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An account of a serious medical emergency on a transoceanic flight

• gragas 10y ago
  Why was this post renamed?
• icinnamon 10y ago
  Always been curious about what occurs "behind the scenes" in situations like this. Strange how airlines (and the flight attendants!) aren't held more accountable. Would have assumed the FAA would want to look into any in-flight medical emergency.
  • emodendroket 10y ago
    I'm going to guess the FAA is, like a bunch of other regulatory agencies, struggling to meet its obligations with the insufficient funds funneled into it.
    • galonk 10y ago
      Not quite -- the FAA is a classic example of "regulatory capture". Originally they policed the airlines, but now they explicitly state their mission is to assist the business interests of the corps they're supposed to regulate.
      • jeff_marshall 10y ago
        I can't speak for other aspects of FAA oversight, but my limited experience with DO-178B (A process for certifying software for safety-critical applications) has been mostly positive. While the process is rather heavy (and restrictive, regarding development/certification methodology), the outcomes seem to be quite good. Can you provide some examples of where the FAA is doing poorly due to regulatory capture in regard to safety?
        • deleted 10y ago
          [deleted]
    • SpacemanSpiff 10y ago
      This article was linked on HN last fall I believe: http://www.vanityfair.com/news/2015/11/airplane-maintenance-disturbing-truth http://www.vanityfair.com/news/2015/11/airplane-maintenance-... Basically the airlines are outsourcing maintenance to places like El Salvador, Mexico, and China. The FAA has very little capacity for providing the same level of oversight previously conducted in US-based maintenance facilities. Scary.
      • emodendroket 10y ago
        Yikes. Horrifying stuff. If you've ever read the book "Poorly Made in China" it's kind of frightening to imagine the same techniques being applied to airplane maintenance.
  • Implicated 10y ago
    I was wondering similar things... Why aren't there required 'debriefing' of medical staff and plane staff immediately following in-air medical emergencies? If, for nothing more, to confirm protocols were followed and determine if adjustments are warranted. Aside from that, the fact that disturbing other passengers was even remotely a concern in the case where a person is laying on the floor in a medical emergency is sickening.
    • webtechgal 10y ago
      > Why aren't there required 'debriefing' of medical staff and plane staff immediately following in-air medical emergencies? IMO this suggestion is worth its weight in gold. Imagine what sort of a (valuable) resource could be created out of a databank of information culled from such incidences, growing with time.
  • GirlsCanCode 10y ago
    An obese diabetic decides to fly. How much trouble should the rest of society be subject to?
  • matt_fleming 10y ago
    And is there ever any accountability for pax who are not "fit to fly" (note: I'm not saying that's the case here!) taking the chance and flying anyway?
• intrasight 10y ago
  What a sad, disheartening tale.
  • nraynaud 10y ago
    Well, the patient survived, the plane got to destination, I'd call it a shitty situation that ended well.
    • intrasight 10y ago
      True. Still makes me sad and angry when incompetent people interfere with competent people working to save lives.
• eganist 10y ago
  With regards to the kit which was not aboard the plane, I have a few quick questions from anyone in the know. Missing were: - Aspirin - Nitroglycerin - Masks - Fluid cleanup kits - Airways I'm assuming the latter three are one-time-use. I'm assuming the former two have expiration dates. Does anyone have info on how often these items might be used aboard flights and/or actually reach their expiration dates? I'm asking specifically to see how much money is saved by not stocking up and simply assuming that the resulting lawsuits and fines are cheaper than keeping kit stocked. I simply can't attribute this kind of neglect to human error. Someone has to have done the math on this.
  • emodendroket 10y ago
    I don't know about nitoglycerin, but aspirin expiration dates aren't really "hard" ones; you can basically ignore them.
    • lifeformed 10y ago
      Is medical nitroglycerin different than the explodey kind?
      • JshWright 10y ago
        Chemically? No. It's just a very small amount (a few hundred micrograms), mixed with a lot of 'filler'.
      • bzbarsky 10y ago
        The actual molecule is not. In medical use you don't use pure nitroglycerin; you typically dilute it with other stuff. For example https://en.wikipedia.org/wiki/Nitroglycerin_(drug)#/media/File:Nitro.JPG https://en.wikipedia.org/wiki/Nitroglycerin_(drug)#/media/Fi... shows that the IV solution is 40mg of nitroglycerin per 100 mL of solution, or about .04% by mass. I doubt it's very explodey. Of course even if you want to explode stuff you normally don't use pure nitroglycerin either, because it's _too_ explodey. According to https://en.wikipedia.org/wiki/Dynamite#Form https://en.wikipedia.org/wiki/Dynamite#Form dynamite is 20-60% nitroglycerin nowadays. Still a lot more than 0.04%.
• zitterbewegung 10y ago
  What if the flight attendant did cause serious injury or death? Who would be liable?
