In Flight Emergencies
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March 2016 brings us the first Emergency Medicine Interest Group (EMIG) workshop of the year. We are looking forward to this week’s session on inflight emergencies.
Here we present some brief information (workshop pre-reading) about ‘in-flight emergencies’ based on the recent NEJM article by Nable et al (2015) and FOAMed.
NEJM Article Summary
What are the stats?
What medical kits are carried?
On most flights the following are available:
- Limited Emergency Drugs (see below)
- Limited equipment including bandages
- A Defibrillator (AED)
- Oxygen cylinders are not routinely carried on flights (but patients may apply to an airline to bring their own with them).
- Crew may be able to assist with providing limited oxygen or change of plane altitude (Dalton’s Law)
- Emergency oxygen via drop down masks is provided by ‘chemical oxygen concentrating systems‘ activated in an emergency decompression of the cabin.
What is the full list of typical equipment available on commercial airlines?
How common are emergencies in the air?
Emergencies occur approximately in one in every 600 flights. Births and Deaths are very rare but do occur. To prevent the former, pregnant women within a month of delivering (due date) are barred from flying (international flights). In the USA, domestic flights allow women to fly up to 7 days before due dates and after 7 days post-partum. Deaths occur very rarely, but may happen on occasion even where an expensive emergency diversion and effective CPR have occurred in the air.
What emergencies commonly occur?
(Stats from Dr Joe Lex, USA)
- Lightheadedness or fainting (37%)
- Respiratory problems (12%)
- Nausea or vomiting (10%) – some articles say this is more common
- Cardiac symptoms (8%)
- Seizures (6%)
- Other Emergencies (Lacerations 0.3%, Cardiac arrest ~0.3%, Ear pain ~0.4%, Obstetrical or gynecological symptoms ~0.5%, Headache ~1%)
Am I at risk if respond (in a legal sense)?
In a word, no.
“In 1998, Congress passed the Aviation Medi- cal Assistance Act (AMAA), which protects providers who respond to in-flight medical emer- gencies from liability and thus encourages medical professionals to assist in emergencies”