I recently responded to three (yes, three) in flight medical emergencies with a fellow passenger who is a family physician…we basically worked a night shift on the red eye to the UK. While I have responded to in-flight medical emergencies before, this was certainly the most amount of times in one flight, and it was the most organised response I have witnessed from an airline.

The Air Canada cabin crew were extremely professional and helpful, and provided me and my colleague with indemnity cover letters and a thank you before we even landed. This shows an appreciation for those who step up to provide volunteer medical cover on flights – I have often volunteered, and was lucky to be told “Thanks”, never mind receive some form of appreciation.

While the initial call may have been for “If there is a doctor on board please make yourself known”, paramedics are ideally placed to respond to in-flight medical emergencies. Used to responding to calls without the vaguest idea of what may be happening? Check! Used to working in tight spaces with poor lighting? Check! Able to think through clinical options based on limited data and basic observations? Check!

Common in flight emergencies include chest pain, syncope, asthma exacerbations, and GI complaints. There is also the concept of “economy class syndrome,” a sort of midair version of Virchow’s triad: dehydration, immobilization, and predisposing factors increasing the risk of deep vein thrombosis.

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Be prepared for in-flight medical emergencies

As a useful aside, the following equipment is generally kept on board most aircraft and may assist you with decision making and treatment choices. Note that US commercial aircraft are required under regulations to also carry a defibrillator. There are no international regulations.

  • Sphygmomanometer
  • Stethoscope
  • Glucometer (may only have a handful of test strips)
  • Pulse oximeter
  • Pocket mask
  • Penlight
  • Gloves
  • Oral airways
  • IV supplies (catheters, TQ, tape etc.)
  • Medication kit (containing medications such as Gravol, Epi-Pen, Atropine, Haldol, Ativan, IV fluids (NaCl & dextrose), ASA, GTN, Albuterol/Salbutamol MDI,  Furosemide, Epi 1:10,000)


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