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I responded to a few in-flight emergencies on international flights. Each airline has its own idea of what should be in the emergency kit, and there really no s

by paviva 10y ago

I responded to a few in-flight emergencies on international flights. Each airline has its own idea of what should be in the emergency kit, and there really no standards/regulations that I am aware of. Aspirin is easy to ask for from other passengers. Same with Nitro : either the patient IS known for angina, and usually has his own, or he's not, and I would not suggest giving nitro "just in case" with the disastrous side effects it can have. Airways are mostly useless.

tgokh 10y ago
Are you in the US? The FAA has a strict set of minimum medical equipment for each flight with a flight attendant. [1][2]. European regulations require a lot more but don't actually apply to most flights in Europe as they only require an EMK for flights going more than 60 minutes from any airport. Even then, it seems like many European airlines carry a lot more than their American counterparts, though less than the ICAO recomendations [3] [1] https://www.law.cornell.edu/cfr/text/14/part-121/appendix-A https://www.law.cornell.edu/cfr/text/14/part-121/appendix-A [2] http://www.faa.gov/documentLibrary/media/Advisory_Circular/AC121-33B.pdf http://www.faa.gov/documentLibrary/media/Advisory_Circular/A... [3] http://www.sciencedirect.com/science/article/pii/S1477893910001705 http://www.sciencedirect.com/science/article/pii/S1477893910...
- paviva 10y ago
  I'm in Canada. That being said, I've review your first link, and I'm not impressed. * Sphygmonanometer = useless. You can't hear fuck. Just taking the pulse is accurate enough in life or death circumstances. * Stethoscope = almost useless. You can't hear fuck. Might want to use to confirm a suspicion of pneumothorax. * Airways, oropharyngeal. Most people don't know how to use those. Might be useful, though * CPR mask. If he's coding in the plane, he's dead. * Saline solution, 500 cc. As good as two glasses of (holy) water by mouth. * Protective nonpermeable gloves or equivalent. Good ! Should have at least four of those. * Analgesic, non-narcotic, tablets, 325 mg = Tylenol. Who cares * Antihistamine injectable, 50 mg. Why ??? Not more potent than any cheap oral antihistamine. * Bronchodilator. Good * Epi. Good. But they should not have two different concentrations to confuse people. * Lidocaine. Have no idea why anyone would want that.
  - inferiorhuman 10y ago
    > Sphygmonanometer = useless. You can't hear fuck. Just taking the pulse is accurate enough in life or death circumstances. Seems like a digital blood one would be fine? > Antihistamine injectable, 50 mg. Why ??? Not more potent than any cheap oral antihistamine. No more potent, but faster acting, no? Seems like a good idea for anaphylactic shock?
    - JshWright 10y ago
      Antihistamines will not reverse anaphylaxis. If the patient has progressed to anaphylactic shock, they need epinephrine (and you might as well give them the half liter of fluid in the kit as well).
    - paviva 10y ago
      > but faster acting, no? Not really. Even regular tablets begin to act in 20 min, even faster with the sublingual ones. > Seems like a good idea for anaphylactic shock? A very bad one, actually. Some people might want to give an antihistamine first (completely useless in anaphylaxis, by the way), and see what happens, instead of going straight to epi. When you cannot know the provider's experience, its better to assume for the worse, and give one, and one only choice = EPI.
    - nathannecro 10y ago
      I don't quite trust a digital BP cuff. Airplanes aren't really loud at all. I've done vitals in the middle of louder crowds or in the back of a rig. Anaphylaxis is only treatable with epi and fluids.
  - JshWright 10y ago
    > Sphygmonanometer = useless. You can't hear fuck. A systolic pressure is still a useful datapoint. If you want to get a diastolic pressure, see if you can't track down a paramedic (a modern widebody jet isn't much louder than the back of a rig). > Stethoscope = almost useless. You can't hear fuck. See above... > Airways, oropharyngeal. Most people don't know how to use those. Might be useful, though Most people don't know how to use any of this stuff... That's why they page for a doctor... > Saline solution, 500 cc. As good as two glasses of (holy) water by mouth. That's enough to make a difference for a preload sensitive heart failure pt. > Analgesic, non-narcotic, tablets, 325 mg = Tylenol. Who cares Someone in pain? > Lidocaine. Have no idea why anyone would want that. As an antiarrhythmic, I'm sure. A "hail mary pass" at best, but worth a shot, I guess.

