Fly long enough and eventually you will hear the flight attendant over the plane PA system announce mid-flight, “if there is a doctor on board please press your call light.” [if you don’t believe me, just ask OB Doctor Mom].
As an eager pre-medical student a few (ok, many) years ago, I thought this would be the highlight of my career. I imagined I would jump into action as a cool & confident lifesaver that would use my mad MacGyver medical skills to save a life (or lives) midflight before informing the captain that there was no need to make an emergency diversion as I fully solved the life-threatening issue.
The reality–as all trained medical professionals are aware–is far less glamorous. I have only been called upon once during a flight (Toronto to Copenhagen). This 2-beers-deep subspecialty surgeon happily deferred to the three internists, nephrologist, and one critical care doc who also responded to manage the case of “back pain and anxiety” that was plaguing the forty-year-old gentleman in 38F. Given that my best medical use during an inflight emergency would be to quickly obtain a surgical airway it is highly unlikely that I will ever be the jack-of-all-trades, life-saving MacGyver physician that my younger self imagined I would be.
Nonetheless, I like to be aware of the tools available and keep up on the possible conditions which may require treatment on a typical commercial flight. A review of medical issues during flights found that there was 1 medical emergency in every 604 flights. Syncope, respiratory issues, and nausea/vomiting are the most common complaints. Of these issues, 7.3% result in aircraft diversion. An unfortunate 0.3% of passenger issues result in death. A physician is present to respond approximately 50% of the time.
The FAA requires all commercial carriers to maintain a medical kit as well as an AED onboard. Here are the contents:
Noticeably lacking from this kit is any ability to obtain a definitive airway (no endotracheal tube or laryngoscope). There is also no suction machine, anti-emetic , hemostat, or scalpel (for obvious reasons, I suppose). Even before I discovered this medical kit list I always travelled with a headlight, hemostat, and endotracheal tube. Given the lack of these on flights I will continue to do so (of course, if I ever have to use these then it would mean the patient is critically ill and my efforts may very likely be in vain if suction, O2, and definitive care are not soon available). I am considering adding an epi-pen (easier to dose than vial epi) and Zofran (noticeably lacking from onboard kit given the frequency of vomiting) to my kit as well.
Other articles go into the details, but as medical professionals acting in good faith, we are usually protected by Good Samaritan laws. I am also a firm believer of trying to stay up on the basics of medical care in case your services are ever needed regardless of your specialty. I would also recommend travelling with some form of identification with your credentials (be it a copy of your medical license or hospital ID) as this may be required to access the medical kit.
Here’s to uneventful and boring flights!
[Disclaimer: this article is opinion only and is not intended to provide medical advice to diagnose or treat any medical condition]