  • Cieplak 10y ago
    In the US, I might guess the airline could be held civilly liable for negligence or wrongful death. Not sure about the jurisdictional issues given that it was an international flight. Postscript: https://en.wikipedia.org/wiki/Wrongful_death_claim https://en.wikipedia.org/wiki/Wrongful_death_claim
• xarope 10y ago
  In contrast to this story, my wife (a doctor) did attend to an ailing passenger on a transoceanic flight. The attendants were more than helpful, and my wife expressed surprise at how well stocked their medical kit was (drugs etc). After the flight, the airline gave her some duty free goodies on the spot, and a few days later, a one-way business class ticket (I guess to make up for the fact that she sat with this ailing passenger for most of that transoceanic flight). The article didn't mention what airline. We were flying Singapore Airlines. Service does make a difference.
  • deleted 10y ago
    [deleted]
  • eganist 10y ago
    > The article didn't mention what airline. We were flying Singapore Airlines. Service does make a difference. The article mentioned Delta's risk management folks further down. No worries though; I was wondering the same until I came across the conclusion.
  • nkozyra 10y ago
    There's mention of Delta in the article.
    • xarope 10y ago
      Ah, Delta. I flew Delta, once (in the 80s). On the return flight, the flight was "delayed" till the next morning, and despite being a frequent traveller, they basically told me to go away and come back. Needless to say, I swore to never fly Delta again after that. As an aside, I had a lot of good experiences whenever I flew Southwest.
      • cloakandswagger 10y ago
        I'll trade you my own anecdotal experience: Delta is by far the most professional and comfortable airline I've flown with. The difference in quality when comparing Delta to other airlines is stark enough to me that I will book with them, even if the flight is slightly more expensive or less convenient.
• jewbacca 10y ago
  Interesting discussion on the medical particulars on /r/medicine: https://www.reddit.com/r/medicine/comments/50q4fa/yes_there_is_a_doctor_on_the_plane_what_i_learned/ https://www.reddit.com/r/medicine/comments/50q4fa/yes_there_...
  • seizethecheese 10y ago
    An incredible anecdote about a different incident from that thread: > I'm going to share this story passed on to me by an anesthesiologist. He was on a trip from Canada to to Europe to visit family. He doesn't enjoy flying very much, even less so without anyone he knows to keep him distracted. So he purposefully got a late flight so he could sleep through it. Before boarding he took a few sleeping pills and downed a shot. He's an anesthesiologist, please don't try this at home. He boarded the plane almost last, did up his seat belt, and went nearly straight to sleep. Somewhere over the ocean he was half awake, in a lovely daze of drugs when he heard over the PA. "If there is a doctor on board the plane can they please identify themselves to the flight crew." He thinks about it for a minute, debating what to do and hoping someone else will say something before he has to. Finally he feels like he has no choice. He hits the call button on his seat arm and shortly after, a flight attendant comes to his row. He explains he's a Doctor and he'd like to help if possible. The flight attendant looks at him and says, "Sir, we called the Doctor for you, We've been unable to wake you for the past two hours, and we had to re-seat the passenger beside you because you were drooling on them."
    • quickpost 10y ago
      Anesthesiologists are definitely a different breed. That approach (a few sleeping pills and a shot) definitely jives with my encounters with a few of them. Epic.
      • SomeHacker44 10y ago
        When I fly commercial, I fly Delta. Once, on an SD to NYC red eye in which I take a prescription sleeping pill, the person behind me took the same one and two shots. Scared me but I guess not fatal for him.
• coldcode 10y ago
  Delta is either incompetent when it comes to preparation, or maybe the FAA has no actual way to force compliance with its rules so things like this get ignored. No matter what the rules are on an airline there is no excuse for putting people's lives secondary to them.
• empressplay 10y ago
  Flying to Australia on Delta isn't advised in any circumstance. I know they're cheaper than Qantas or Air New Zealand but you get what you pay for. Just don't do it.
  • XorNot 10y ago
    I've given up trying to save money when flying. There's a list of airlines I trust, and I buy at whatever price their tickets are. The trip is either worth that much, or not worth going at all.
    • sobbybutter 10y ago
      I'm curious--which do you find good (and bad!)?
      • XorNot 10y ago
        I'm in Australia, so my good list is Qantas, Emirates and Singapore Airlines for any flight longer then about 2 hours.
    • kalleboo 10y ago
      I just avoid any US-based carrier, that's served me well. I don't live in the US though, so I have that luxury.
  • wyclif 10y ago
    I believe what you say about Delta, having flown them many times, but I'm curious about what is specifically better re: Qantas or ANZ?
    • lostlogin 10y ago
      Not sure what's better as I have generally used them or Singapore, but I can vouch for the fact that their safety videos are excruciatingly, embarrassing, terribly bad.
    • 10y ago
• goatherders 10y ago
  I am sure there are horror stories for every airline so it seems unfair to gang up on Delta. Actually, no. That isn't what I meant. I flew Delta a month ago and won't be doing so again. Free TV shows and new planes don't compensate for being late or having unfriendly staff members. Never mind this tale...
