\n<\/p>\n
B<\/span>ritish Airways flight 032, bound for London, was still on the tarmac in Hong Kong when Prof Angus Wallace heard the passenger announcement dreaded by many medics: \u201cIf there is a doctor on board, would they please make themselves known to cabin staff.\u201d<\/p>\n Wallace, then the head of orthopaedic surgery at Queen\u2019s Medical Centre in Nottingham, answered the call, as did Dr Tom Wong, a medical resident at the time.<\/p>\n It was 1995; the pair were asked to provide assistance to 39-year-old Paula Dixon, who had fallen off a motorbike en route to the airport. The problem seemed to be some bruising and a potentially fractured right forearm, which the doctors splinted after takeoff.<\/p>\n But an hour into the flight, Dixon developed chest pain and her condition began to worsen. The doctors diagnosed her with a life-threatening tension pneumothorax \u2013 a collapsed lung caused by air trapped in the chest cavity \u2013 and likely rib fractures.<\/p>\n They couldn\u2019t receive immediate advice from ground staff, so Wallace decided to operate. The aircraft\u2019s medical kit had a urinary catheter and lignocaine, a local anaesthetic, but \u201cthere the routine equipment ended\u201d, Wallace later wrote.<\/p>\n The pair\u2019s midair improvisation has since become legendary in medical circles. They \u201cprepared heated hand towels for sterile drapes\u201d, fashioned a one-way valve from a bottle of water with holes poked in the cap, and used part of a coathanger, sterilised in \u201cfive-star brandy\u201d, to insert tubing into Dixon\u2019s chest, releasing the trapped air.<\/p>\n \u201cWithin five minutes the patient had almost fully recovered,\u201d Wallace wrote in the British Medical Journal. \u201cThe patient was left sitting in her passenger seat and settled down to enjoy her meal and the inflight entertainment.\u201d<\/p>\n In-flight medical emergencies are not common: one occurs about every 604 flights, a US study found \u2013 a rate of 16 incidents for every 1 million passengers. The vast majority, according to Lufthansa data, occur on international flights. Deaths on board are even more rare: about one in every 3 to 5 million passengers.<\/p>\n But those statistics may be cold comfort for a doctor awoken mid-flight by a request for assistance, as was the case for Matt, who was flying from Brisbane to Canberra nearly a decade ago when a man at the front of the plane collapsed.<\/p>\n Matt, who asked to be identified only by his first name, was prodded by his father to help, despite only being an intern \u2013 a doctor in his first year of paid work. \u201cWhen I get there, he\u2019s short of breath, but talking to me. I do an initial assessment and I can feel a pulse, but it\u2019s pretty weak,\u201d he recalls.<\/p>\n The flight attendant asked Matt if he thought they should divert the plane to Sydney, which would shave several minutes off the flight time. \u201cAll these people are staring,\u201d adding pressure to \u201cat least pretend I know what I\u2019m doing\u201d, he says.<\/p>\n The man\u2019s heartbeat was extremely slow, suggesting a potential cardiac cause, but he looked \u201cpretty safe\u201d \u2013 conscious, talking, and not complaining of any chest pain. \u201cI don\u2019t know what\u2019s wrong,\u201d Matt told the crew, \u201cbut I don\u2019t think five minutes is going to make a big difference.\u201d<\/p>\n The plane landed as planned, was met by paramedics on the tarmac, and the man was safely transported to hospital. The airline staff offered Matt a bottle of wine as thanks. \u201cThey had white or red, and being the intern, I was like: can I have both?\u201d (They acquiesced.)<\/p>\n Matt recalls being provided with something that looked like a \u201ctoy stethoscope\u201d when he asked the crew what medical equipment was on board. For years, Australian doctors have lamented that the equipment airlines carry is not standardised.<\/p>\n Under current Australian regulations, aircraft that fly more than 30 passengers for more than an hour must carry emergency medical kits \u2013 but what those kits contain is \u201cat the discretion of the operator\u201d. Ian Hosegood, the executive manager of safety and health at Qantas, says the airline\u2019s planes all carry first aid kits, defibrillators and emergency medical kits.<\/p>\n \u201cWe carry equipment well above regulatory requirements \u2013 from Narcan and EpiPens to antibiotics and advanced airway tools \u2013 so our teams are prepared for whatever comes their way,\u201d he says.