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Top 10 in-flight medical emergencies. Important. Do no harm 70% incidents managed by crew Practice within limits of training and knowledge. Chest Pain. Careful history Differential same as on ground Antacid may help exclude indigestion MI suspected Aspirin, opioid, oxygen

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important
Important
  • Do no harm
  • 70% incidents managed by crew
  • Practice within limits of training and knowledge
chest pain
Chest Pain
  • Careful history
  • Differential same as on ground
  • Antacid may help exclude indigestion
  • MI suspected
    • Aspirin, opioid, oxygen
    • Cardiac monitor may be available with link to ground based advisory service
collapse
Collapse
  • Usually due to simple faint
    • Remain calm
    • Check pulse BP
  • Epilepsy no increased risk when flying
    • Crew are trained to manage fits
    • Aircarft carry parentral diazepam
life threatening collapse
Life threatening collapse
  • Crew trained in basic CPR
  • Many carry defibrillators
    • Crew will be trained in use
  • Doctor’s role IV access & giving drugs
asthma
Asthma
  • Commonest life threatening condition on aircraft
  • Induced by realisation tha tinhalers are in baggage hold
  • Oxygen available and usually injectable bronchodilator and adrenaline
  • May carry inhalers but not nebulisers
head injuries
Head injuries
  • Items falling from overhead luggage compartment
  • Little a Dr can do except perahps advice re need to divert
mental health problems
Mental health problems
  • Anxiety
  • Phobias
  • Major psychiatric illness
  • Conformation of diagnosis and reassurance
  • Diazepam/lorazepam might be available be cautious as may have drunl xs alcohol or taken other illicit drugs
abdominal problems
Abdominal problems
  • D & V common
  • Doctors role is providing diagnosis
  • Advsing on need to divert
diabetes
Diabetes
  • Hypoglycaemic episodes frequent
  • Glucose injections usually available
allergic reactions
Allergic reactions
  • Anaphylaxis occurs rarely
  • Adrenailine and antihistamine sometimed injectable steroid carried
  • Passengers with known allergies may have own epipen
obs and gynae
Obs and Gynae
  • Several babies born on board every year
  • Drs have very little roll to play except provide reassurance and uterine contractant such as ergometrine
miscarriage
Miscarriage
  • Occur occasionally
  • Examination facilities limited
  • Monitor general condition is only real possibilty
diverting aircraft
Diverting Aircraft
  • Cardiac problems 28%
  • Neurological problems 20%
  • Food poisoning 20%
liability
Liability
  • In UK no legal duty for Dr to offer assistant in an emergency
  • GMC considers that such a duty exists
  • Law varies from country to country
  • Several airline have indemnity to cover Drs that come forward
  • MDU covers its members
liability16
Liability
  • US Aviation medical assistance act 1998
  • Protects Drs that act in good Samaritan situations
  • Gives legal protection for airlines
medlink
Medlink
  • Direct communication between flight crew and MedAire
  • Instant expert advice
  • List of Airports suitable for diversion
  • Once MedAire contacted Dr is relieved of liability
  • Captain makes decision to divert
  • MedAire has insurance cover