• paviva 10y ago
  Interesting story and I can partially confirm. I have responded to a few on-flight emergencies on international flights and experience varies according to the airline. Lufthansa has a really great kit to deal with agitated passengers, but nothing to deal with pain. Air Canada's kit is pretty worthless. Most airlines fall in between. That being said, I find the doctor's requirement a bit unrealistic. Airways ? Common, good luck placing an airway in the cramped flight conditions. A BVM [1] would be more useful. IVs ... Completely useless, too. First, unless you have a good nurse on board, you wont be able to open up a good vein. Second, you cannot expect airways companies to store enough of IV fluids to make a difference either way. Third, fluids don't save lives unless you have other medications coming in the next few minutes. The lack of nitro might be a good thing too. Rarely useful, and most likely to result in the passenger passing out/dying than helping anyone.
  • ackfoo 10y ago
    What an odd reply. I have placed airways in helicopters and Piper twin-engine aircraft that were serving as air ambulances. Those are far more cramped than a commercial airliner. Control of the airway can make all the difference when things go bad in a hurry. IV fluids are critical in dehydration--no drugs to follow. Oh. I wrote the foregoing and then I re-read the part about "a good nurse...open up a good vein" and I realized you are a troll with no medical experience or qualifications. Good one.
    • JshWright 10y ago
      > IV fluids are critical in dehydration--no drugs to follow. If someone was able to walk on a plane, it's unlikely they are severely dehydrated... Plenty of other reasons to carry fluids though.
      • neurotech1 10y ago
        Actually, being at 30,000+ feet the air is extremely dry. Getting severely dehydrated during the flight is quite possible. More so if alcohol is involved.
    • 10y ago
• lgleason 10y ago
  Given that this was a 17 hour flight I would bet that this was probably the jnb to atl flight (Johannesburg to Atlanta). I fly that route frequently and this does not surprise me.
  • gallonofmilk 10y ago
    that's quite a long route to travel frequently!
  • smartbit 10y ago
    More longest flights here https://en.wikipedia.org/wiki/Non-stop_flight#Longest_flights https://en.wikipedia.org/wiki/Non-stop_flight#Longest_flight...
• JshWright 10y ago
  > The AED indicated a normal cardiac rhythm. That's not something AEDs can do... An AED can tell you whether or not the patient is in one of two very specific rhythms or not. If the heart is in ventricular fibrillation or ventricular tachycardia, the AED will advise a shock is necessary, otherwise it will report "no shock advised". There are all sorts of nasty cardiac rhythms that an AED will no shock, and there is way to differentiate that.
  • PhasmaFelis 10y ago
    There's a thread on the r/medicine discussion where someone asserts that some AEDs with a monitoring display can be manipulated to get at least some indication of the cardiac rhythm. I'm definitely not qualified to say if they're correct. https://www.reddit.com/r/medicine/comments/50q4fa/yes_there_is_a_doctor_on_the_plane_what_i_learned/d76f2g2 https://www.reddit.com/r/medicine/comments/50q4fa/yes_there_...
• vacri 10y ago
  On a tangent, not all doctors are suitable for emergency work. I used to work with a paediatric neurologist, who was excellent in her field and a respected specialist, and she told the story of the call going out on a plane for a man who was having a heart attack. She hesitated about it - she hadn't "done hearts" since medical school twenty years earlier. Just as she was about to volunteer, however, another doctor put his hand up... and he was a cardiologist.
  • Johnny555 10y ago
    If it were me unconscious on the floor, I'd take a pediatric neurologist that "hasn't done hearts" for 20 years over a flight attendant with 8 hours of "first aid" training.
    • pmiller2 10y ago
      Definitely. I'd rather have any medical professional (any doctor, nurse, emt, paramedic, etc.) attending me in that situation rather than someone whose medical training consists of a first aid course and maybe a CPR certification.
    • webtechgal 10y ago
      Heck - I'd settle even for a vet... any day...
      • ndespres 10y ago
        I fear the day I have to call upon my experience birthing livestock to help deliver a human baby.
    • vacri 10y ago
      Oh, for sure. I certainly don't mean to disparage her skills, just that 'doctors' come in a lot of different varieties, and not all of them retain general medical skills. I remember a friend who became a paramedic. My home state brought in ambulances-for-everybody. If you wanted an ambulance, the dispatcher couldn't say no anymore, you got an ambulance. And for people on low-income cards, those ambulances were free. So my friend got called out to a lot of junk calls (his term: "coughs, colds, and sore holes"), and said that it was a problem for the paramedics because their skills rusted - some paramedics reported only seeing one heart attack in a year, and they have to pause and think what needs to be done again. Medicine is very much a 'use it or lose it' discipline, at least when it comes to the details.
• post_break 10y ago
  Should he have been allowed to sit in an exit row with all that going on? I mean they knew he had these conditions before hand.
  • jrockway 10y ago
    The requirements are the ability to understand English and lift 50 pounds. No lifting required for a modern widebody anyway. Open the door and get out, that's your only job when you're sitting in the exit row.
    • Symbiote 10y ago
      Or not open the door -- for instance, if there is water or fire on the other side. Hence needing to understand English.
  • donretag 10y ago
    That was my first response to the article as well. However, I do not put blame on the airline since his condition could not have been noticeable upon boarding. I would assume they would have done something about a noticeably sick passenger regardless of seat location. Instead, the passenger was incredibly selfish for taking an exit row seat considering they knew they were sick.
