Handling In-Flight Medical Emergencies

• dennoc

  24 Mar 07, 16:47

  With the recent report of BA dead passenger, I canÂ’t help but wonder how crews react in/to the situation and what are decisions made. Though itÂ’s a rare case but there surely be other unexpected incidents occurring.
  
  IÂ’ve heard that there are some medical doctors who fly quite often; I wonder what are the chances of having them onboard in time of medical crisis. IÂ’m still triggered by it to ask more.
  
  I believe both cabin crews and probably flight crews too will have to undergo first aid and CPR course as part of their training.
  - Were they taught the basic cardiac life support as well?
  - What other training is required?
  
  When encountering medical emergencies to anyone onboard,
  - What skill or knowledge is required of the crews?
  - How are they trained to react to that?
  
  I believe first aid kits are made available on all flights.
  - What about defibrillators, stretchers or other equipments?
  - If yes, is it available on bigger aircraft only
  
  When confronted with emergency situation,
  - Are the Captains allowed to make discretion to divert flight?
  - Will the passengers be consulted for diversion?
  - Can diversion be aborted even if passengers are put at risk, due to operating costs?
  - How is it escalated, to whom and what assistance is given?
  
  I hope IÂ’ll have the answers to the above.
  
• storywolf

  24 Mar 07, 17:52

  Originally posted by dennoc:

  With the recent report of BA dead passenger, I canÂ’t help but wonder how crews react in/to the situation and what are decisions made. Though itÂ’s a rare case but there surely be other unexpected incidents occurring.
  
  IÂ’ve heard that there are some medical doctors who fly quite often; I wonder what are the chances of having them onboard in time of medical crisis. IÂ’m still triggered by it to ask more.
  
  I believe both cabin crews and probably flight crews too will have to undergo first aid and CPR course as part of their training.
  - Were they taught the basic cardiac life support as well?
  - What other training is required?
  
  When encountering medical emergencies to anyone onboard,
  - What skill or knowledge is required of the crews?
  - How are they trained to react to that?
  
  I believe first aid kits are made available on all flights.
  - What about defibrillators, stretchers or other equipments?
  - If yes, is it available on bigger aircraft only
  
  When confronted with emergency situation,
  - Are the Captains allowed to make discretion to divert flight?
  - Will the passengers be consulted for diversion?
  - Can diversion be aborted even if passengers are put at risk, due to operating costs?
  - How is it escalated, to whom and what assistance is given?
  
  I hope IÂ’ll have the answers to the above.
  

  The cabin crews are all taught first aid - whcih include CPR. They have the basic first aid kits to machine that give electrical shock for heart attack cases.
  
  There is no medical doctor on board, usually if there is they are the passengers. Usually for more serious cases - usually the captain will use the announment system on the plane to ask for any doctor on board to identify themselves to the cabin crew so that can get their assistance.
  
  The captain will be the one after discussion with the ground make the final decision as to divert the flight. Usually he have to calculate a lot of factor, like fuel, new destintation - route, airport , weather situation.
  
  
• Xfr8dog

  28 Mar 07, 08:52

  If there are no doctors on board, we can get a phone patch through our dispatcher to MedLink, where we can talk to a doctor who can assess the situation.
  
  http://www.medaire.com/comm_medlink.html
  
  While the CA is the final authority, the decision whether to divert or not is a joint one between him/her and the dispatcher, taking into account the recommendation of the doctor. So many factors go into making that determination. Like someone else mentioned, weather at diversion airport, availability of medical facilities to handle the situation, is it serious enough to warrant an overweight landing, stuff like that.
  
  
• dennoc

  7 Apr 07, 21:28

  Sharing with those who are interested to find out the answers to my queries, have been answered by a kind soul, Captain Lim.
  
  a. Yes, both cabin crews and the flight crews have to undergo First Aid and CPR course as part of their training. They are taught the basic cardiac life support and the use of the defibrillators too.
  
  b. Some of the initial courses last between 2 to 5 days and are followed by a practical and a multiple choice written examination. It covers all aspects of first aid which occur in the aircraft as well as the occupational health, manual handling, altitude physiology and details of medical equipment carried on board. In addition to the initial courses, the flight and cabin crew return for their annual refresher course and cardiopulmonary resuscitation practice that lasts a day, followed by an examination.
  
  c. Remember, the flight crews are trained on basic first aid and the use of the life supporting equipment. For more serious medical emergencies, they would have to rely on the professionals. Hence the announcement “Is there a doctor on board?” is often heard over the public announcement.
  
  In the United Kingdom, there is no legal duty for a doctor to offer assistance in an emergency although the General Medical Council considers that such a duty exists. The question of legal liability for medical emergencies on board aircraft is confusing because the law varies from country to country. Several major airlines have now taken out insurance policies indemnifying doctors who come forward to help.
  
  d. First Aid Kits are mandatory equipment on board all commercial aircraft but the contents may differ from airlines to airlines. Virgin Atlantic was the first airline to carry automatic external defibrillators (AED). Provision of AED on board aircraft was controversial until the old unsuccessful and expensive procedure of cardiopulmonary resuscitation and diversion was challenged. Recent litigation has helped to increase their popularity. Now most major long haul carriers have obtained them and are training cabin staff in their use. And that means, AEDs are mainly carried on bigger planes.
  
  e. Yes, all aircraft commanders have the discretion to make a diversion on medical emergencies based on the severity of the case. Of course, they would consult all parties – doctors in the air or from the ground and the airlines before coming to a decision. (Most airlines have their own medical departments with doctors on call to advise about any clinical emergencies.)
  
  f. Normally the affected passengers are too seriously ill or unconscious to be consulted and if the commanderÂ’s decision is to divert, he does so because a life is at stake. In my opinion, an airlineÂ’s reputation would be affected if it were found that it aborted a medical diversion and lost a life just to save cost!