A Journey on EMIG Air

EMIG Review by Alexander Carroll, Mandy Wang

EMIG Air Navjot

The Emergency Medicine Interest Group (EMIG) donned their pilot hats, economy seating and in-flight menus in a workshop that aimed to educate students on common medical emergencies faced at 30,000 feet.

Over the course of two workshops on the 14th & 15th of March, approximately 60 Westmead students from all stages were faced with hands-on experience in the most prevalent medical emergencies in-flight; though snakebites were noticeably absent.

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Seizure patient (Maggie) receiving assistance in the aisle, mid-flight.

The Westmead Clinical School JS Museum and Skills Laboratory were transformed into ‘EMIG Air’ equipped with all the standard medical supplies an airline would carry.

Inspired by a recent publication in The New England Journal of Medicine (NEJM), The ED specialists and registrars from including Dr Vukasovic, the director of the department, guided the students through a host of scenarios.  A lot of the fidelity of the simulation scenarios was provided with the help of some very enthusiastic student actors.

The stations covered a broad range of symptoms: acute chest pain, dyspnoea, and altered mental status. Each scenario was interactive and allowed the students to collaborate and formulate differential diagnoses and management plans. Instruments available included: oxygen masks, ECG, defibrillator, sphygmomanometer and stethoscopes in addition to medications including: nitroglycerin, aspirin, antihistamines, injectable dextrose, adrenaline and more.

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‘Is there a doctor on board? Oh you’re a medical student? You’ll do!’

According to the NEJM study, an in-flight emergency occurs on average 1/600 flights with the most common complaints being: lightheadedness (37%), respiratory issues (12%) and nausea (10%).  Given we are forced into a prolonged upright (sitting) position after a few drinks at the airport, the high prevalence of syncope and light-headedness seems to make sense.

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Thankfully, according the Economist only 7% of flights with Emergencies are diverted due to the high numbers of medical staff travelling on planes.

At the workshop, students learnt about the limitations in medical assistance in-flight, the physiology of altitude and the stresses it can place on individuals such as cabin pressure, oxygen availability and altitude. For more information, visit our blog post on the subject.

The workshops were a huge success with the take home message being that in an in-flight emergency we should feel compelled to (and are protected by law to) assist in emergencies in whatever capacity we can to extend the best possible care to patients. Next time you choose to fly, fly EMIG Air.

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Andrew Coggins welcomes students to ‘EMIG Air’ and provides the in-flight refreshments.

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References

  1. Jose V. Nable, M.D., N.R.P., Christina L. Tupe, M.D., Bruce D. Gehle, J.D., and William J. Brady, M.D. In-Flight Medical Emergencies during Commercial Travel. N Engl J Med 2015; 373:939-945. (http://www.nejm.org/doi/full/10.1056/NEJMra1409213)

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