  • hueving 10y ago
    What? How did the airline know of these conditions before hand? You don't provide your medical history when you buy a ticket.
• rdl 10y ago
  I'd like to know what airline this was so I can never fly them. 1) This obviously physically incapable person was sitting in exit row initially 2) The F/A of negative utility (the physician probably should have escalated to the pilot, or at least the purser.) That has to be a combination of training and personal incompetence. (Actually, she sounds like the lead flight attendant, which means she should just be fired.) 3) The medical kit. wtf. Ah -- appears to be Delta, which I'd never fly on a 17h international flight anyway.
  • yladiz 10y ago
    The only way for the stewardess to check if a customer can sit in the exit row is to ask, "Are you willing and able to help passengers in the event of an emergency?" If the customer has no obvious outward appearance that might cause an issue, there's no way to know. The person in question in the exit row had a syncopal episode; syncope is defined on Wikipedia as, "Syncope, also known as fainting, is defined as a short loss of consciousness and muscle strength, characterized by a fast onset, short duration, and spontaneous recovery." Having diabetes doesn't disqualify you from being an in exit row. Your other critiques are warranted; the lead FA shouldn't have acted the way the story portrays her to, and the medical kit was woefully understocked. As an aside, do you think that because it's Delta it makes it worse? Why would American or United or Southwest or Allegiant or Silver or any other airline be intrinsically better? This was a lapse in judgement for not having the medical kit stocked, possibly a large one, but one particular organization isn't necessarily worse than any other.
    • rdl 10y ago
      The training lapses and other personnel issues which put a flight attendant in the lead role on a top international route (so, one of their most senior/experienced; likely 50+ years old and with 20-30 years in the job...international routes are pretty highly coveted) are an independent issue from the stocking issue, and do come down on the airline as well.
• throw7 10y ago
  The specific airline protocols makes all the difference... which isn't specified in the article. Also something as simple as all the medication being in a foreign language can be a stumblimg block on an international flight.
  • alasdair_ 10y ago
    Don't all international pilots speak English as a requirement for talking with air traffic control? I would assume that if English is standard for pilots it would also be standard for emergency equipment (in addition to any other languages)
    • tbihl 10y ago
      I just hope that the "English speakers" on planes are better than the ones nominally fulfilling the same requirement on merchant vessels.
    • hueving 10y ago
      Pilots do, but some of the flight attendants may not.
• PhasmaFelis 10y ago
  I really want to know what was going on in the one flight attendant's head. I mean, I'd actually like to hear it from her. It's possible that she's actually a horrible, soulless bureaucrat by nature, but I'd like to think that something else--fatigue, life circumstances--was messing with her and causing her to make really stupid decisions just then.
  • Zancarius 10y ago
    There's also the possibility that her behavior was exaggerated in the article. Unlikely? Maybe, maybe not. That said, there are some especially nasty people who are often in positions they have no business being. This may be such a case. I'd like to give her the benefit of the doubt. I was also thinking of circumstances that may help explain her behavior. It's difficult, but here's what I came up with (this is merely speculation; I have no idea what may have been going through her mind): 1) She may have been afraid of getting fired if things weren't done exactly by the book, 2) she may have been afraid the airline would be liable for anything the doctor did (and perhaps, by extension, herself), 3) perhaps she knew something about the under-stocked medical supplies and fear or repercussions lead to her (re)actions, 4) she had zero empathy, or 5) simply distrusted the doctors. In the case of #1, there's not much you can do outside rectifying the company's culture. If employees are so terrified of being fired for assisting, or allowing someone qualified to assist, in an emergency, there's something horribly wrong with that organization. As for #2, the same may apply with #1, but if the airline is afraid of being liable for an in-flight emergency they shouldn't be in that business, and they certainly shouldn't place the burden of determining liability on the shoulders of a flight attendant when they can afford a legal team. #3 is a bit of a stretch, but given the discussion above, it seems surprising to me that the medkit would be so sorely under-stocked. Possibly an extension of #2. #4 is probably the real culprit, although your explanation of stress or life circumstances may be much more likely. Perhaps she was tired and cranky. (Still, not an excuse, but people do strange things when they're tired or ill.) #5 is also a possibility, but if you're trapped in an aluminum cylinder tens of thousands of feet above the middle of an empty ocean, you really ought to reconsider your career choices if the only people who might be able to save a passenger's life are the very people you don't trust. There's another point I read above that I agree with. If the flight attendants aren't letting you do what you can to help a passenger, perhaps getting the pilot-in-command to assess the situation might be a better option if time and circumstance allow. They likely don't want to be held responsible for someone dying on their aircraft, and they probably have experience with in-flight passenger-related emergencies. They can instruct the flight crew on an appropriate course of action, even if that action is to simply stay out of the way. Oh, one other possibility is that the head flight attendant seemed overly preoccupied with other passengers' comfort. In a situation like that where someone might die, passenger's comfort probably shouldn't enter the equation. Sure, you don't want to endanger them, and maybe you don't want to inconvenience them (much), but if it's a life or death situation... give me a break! Gosh, this post is a bit ranty. Sorry about that.
