Top 10 in-flight medical emergencies

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Top 10 in-flight medical emergencies
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Important

• Do no harm
• 70 incidents managed by crew
• Practice within limits of training and knowledge

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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

4
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

5
Life threatening collapse

• Crew trained in basic CPR
• Many carry defibrillators
• Crew will be trained in use
• Doctors role IV access giving drugs

6
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

7
Head injuries

• Items falling from overhead luggage compartment
• Little a Dr can do except perahps advice re need
  to divert

8
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

9
Abdominal problems

• D V common
• Doctors role is providing diagnosis
• Advsing on need to divert

10
Diabetes

• Hypoglycaemic episodes frequent
• Glucose injections usually available

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Allergic reactions

• Anaphylaxis occurs rarely
• Adrenailine and antihistamine sometimed
  injectable steroid carried
• Passengers with known allergies may have own
  epipen

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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

13
Miscarriage

• Occur occasionally
• Examination facilities limited
• Monitor general condition is only real possibilty

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Diverting Aircraft

• Cardiac problems 28
• Neurological problems 20
• Food poisoning 20

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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

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Liability

• US Aviation medical assistance act 1998
• Protects Drs that act in good Samaritan
  situations
• Gives legal protection for airlines

17
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