As more people travel and as the population ages, the number of people who experience some type of medical emergency aboard an airplane is likely to increase.
The good news is that most airlines no longer simply hope that a doctor or nurse will be on board to help out. Flight crews on most major airlines now have direct links to some form of ground-based medical assistance.
Some airline companies have doctors available on the ground who are board-certified in emergency medicine and with training in aviation medicine, who are available 24 hours a day for a consultation.
When contacted, the ground-based physician advises the flight crew, and any medically qualified passenger who volunteers to assist, on treatment.
And people do often volunteer to help, suggests a study conducted in 2000. In nearly 70% of cases in which someone fell ill on a US-registered aircraft, a healthcare professional -- such as a doctor, nurse or paramedic -- stepped forward to lend a hand.
Most often, the care people received tended to be appropriate. In 79% of cases, the diagnosis matched that given at a hospital later on and the passenger improved in 60% of cases.
Experts estimate that in the US there are 13 to 33 in-flight medical problems per day, while worldwide, as many as 350 in-flight medical problems occur each day, the report indicates.
Overall, most medical problems that occur on airplanes are not serious, with the bulk of events attributed to fainting, dizziness and hyperventilation.
Still, many passengers may be unaware of the health implications of air travel, the researchers point out. For instance, oxygen availability tends to drop in flight, although the drop is not noticeable for healthy individuals. However, those with heart or lung problems may be at risk for low-blood oxygen.
Just last week, the British Thoracic Society recommended that patients with severe asthma, chronic obstructive pulmonary disease (which includes emphysema and chronic bronchitis), cystic fibrosis and other lung ailments get a medical assessment before flying.
The drop in cabin pressure can cause gas in the body to expand. While this may cause only minor cramping in healthy people, it can be hazardous to those who have recently had surgery or who have pneumatic splints, feeding tubes, urinary catheters or other medical equipment.
Airlines are required to have an emergency medical kit on board, and the contents are becoming increasingly sophisticated. By 2004, the Federal Aviation Administration will require the kits to include bronchodilator inhalers (to treat breathing difficulty), oral antihistamines (to treat allergic reactions), non-narcotic painkillers, and automated external defibrillators (to treat cardiac arrest).
In serious cases, airplanes can make emergency landings. This happens in about 13% of cases in which a medical problem develops on board.
The New England Journal of Medicine April 4, 2002;346:1067-1073
For those of you who fly regularly this will certainly provide a measure of relief.
However, if you are following the eating plan the likelihood is certainly significantly reduced that you will require this type of assistance.
About four years ago I was half through my flight back from Seattle where I attended the Jonathan Wright Nutrition Conference and the attendant inquired over the intercom if there were any doctors on the plane as one of the passengers was very sick.
I went back in the plane to evaluate the problem. The most important aspect of medical treatment is the evaluation and getting a good history, especially in emergency settings.
I was quickly able to determine that this man, who was very pale, not breathing comfortably and talking very weakly was in his 60's, and has a history of a heart attack and previous bypass surgery and was on heart failure medications and two high blood pressure medications one which his doctor just started him on.
So the first thing I had the flight attendants do was to break out the emergency kit which was a major joke. It did have a toy stethescope and a $10 blood pressure meter and cuff though. Fortunately these two pieces of equipment were enough to save this man's life.
I listened to this man's heart, which was faint, but beating normally. I then took his blood pressure and it was 30/0.
It was clear that he was having a hypotensive not hypertensive crisis. He was not getting enough blood and oxygen to his brain. The new blood pressure drugs his doctor put him on worked very well, so well they he stopped getting enough blood to his brain.
The flight and pressure changes probably worsened this problem. So I immediately evacuated his row and had the flight attendants gather up about a dozen or more blankets and I laid him down flat with his back. I put the blankets so they elevated his rear and his head was lower than his heart so the blood could drain back into his brain.
Fortunately the strategy worked quite nicely and he pinked right up and felt much better.
I didn't have to have the plane make an emergency landing to help him through this problem.
Although there is no way to know, it is highly likely this man would have not survived had someone not recognized the problem and taken aggressive action.
If he had remained in the seated position for much longer he most surely would have passed out, but he may have had some type of serious cardiac or brain related injury if his pressure was that low for much longer.
This is the only time I have ever had the opportunity to play a role in an emergency situation outside of the hospital. I find it most interesting that this story illustrates the number four cause of death in this country.
It is given the euphemism ADR or adverse drug reactions. But all this means is that drugs prescribed by doctors are the number four cause of death in this country.