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Care in the air: physicians’ roles in in-flight medical emergencies

Monday 05 Sep 2016 {{NI.ViewCount}} Views {{NI.ViewCount}} Views

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Physicians fly frequently for business and pleasure, and it is not rare to encounter a sudden intercom call for assistance with an in-flight emergency (IFE). Indeed, a CNN report in 2015 quoted the frequency to be one in every 604 flights. When you hear the announcement, do you slump down in your seat and pretend to be engrossed in reading the airline magazine? Or do you feign sleep? Flying for many is “down time” or an opportunity to catch up on work, and they don’t want to be bothered practicing medicine when they don’t have to. Others worry about leaving their comfort zone and caring for patients whose problems are not in their usual scope of practice. Finally, many are concerned regarding liability issues.

As we all prepare to fly to Japan for the ICS Annual Meeting, we should be aware of a recent spate of articles dealing with this topic as well as the ethics of volunteering while in flight. There is too much to cover in this brief article, but a few key points will be reviewed. The references below provide more extensive information for those who wish to explore the subject in more depth.

  • Although there is no legal mandate for physicians to respond to an IFE, many believe that there is an ethical obligation to do so.
  • In addition to emergency medical kits aboard most airplanes, many carry AEDs as well. These can be useful not only for treating arrhythmias or cardiac arrest, but they are also useful for monitoring patients during a flight.
  • Helping a passenger does create a doctor-patient relationship with attendant responsibilities. The laws governing this relationship are derived from the country of the airlines’ origin.
  • And finally – avoid being the sick passenger! Don’t get on a plane if you are not well or recently had surgery. Use good judgment.

Safe travels to all!

Article by the Publication and Communications Committee

Additional Information

Sick and dying at 30,000 feet

Stone MB, Lubarsky DA, Agarwal GG. Lessons learned during an in-flight medical emergency: Case report and discussion. J Travel Med 2014:21:130-132

Nable JV, Tupe CL, Gehle BD, Brady WJ. In-flight Medical Emergencies during commercial travel. NEJM 201;373:939-945.

World Medical Association Resolution on Medical Assistance in Air Travel, 2006

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