Emergency physicians should consider altitude physiology, aircraft operation, and medical equipment on board the plane

“Even for experienced emergency physicians, there are additional considerations when responding to a medical emergency during a flight,” says Christian Martin-Gill, MD, MPH, assistant professor of emergency medicine at the University of Pittsburgh School of Medicine in Pittsburgh, Pa. Those include issues about altitude physiology, issues regarding operation of the aircraft (such as when and how flights can be diverted), and types and capabilities of medical equipment on board. Flight crews are trained to deal with emergencies. For example, according to American Airlines spokesperson Matt Miller, all flight attendants are CPR-trained, and the airline was the first to provide AEDs on its aircraft. (American Airlines installed AEDs in 1997, before the FAA requirement in 2004.) As do other commercial airlines, American Airlines crews also have access to 24-7 ground-based expert consultants to guide them—and any volunteer health-care providers on board—through a medical emergency.

When the *&^% hits the turbofans, EPs need to know what they are likely getting into and what resources are available.

The study data published by Dr. Martin-Gill and his emergency medicine colleagues at the University of Pittsburgh ground-based medical communications center revealed the most common types of medical emergencies and also furnished recommendations for traveling physicians or other health care providers who might be called to respond to in-flight medical emergencies.¹

Dr. Martin-Gill emphasizes that familiarity with required on-board medical equipment can increase providers’ level of comfort if asked to volunteer.

For a list of the medical equipment and items included in the emergency medical kits, go to http://rgl.faa.gov/Regulatory_and_Guidance_Library/rgAdvisoryCircular.nsf/list/AC%20121-33B/$FILE/AC121-33B.pdf.