Abstract
Easier access, organised holidays targeting differing age groups, an ageing population and lower fares have resulted in a varied air-travelling population of all ages. Medical issues surrounding air travel such as thromboembolic events and the so called ‘economy class syndrome’, as well as dramatic medical intervention at 36,000ft do make for equally dramatic headlines in the popular press. As passengers are more aware of the medical vulnerability of air travel, airlines too are conscious of the medical support they can offer to their passengers. The British Medical Association (BMA) has recently raised concerns over training of flight staff and equipment carried during flights. Issues under debate include whether it is correct for airlines to rely on ‘Samaritan’ doctors or nurses that happen to be on board, or whether qualified medical staff should be part of the aircrew.
Our study reports the analysis of medical emergencies occurring on a major international airline over a period of six months. We looked at the nature of the medical complaint, the treatment received and who gave this treatment. This airline ensures cabin crew receive 30 hours of training in first aid and basic life support during their introductory training period that is followed by annual updates. Senior aircrew, usually the purser are trained in the use of an automated defibrillator. The aircraft carries a first aid kit that all cabin crew are trained to use. In addition there is a medical kit that can be used by any doctor, nurse or paramedic who may respond to an assistance call. In addition in-flight advice is available from Medlink, an independent company that will give direct advice including medical diversion and arrange support for patients on landing
Exacerbation of pre-existing medical problems accounted for the majority of in-flight emergencies. Pre-flight advice, screening and an increased vigilance by ground staff may recognise passengers who are medically unfit to fly.
Syncope accounts for 91% of new in-flight emergencies and appear related to a prolonged period of sitting. In-flight advice as part of Deep Venous Thrombosis (DVT) prevention is given on many long haul flights. This advice should also emphasise the importance of an exercise regime prior to getting up from the sitting position to reduce the number of syncopal episodes.
With adequate cabin crew training, in flight telephone support from commercial companies and careful selection of drugs, the need for ‘Samaritan’ medical help can be greatly reduced.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