• xacaxulu 10y ago
  Along with not stocking medical equipment, didn't Delta's data center just go down?
  • dredmorbius 10y ago
    You're being dinged for this as I write, but that's an interesting observation and a sign of failure-to-manage-complexity on Delta's part. Though information-system-related service failures are generally increasing among carriers, if I'm recalling the coverage of Delta's outage correctly. Still remains a good flag to raise.
• jmspring 10y ago
  Snark, it's friday night... "Delta, Delta, Delta, can I Help ya, help ya help ya?" ...
• seesomesense 10y ago
  My wife ( a doctor ) had to attend to a patient who had a medical episode on Singapore Airways (might have been the a Sydney to Singapore or a Singapore to London flight ). According to her, things went well, the air crew were professional and helpful, equipment was available. There was another doctor on the flight who volunteered his help. The two doctors liased and decided that my wife's training and skills were more relevant to the situation. My wife was thanked and given symbolic remuneration ( which she will probably never bother to cash in ). She felt valued and will probably be willing to help again if in a similar situation with Singapore Airlines.
• dr_ 10y ago
  Similar experience, although less dramatic circumstances, on a Qatar flight. I was asleep, when my wife awoke my and volunteered me to address the needs of a passenger passing out in the aisle of the plane. I asked for equipment to check his vitals. Bp was on the low side so I asked he remain supine with his legs slightly elevated. There was a lady sitting next to us who criticized my every move (she felt I wasn't getting an accurate pressure because he was laying down, but I was more concerned with maintaining his pressure than having it bottom out further). The passengers were upset he was laying in the aisle. Turns out the lady next to me was a physician as well, but she never volunteered this or assisted in any way. He eventually got better and I allowed him to return to his seat. I checked on him as we landed and left the plane. Medical services came with a wheelchair to take him off. No appreciation from the crew on this, but I guess that doesn't matter at the end of the day. barring the criticism I received for how I was handling it, the situation ended well.
  • niij 10y ago
    Too many chiefs, not enough Indians. Thank you for doing the right thing!
    • deleted 10y ago
      [deleted]
  • geoka9 10y ago
    Thank you!
  • cm2187 10y ago
    Don't physicians in the US take the hippocratic oath too?
    • ntaylor 10y ago
      They surely do.
  • clort 10y ago
    Its interesting that the other doctor did not volunteer this information. I did pool lifeguard training a few years ago (in the UK) and was told that as this training is at a higher level than basic first aid training I would be legally required to notify my status and presence in an emergency, and that not doing so could leave me open to prosecution. Do doctors not have any obligations such as this laid upon them? (My lifeguard certification has expired now)
• ghufran_syed 10y ago
  As an emergency physician, the first thing I would say if I ever met the doc would be 'well done' for volunteering - it's a hard thing to do. I'm also very glad that it seems the patient did ok. However, in these kind of situations, I don't think it's in the patient's best interests to avoid diversion. The algorithm should be: 1) sick vs not sick - this person was clearly sick (when an ER docs say someone is 'sick', they usually mean there is a non-trivial probability that they could die in the next 24 hours) 2) Could a delay in critical care treatment lead to a worse outcome for the patient? If so, I would argue that you have to advise diversion to the nearest airport with the required standard of medical care. That means that it might be ok to advise taking one hour to get to a major city, rather than taking 10 minutes to land at a rural airfield with a tiny hospital nearby - that's a judgement call. The only reason not to divert that I can think of is the cost to the airline, and passenger inconvenience: both of those looks like really bad reasons if the guys gets worse again and dies on the plane, when they might easily have been saved if they had diverted to a nearer airport + hospital. I agree with another comment regarding the difficulty of IV's, particularly in shocked patient. Ideally, the airline kits would stock intra-osseous needles (needles with a screw that are screwed into the bone of the shin or upper arm using an electric dril). It sounds brutal,but is probably not much more painful than an IV, and takes seconds to do with training. The crew could be trained to use them as part of their first-aid training - the training takes less than an hour, and it would probably make more difference to patient outcome than having adrenaline on board would. I totally agree about speaking to the pilot in person when you have a critically ill patient - they know (or can figure out) flight times to the various possible diversion airports, you (probably) know better what kind of care the patient needs, and the chances of finding that kind of care in a given city.
  • sandworm101 10y ago
    > It sounds brutal,but is probably not much more painful than an IV, With due respect to a doctor, I've had an IV in my own arm and have seen an i-oss deployed on someone a few feet from me. The pain is not comparable, even when it is done by a expert. When it goes wrong and has to be repeated... The pain of i-oss needles has been much discussed in relation to the death penalty. They hurt. My dentist told me about "pick a friend day" when they practiced injections deep into the jaw. Are there any med schools where students practice with i-oss needles on each other?
• alphaoverlord 10y ago
  I had a good experience on American Airlines. Volunteered when the announcement was made and had flight attendants that were attentive, helpful, and appreciative of my help. I didn't ask for anything but they thanked me as I left the plane - to my suprise, a couple of days later I got an email saying I was credited 25k points on my frequent flier account. I was quite far away from my seat and didn't realize they kept track of who I was. Was very pleasantly suprised and thought things went well.
