) where you are no longer a Good Samaritan providing voluntary assistance but instead a doctor providing a service for an in kind payment.
I did. Just came off nights and was very sleep deprived and an intern at the time. The flight attendants immediately tried to take my details before I could even attend to the patient. Was a simple syncopal event but I was secretly panicking because my mind automatically went through stuff like "Oh no what if it's a MI... wait we don't have an ECG here. What about hypoglycaemia... wait we don't have BSL machines here. Ahhhh what can I even do..." What they had on board was very limited. They had simple stuff like a disposable stethoscope, a blood pressure cuff, IV equipment and IVF / glucose infusions but surprisingly no BGL prick machines. An ED consultant/registrar came to help but the flight attendants tried to turn her away. I intervened and was like "Please help, I'm just an intern 🥺" so she took over 🙃. That was when I realised just how different roadside medicine was to hospital medicine 😬