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  • Airworthiness

    Years ago, I used to read mysteries nonstop. One book had this kid with a chronic condition being on a tour with a ranger is a remote area of the Southwest. Sure enough, he had a medical emergency. Can't remember if they called for airlift or bore him out just for the added tension.

    Thinking about that made me wonder about something. When an airliner takes off for one of these long nonstop flights, what happens in medical crises. I've read about asking if a doctor is on the plane. But does any airline extensively train the crew in EMT procedures? I feel confident that people have died during flights, but the industry wouldn't want that to be the probably outcome.

    Is this part of "airworthiness"? Other aspects of the crew's experience and training seem to be, though my impression is that it is the plane that gets airworthiness certification, not the humans. I'd think some airline might get a competitive edge by have a more medically-trained crew. I mean, are the cabin attendants that much more qualified than the waitstaff at a restaurant?

    I hope they stock aspirin since an immediate aspirin has the reputation of being valuable during any sort of cardiac emergency.

  • #2
    Originally posted by EconomyClass View Post
    Years ago, I used to read mysteries nonstop. One book had this kid with a chronic condition being on a tour with a ranger is a remote area of the Southwest. Sure enough, he had a medical emergency. Can't remember if they called for airlift or bore him out just for the added tension.

    Thinking about that made me wonder about something. When an airliner takes off for one of these long nonstop flights, what happens in medical crises. I've read about asking if a doctor is on the plane. But does any airline extensively train the crew in EMT procedures? I feel confident that people have died during flights, but the industry wouldn't want that to be the probably outcome.

    Is this part of "airworthiness"? Other aspects of the crew's experience and training seem to be, though my impression is that it is the plane that gets airworthiness certification, not the humans. I'd think some airline might get a competitive edge by have a more medically-trained crew. I mean, are the cabin attendants that much more qualified than the waitstaff at a restaurant?

    I hope they stock aspirin since an immediate aspirin has the reputation of being valuable during any sort of cardiac emergency.
    They're not going to train the crew in "EMT" procedures. The lowest level of EMT there is (EMT-B) still has 6 months of classroom time and loads of clinical time after that and even then they spend most of their time once they get a job driving the ambulance and cleaning up after it. I could see them (FA's) being trained in first aid maybe. When you're talking in reference to cardiac problems an EMT-B is not going to do you much good. Paramedics are trained to handle cardiac emergencies and to a lesser (much lesser) extent RN's are as well. I happen to be a Paramedic/BSN so I've run through both gauntlets and can tell you that on the whole 95% of RN's are worthless in emergency situations unless someone is telling them what to do. Moving on, a Paramedic on board an aircraft with no equipment (drugs, cardiac monitor, and other stuff I won't get into, etc) is like taking your car to a mechanic who has no tools. He could probably tell what's wrong but he can't do a damn thing to fix it. Its funny, when flights used to get booked through my company, they'd always ask if I'd sit by the emergency doors like somehow I was going to be able to reach over and cure someone with bare hands.

    As far as airworthiness, I believe an AED should be on board each flight as any idiot can operate one, you literally hook it up and step away from it. But as far as meds go, no one who isn't trained in clinical pharmacology should be doling out anything, not even aspirin.
    "TX911, you're a dumbass, its just aspirin for pete's sake!"
    Well, here's the thing about that. If some old timer is on board and starts having chest pains, chances are its not the first time. He/She probably has a history of it. Now, take that same patient with a history of chest pains and coronary disease and add to that the fact that they're probably on some kind of RX already. What if that Rx happens to be Coumadin? People in pain don't usually say "hey wait a minute, I'm on (insert RX here)." They just want something to stop the pain and will likely take anything you give them (though the point of aspirin in a cardiac emergency is not to stop pain but to prevent platelet aggregation). All of a sudden some FA has just given a passenger a drug (aspirin) that can potentiate the effects of an already very potent blood thinner and now you could potentially have a real mess on your hands. Next thing you know, airline is getting sued because the passenger's INR came back ridiculous due to that little ole aspirin that FA gave that little old man to help him. And if you think that the Good Samaritan Law will protect them from that, think again. The GSL addresses reasonable measures. A good lawyer can make breathing oxygen seem like an unreasonable thing to do. See where I'm going with this?

    Ideally you would have degreed, trained, insured med staff on board the aircraft with some basic tools and meds. Vital equipment, Cardiac monitor (we have a cardiac monitor that once we run a patient's 18 lead, we can assess it, start treating, and then bluetooth it directly to the cath lab, that would definitely be useful in flight), O2, ASA, Nitro, D50 or glucagon for the diabetics, IV fluid, etc. But i just don't see that happening.

    Besideswhich, I think its the person's responsibility to know whether or not they're fit to fly for a long distance. If they know they may need an aspirin or their nitro during the flight, it should be their responsibility to bring it with them I think. But that's just me and I'm an asshole about that kind of stuff

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    • #3
      Whew! Didn't realize all them bees were in there. Sorry I stuck my hand in.

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      • #4
        Numerous decades ago FAs were recruited among the nursing community. Those days are gone, as are the days of good-looking flight attendants.

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        • #5
          With our airline the cabin crew are all first aid certificated, and receive some additional airline training on handling emergencies inflight, but certainly no-where near the level of a paramedic. The concept is that they have to be able to handle the common issues, which tend to be minor falls, fainting and constant vomiting. Anything more serious than that is when we would ask if there is a pro on board.

          We also carry an AED, with the cabin manager trained in its use (but as TX has pointed out, they're designed to be used by anyone). Not all airlines carry this.

          We also have quite an impressive medical kit with all manner of things inside it, although they can only be used by a doctor if there happens to be one onboard. I can't pronounce half the things inside it, let alone consider injecting them into someone!

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          • #6
            Originally posted by EconomyClass View Post
            Whew! Didn't realize all them bees were in there. Sorry I stuck my hand in.
            Oh I wasn't trying to be rude. I was just pointing out that there's a whole new kind of shit storm in store for airlines if they actually wanted to implement that sort of thing. Its pretty sad that in this day and age its actually legally better for you to not try to help anyone rather than lend a hand isn't it?

            In any case, i may be over thinking it, but as someone who works in the med field and gets a front row seat to the absolute, utter, disgusting stupidity and shittiness of my fellow man, I would err on the side of caution if I were the airline and just put a disclaimer on my ticket site about "flying at your own risk" which I'm sure they probably do anyway.

            Again, I didn't mean to be rude

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            • #7
              Originally posted by MCM View Post
              We also carry an AED, with the cabin manager trained in its use (but as TX has pointed out, they're designed to be used by anyone). Not all airlines carry this.
              !
              Here's a stupid question for you that's been bugging me: Is there any way that the discharge of an AED could interfere with the aircraft's instruments or otherwise cause a problem?

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