  • deleted 10y ago
    [deleted]
• Tomte 10y ago
  "Don’t expect so much as a thank you from the airline." Lufthansa at least has a formal program to identify doctors between their passengers: http://www.lufthansa.com/us/en/Doctor-on-board http://www.lufthansa.com/us/en/Doctor-on-board
• naiv 10y ago
  In 2015, I was on flight EY23 that was first stranded on the the tarmac in Abu Dhabi because of fog for 13 hours and then diverted to Vienna because a passenger had a heart attack inflight. So a short 7 hour flight turned into 30 hours of horror. (http://www.thenational.ae/uae/elderly-passenger-dies-on-board-delayed-etihad-flight http://www.thenational.ae/uae/elderly-passenger-dies-on-boar...) It seems that some airlines have a very strict protocol. There were at least 4 doctors on board but they were not allowed to help the crew with CPR or help much more than with checking the blood pressure. Interesting enough, the crew was always connected to a company that has emergency-medicine specialists on the ground, so the crew became their remote hands.
• _pferreir_ 10y ago
  I've been through a similar experience that unfortunately ended up quite badly. Here's my account, I hope it helps the discussion. I was on a 2 hour flight, we had left maybe 15 minutes before when the passenger sitting right in front of me started feeling unwell. He was travelling alone, so the passenger sitting next to him notified the flight attendant. The flight attendant asked whether he had a history of diabetes, but he was in such pain that he could barely articulate a word. He would only say "it hurts". Believing it was an episode of hypoglycemic shock (not sure based on what, but well, IANAD), the flight attendant brought him a glass of soda and, maybe five minutes later, seeing no improvement, shouted the usual "is there a doctor on board?" question. There was indeed a doctor on board (two, actually), who immediately proceeded to examine the person (he even had a stethoscope). He asked for the emergency kit as well, which proved to be quite minimal. As the flight attendant debriefed the doctor (who at this point, still believing the thesis of hypoglycemic shock, tried to measure the heart rate in parallel), the patient collapsed. It was then clear to everyone that he was experiencing cardiac arrest. The doctor quickly put together, with his other colleague, a small group of people that manage to lay the person down on the aisle floor. In the meantime, the pilot was informed of the situation and diverted the plane to the closest airport en route. By then, at least 20 minutes had passed since the start of episode. CPR was at first successful, but the patient lost his senses again after a few minutes. A second attempt at CPR proved unsuccessful. We landed maybe 30 minutes after the pilot got to know about it. The ground medical team hopelessly tried reanimation with a defibrillator (there was none on board, BTW), nothing. It was pretty sad, especially because I have the feeling that if that person had been on the ground he would have almost for sure survived (IANAD, once again, so, it's just a feeling). Anyway, things that went awfully wrong and are a danger to airline passengers: * As I've said before the first aid kit was pretty basic and, according to the doctors, lacked some essential material; * Most commercial planes aren't equipped with a defibrillator. They're not mandatory, at least not in Europe. * Airline crews know nothing about first-aid. They're just not prepared. They cannot recognize the simplest symptoms of a heart-attack. * They clearly didn't know what the first aid kit had or hadn't. They couldn't name the contents. To be fair, the crew was french-speaking while the doctor was not, so maybe they just didn't know the names of things in English. Still, crews on international flights are supposed to have a good level of English. * Most flight attendants behave like robots in stressful situations. They have such a respect for protocol and rules that they will be reluctant to break them even if that means saving a life. For instance, as the doctors were applying the last round of CPR, they considered improvising a tracheotomy using a pen (desperate measure, but who knows whether it would have worked?) By then the plane had started descending and was maybe 10 minutes away from landing. As the doctors asked for a pen, the crew remained still in their seats. Bottom line: if I ever have a heart attack (which I hope I won't), I'd better not be on a plane.
• consto 10y ago
  After reading the article I am very angry at that flight attendant.
• dankohn1 10y ago
  I'm writing this 2 hours into a 14.5 hour flight from Shanghai to New York [0], and I'd just like to thank all physicians everywhere who have answered the ding. [0] https://flightaware.com/live/flight/UAL87 https://flightaware.com/live/flight/UAL87
  • twosheep 10y ago
    I'm not sure EWR counts as New York ;-)
• plg 10y ago
  what do they do (with the body) if someone dies on a long haul flight and it's still many many hours to land
  • nobody_nowhere 10y ago
    They keep going.
  • tacostakohashi 10y ago
    https://www.theguardian.com/business/2004/may/11/theairlineindustry.travelnews https://www.theguardian.com/business/2004/may/11/theairlinei...
  • dredmorbius 10y ago
    Triage. If you can improve the situation by landing, and not endanger others, you land. Dead bodies aren't recoverable. Keep going where you were going, unless you've got other reasons not to.
• hetfeld 10y ago
  Oh, yeah. Delta again...
• Waterluvian 10y ago
  I really hope to see a follow-up story of the FAA giving Delta a serious scolding.
