Medical Emergencies on Flights: How Airlines Respond Effectively

In-flight medical emergencies, while not common, occur more frequently than many passengers might assume. A recent study covering nearly 78,000 cases from March 2022 to December 2023 found that such incidents arise approximately once every 212 flights. This statistic highlights the importance of understanding how airlines manage these critical situations.

During a recent flight to San Francisco, emergency physician Dr. Scott Kapoor experienced a mid-air medical situation when the crew called for help due to a passenger reporting chest pains. Several physicians, including Kapoor, responded as they were attending a medical conference. Fortunately, the passenger’s symptoms resolved, and the aircraft did not need to divert for additional medical assistance.

According to the study, women accounted for slightly over half of the recorded medical emergencies, with long-haul flights, typically those lasting six hours or more, representing almost half of all cases.

Protocols for Medical Emergencies

Airlines have established clear protocols for handling medical emergencies, as confirmed by Dr. Vincent Poirier, a senior medical advisor to Air Canada and Air Transat. He noted that the most frequent issues include loss of consciousness, gastrointestinal problems, and heart or lung complications. When a passenger appears to be in distress, flight crews initiate basic first aid, which includes performing CPR and utilizing an automatic external defibrillator.

Flight attendants are equipped with first-aid kits containing over-the-counter medications, such as Tylenol and Aspirin, as well as anti-nausea medications and bandaging supplies. If these measures do not suffice, the crew will seek assistance from any medical professionals onboard.

“It doesn’t need to be a doctor,” Poirier stated, emphasizing that nurses and paramedics can also provide valuable assistance.

Engaging Ground Support

When dealing with a medical emergency, airlines often contact ground support services such as MedAire, which specializes in aviation medical support. Dr. Paolo Alves, the global medical director for MedAire, explained that protocols can differ among airlines. Some may immediately reach out to MedAire, while others only do so if no volunteers step forward.

Once contacted, MedAire connects airline personnel with a trained emergency physician who can provide guidance. Advanced medical monitoring devices on some aircraft enable MedAire to receive critical data, including blood pressure and heart rate, through satellite communication.

“Depending on the situation, we might instruct them to access the kit and provide specific medications,” Alves noted. However, flight attendants typically cannot administer injectable medications or those requiring a prescription.

The cramped conditions of an aircraft can complicate medical care. Emergency physician Dr. David Kodama highlighted the challenges associated with treating patients at cruising altitude, stating, “It’s a loud environment, it’s a cramped environment.” Despite these challenges, medical professionals who volunteer can significantly impact patient outcomes, even by simply communicating with ground support.

Regulations and Recommendations

Transport Canada and the Federal Aviation Administration enforce strict regulations regarding in-flight medical kits. Airlines carrying more than 100 passengers must include essential medications such as epinephrine and nitroglycerin to address severe allergic reactions and heart issues. Additionally, Air Canada and Air Transat stock antipsychotic and anti-anxiety medications, along with naloxone kits.

Poirier emphasized the importance of having naloxone available, noting that it is strongly recommended even if not mandated. The emergency kits must also contain tools like blood pressure cuffs and CPR masks with oxygen ports.

Medical professionals who volunteer assistance during in-flight emergencies are generally protected by Good Samaritan laws, reducing the risk of malpractice claims if complications arise. Passengers can take proactive steps to minimize the likelihood of experiencing a medical emergency by consulting with a travel medicine physician before flying.

Furthermore, Poirier advises that individuals carry their medications onboard and maintain a list for reference in emergencies. Staying hydrated and stretching during long flights are also crucial to prevent conditions such as cramps and blood clots.

Understanding how airlines respond to medical emergencies can empower passengers to travel more confidently, knowing that there are effective protocols and resources in place to handle unexpected health issues in the air.