by paviva 10y ago

tgokh 10y ago

Are you in the US? The FAA has a strict set of minimum medical equipment for each flight with a flight attendant. [1][2]. European regulations require a lot more but don't actually apply to most flights in Europe as they only require an EMK for flights going more than 60 minutes from any airport. Even then, it seems like many European airlines carry a lot more than their American counterparts, though less than the ICAO recomendations [3] [1] https://www.law.cornell.edu/cfr/text/14/part-121/appendix-A https://www.law.cornell.edu/cfr/text/14/part-121/appendix-A [2] http://www.faa.gov/documentLibrary/media/Advisory_Circular/AC121-33B.pdf http://www.faa.gov/documentLibrary/media/Advisory_Circular/A... [3] http://www.sciencedirect.com/science/article/pii/S1477893910001705 http://www.sciencedirect.com/science/article/pii/S1477893910...

paviva 10y ago
I'm in Canada. That being said, I've review your first link, and I'm not impressed. * Sphygmonanometer = useless. You can't hear fuck. Just taking the pulse is accurate enough in life or death circumstances. * Stethoscope = almost useless. You can't hear fuck. Might want to use to confirm a suspicion of pneumothorax. * Airways, oropharyngeal. Most people don't know how to use those. Might be useful, though * CPR mask. If he's coding in the plane, he's dead. * Saline solution, 500 cc. As good as two glasses of (holy) water by mouth. * Protective nonpermeable gloves or equivalent. Good ! Should have at least four of those. * Analgesic, non-narcotic, tablets, 325 mg = Tylenol. Who cares * Antihistamine injectable, 50 mg. Why ??? Not more potent than any cheap oral antihistamine. * Bronchodilator. Good * Epi. Good. But they should not have two different concentrations to confuse people. * Lidocaine. Have no idea why anyone would want that.
- inferiorhuman 10y ago
  > Sphygmonanometer = useless. You can't hear fuck. Just taking the pulse is accurate enough in life or death circumstances. Seems like a digital blood one would be fine? > Antihistamine injectable, 50 mg. Why ??? Not more potent than any cheap oral antihistamine. No more potent, but faster acting, no? Seems like a good idea for anaphylactic shock?
  - JshWright 10y ago
    Antihistamines will not reverse anaphylaxis. If the patient has progressed to anaphylactic shock, they need epinephrine (and you might as well give them the half liter of fluid in the kit as well).
  - paviva 10y ago
    > but faster acting, no? Not really. Even regular tablets begin to act in 20 min, even faster with the sublingual ones. > Seems like a good idea for anaphylactic shock? A very bad one, actually. Some people might want to give an antihistamine first (completely useless in anaphylaxis, by the way), and see what happens, instead of going straight to epi. When you cannot know the provider's experience, its better to assume for the worse, and give one, and one only choice = EPI.
  - nathannecro 10y ago
    I don't quite trust a digital BP cuff. Airplanes aren't really loud at all. I've done vitals in the middle of louder crowds or in the back of a rig. Anaphylaxis is only treatable with epi and fluids.
- JshWright 10y ago
  > Sphygmonanometer = useless. You can't hear fuck. A systolic pressure is still a useful datapoint. If you want to get a diastolic pressure, see if you can't track down a paramedic (a modern widebody jet isn't much louder than the back of a rig). > Stethoscope = almost useless. You can't hear fuck. See above... > Airways, oropharyngeal. Most people don't know how to use those. Might be useful, though Most people don't know how to use any of this stuff... That's why they page for a doctor... > Saline solution, 500 cc. As good as two glasses of (holy) water by mouth. That's enough to make a difference for a preload sensitive heart failure pt. > Analgesic, non-narcotic, tablets, 325 mg = Tylenol. Who cares Someone in pain? > Lidocaine. Have no idea why anyone would want that. As an antiarrhythmic, I'm sure. A "hail mary pass" at best, but worth a shot, I guess.