• Drdrdrq 10y ago
  Of course OP will not be able to get his emergency kit through security check... :(
  • nommm-nommm 10y ago
    The author of this article is a woman.
• imroot 10y ago
  My friend (who is an ER Doctor) had a medical emergency (man had a stroke) on her flight from Pittsburg to Miami when she came to visit my family a few months ago. She actually told me afterwards that she thought that the bag was extremely well stocked and that she had the ability to perform whatever she needed. They used the Airphone to validate her medical license, gave her the med bag, and told her that if she needed anything to drink, to just call. I've had similar experiences on US Airways (Pre-American); I'm a paramedic and someone had an MI -- they airphoned me to a doctor on the ground and he and I diagnosed the patient together, and he gave me orders to push drugs. On my friend's flight, the Flight Attendant gave her many many small bottles of bourbon to say "Thank you" and American Airlines gave her 25,000 bonus miles as a "thanks," and they upgraded me to first class for my trip home as a way to say thanks for me.
• MistahKoala 10y ago
  Watching the side discussion(s) going on between clinicians, it's surprising to see how much disagreement/debate there is about equipment and procedures for dealing with medical emergencies on flights. I don't know why, but I took for granted that it would be a bit less controversial.
  • feminem 10y ago
    That's why we published the article. To help push consistency on flights, not to flame this particular airline. All experiences are variable.
• tajen 10y ago
  Is that "feminem.org" the kind of websites where men can't write because of their sex? Haven't we agreed that was a stupid form of discrmination that belonged to the past? Why did I have in the head five years ago when I retweeted the #HeForShe campaign? PS: Oh I forgot, this is Paul Graham's land, who himself organizes discrimination at a whole conference level: http://www.femalefoundersconference.org http://www.femalefoundersconference.org
  • feminem 10y ago
    Actually men contribute to FemInEM too! Isn't that awesome! https://feminem.org/2016/06/27/kangaroo-doc-became-fan-feminem/ https://feminem.org/2016/06/27/kangaroo-doc-became-fan-femin...
    • tajen 10y ago
      Great article, plus it's spot-on on what I wanted to demonstrate. From your article: > It’s not uncommon to see males in rural medicine raking in dollars by performing the lucrative procedural work…with their ability to provide such a service entirely dependent on female colleagues keeping the practice afloat by trudging through the toil of family medicine. I see the website isn't exempt from reinforcing prejudices against males and generalizations. Isn't trying to determine which gender is better, just, plainly, an outdated practice? Women have complained that society doesn't give them enough self-confidence, which hurts their choice for STEM. As a male, I feel hurt everytime a feminist article assigns specific qualities to women and defects to males. You see, I've personally lacked self-confidence in my career, which means I didn't succeed to reach the job I wanted in the economy. Now I often ask "Tell me 10 qualities of women" then "Tell me 10 qualities of males". I reliably get, whether the interviewee is a male or female, 10 qualities of women being smarter and only 1 for males: Strength. That is, we're depicted as testosterone with little brains. How can we, males, progress in companies if people see women as inherently more clever?
• owenversteeg 10y ago
  I'm curious what the worst profession to hear when they ask "is there an x on board" is. Sure, "is there a doctor on board" is scary but usually ends fine. "Is there a herpetologist on board" could get interesting, a la Snakes on a Plane. "Is there an electrical engineer on board" would be scary, and "is there a computer scientist on board" would be downright terrifying. Maybe "is there an infectious disease specialist"?
  • giarc 10y ago
    Long story, but I work in infection prevention (like infectious disease, but I'm not a doctor). I was on the receiving end of care once. I was flying back home and had an large episode of vomiting in the rear bathroom. I'm pretty tall and the vomiting came on quickly so it ended up everywhere (I couldn't bend down enough to hit the toilet). It took me quite a while to clean up. I came out of the bathroom and told the flight attendants that they should close the bathroom to prevent other people from getting what I thought I had (I named off a bunch of likely viral candidates). This kind of freaked them out. They closed the bathroom and I returned to my seat. After 5 minutes the FA came back and said the pilot wanted this medical form filled out (demographics, symptoms etc). The FA left and another 10 minutes passed. They came back and said that ground medical operations wanted to ask some questions. The FA asked the questions and responded back to ground operations. After that, they decided they wanted EMS to come and meet the plane when we landed. The FAs announced this to the passengers and asked everyone to remained seated. Two EMS staff came on board and asked me what was going on. I told them and they asked if I wanted to go to the hospital to which I responded absolutely not. The whole ordeal was quite embarrassing. Needless to say, if you are an expert, don't use technical words, just say "I puked in there, you should close it."
  • rsync 10y ago
    "Is there a pilot on board ?"
    • neurotech1 10y ago
      That actually happened fairly recently with a United Airlines 737: http://www.af.mil/News/ArticleDisplay/tabid/223/Article/485155/af-pilot-helps-in-airline-emergency.aspx http://www.af.mil/News/ArticleDisplay/tabid/223/Article/4851...
• omegant 10y ago
  I think I´m able to give some perspective and tips here. I'm commercial pilot flying long haul and I´ve had some medical incidents during my flights, including a recent suicidal lady cutting her wrists while arriving to JFK airport in NY, or a possible heart attack while in the middle of the Sahara. Also my wife is a doctor who had to help in 3 flights already. If you are a physician: -The cabin crew MUST help you in all the things you require, that is: ·Providing food, liquids, blankets (for free of course). ·Providing the mandatory medical kit (that can only be opened by qualified persons never by the crew on their own). ·move the passenger wherever you find appropriate (galley, the aisle, laying in several seats, etc...). ·Don't accept any excuse regarding the medical kit, some pursers are willing to avoid the paperwork involved after opening it (this happened to my wife in an Easy Jet flight, unfortunately I was in another row taking care of the kids and didn't know about it till the end of the flight). It must be fully stocked when opened (usually they are closed with a lock), if it's not the company was breaking the regulations. The medical kit is a no go item (it must be present and in perfect conditions for a flight to begin). ·Request the cabin crew to keep other passengers away. People loves a good show, and is able of disgusting behaviour (like taking photos of a semi-nude patient to "share", looking over the doctor's shoulder, etc..) ·Most cabin crew are super professional and will help to the best of their capabilities, but you can always find an idiot. Don't let them intimidate you. -The pilots are waiting for the instructions of the experts. From the first moment we know there is a medical emergency, we are planing for a diversion to the nearest airport, usually we'll listen to their opinion regarding the need of an immediate hospitalization of the passenger. Although the captain has the last word, no pilot I know is willing to risk avoiding the recommendations of a doctor and face police charges for letting a passenger die for not following instructions. -What I mean is if it's clear to you that it's a heart attack for example, and the patient needs an hospital, tell the pilot ASAP. We are flying at 8 Nautical Miles per minute, and 10-20 minutes flying away from an airport can mean up to an hour more than necessary till you are in the ground. We take the decision based on the instruction of the doctors and nurses onboard. -That said, be careful to ask what city is the captain willing to land at, and what kind of medical facilities it has. If you are flying over the sea or desert, just expect up to 3-4 hours till able to land in a city with a good enough Hospital. I had a discussion with a captain cause he wanted to land in Tamanrasset, a small city in the middle of the Algerian Sahara. We had a passenger with a possible heart attack, and he wanted to land there. I told him that we needed 45 minutes to land, and then wait at 3am till we were able to disembark, an ambulance to arrive and the patient be carried to the local Hospital, that as you may imagine is less than stellar. The purser just confirmed my suspicions, as he just had the exact same case. The patient took more than 3 hours to arrive to the Tamanrasset hospital, and there was nothing there to treat him of his heart attack. So a private flight was called from Italy to evacuate him. It was much simpler and safe to wait till Malaga in Spain, just 2 and a half hours of flight away with a medialized ambulance waiting for you at the parking. -The FAA list of mandatory medical kit onboard http://www.faa.gov/documentLibrary/media/Advisory_Circular/AC121-33B.pdf http://www.faa.gov/documentLibrary/media/Advisory_Circular/A... -You also can find that the passenger has no need of immediate hospitalization, but needs medical help once landed. The crew is able to call emergency teams to be ready once the doors open (EMTs and police) -Some companies have a remote medical service available by radio or satellite phone, they are there to help with the diagnosis and treatment if necessary. But they are not infallible and they could recommend you to land in an airport that has a unsuitable Hospital(it has happened). Right now I'm not aware of any international list with the medical facilities available close to big airports. -Just a recommendation, IANAL but if unfortunately a passenger dies in flight, I would not declare the decease (we are talking strictly medical causes, no aggressions, killings, etc..), keep trying to reanimate, let the EMT take care of the patient once you've landed and they come onboard. Depending the country a declared decease onboard means a judicial investigation, police reports, etc... that will surely take all day once you land (or more). -Most usual medical emergencies onboard are faints, suffered by people with previous medical conditions. Also people drink too much or take some kind of drugs to endure the fear of flying. Also some kind of digestive problems and heart attacks happen but are less common than faints (based on my personal and friends anecdote)
• nommm-nommm 10y ago
  Doctors are great. Always going above and beyond the call of duty. When I was side swiped by an SUV in front of a shopping plaza a doctor was eating dinner in the red lobster inside the plaza. Upon hearing the sound of a car crash she left her dinner and ran to the scene to render aid if needed. Thankfully there were no injuries.
• ddalex 10y ago
  Experience varies - I got very sick on a short haul flight with a low-cost airline in Europe. There was no doctor on board, but the emergency services at the airport came to help as soon as we landed. They determined I can't be moved from the airplane, and that I needed an ambulance to take me to the hospital; and nobody in the crew had any problem waiting for over 2 hours for the ambulance to arrive, even turning on the airplane engines to keep the heat up for me, burning heaven knows how much fuel, and serving the airport emergency staff with water and snacks. Totally unexpected for a budget airline, but highly appreciated. Kudos on this one, Wizz !
• tooFastFuckYou 10y ago
  Another idiotic site that DISABLES ZOOMING on mobile browsers. WTF is with these morons?