<\/p>\n \u201cOur crew manage a wide range of medical situations in the air, including cases where the right equipment and training make a real difference,\u201d Hosegood says. \u201cOn a long Pacific flight, for example, a passenger in severe pain from urinary retention was treated on board using a simple device from our medical kit, which meant we didn\u2019t need to divert.<\/p>\n \u201cWe\u2019ve had passengers suffer a cardiac arrest mid\u2011flight and be successfully resuscitated by our crew using CPR and a defibrillator, often with support from a volunteer doctor on board.\u201d<\/p>\n Four hours into a flight to Canada from Australia \u2013 \u201cfar enough that I really didn\u2019t want to turn around\u201d \u2013 a woman across the aisle from Justin*, an emergency physician, had a seizure and lost consciousness. His wife immediately volunteered him to assist.<\/p>\n Another two medical professionals came to help, one a junior doctor. \u201cThey were quite stressed,\u201d Justin recalls, and they deferred to him after they traded specialties.<\/p>\n The woman was OK after she came to \u2013 she had forgotten to take her epilepsy medication. After providing information to medical staff on the ground via satellite phone, the remainder of Justin\u2019s flight was uneventful.<\/p>\n In Australia, off-duty doctors have a professional \u2013 but no legal \u2013 obligation to assist in emergencies. If they do choose to help, they are protected by legislation from civil liability if they act in good faith.<\/p>\n Despite this, there is understandable reluctance to provide mid-air assistance, especially on international flights where the jurisdiction is less clear.<\/p>\n \u201cThere\u2019s always the stress of the medico-legal side and the stress of it being something significant,\u201d Matt says. He has heard of doctors deliberately having a glass of wine or two at the airport or early during a flight, so they can say: \u201cI\u2019m under the influence, I can\u2019t make a decision, I don\u2019t want to be involved.\u201d<\/p>\n He says: \u201cIf you don\u2019t have a critical care-facing specialty \u2013 say, you\u2019re a psychiatrist \u2013 you wouldn\u2019t have done any kind of resuscitative work in a very long time, most likely. What risk you\u2019re happy to accept is probably the biggest thing \u2013 it\u2019s a completely unfamiliar environment.\u201d<\/p>\n In the unlikely, though feared, event of a death at 10,000 metres, what happens for the remainder of the journey? Last year, a distressed Australian couple spoke about being on a flight during which a woman collapsed and died. The husband sat next to her body, covered in blankets, for several hours.<\/p>\n The International Air Transport Association\u2019s guidelines for dealing with deaths on board suggest moving the body to a seat \u201cwith few other passengers nearby\u201d, or back to their own seat if the plane is full. Restraining with a seatbelt is recommended, as is covering the body up with a body bag if one is available, or a blanket if not.<\/p>\n If you were to have an in-flight medical mishap, you could not hope for better luck than Dorothy Fletcher. In 2003, Fletcher, then 67, had a heart attack while flying from Manchester to Orlando, Florida, for her daughter\u2019s wedding. When the call for help was made, no fewer than 15 heart specialists, on their way to a cardiology conference, stood up. She spent two days in intensive care on arrival, but recovered in time to attend the wedding.<\/p>\n *Name has been changed<\/em><\/p>\n","protected":false},"excerpt":{"rendered":" British Airways flight 032, bound for London, was still on the tarmac in Hong Kong when Prof Angus Wallace heard the passenger announcement dreaded by many medics: \u201cIf there is a doctor on board, would they please make themselves known to cabin staff.\u201d Wallace, then the head of orthopaedic surgery at Queen\u2019s Medical Centre in<\/p>\n","protected":false},"author":1,"featured_media":44068,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[51],"tags":[361,1286,634,3952,22948,1274,3140,16202,1634,2462],"class_list":{"0":"post-44067","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-air","9":"tag-board","10":"tag-call","11":"tag-doctor","12":"tag-dread","13":"tag-emergency","14":"tag-medical","15":"tag-midair","16":"tag-professionals","17":"tag-transport"},"_links":{"self":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts\/44067","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=44067"}],"version-history":[{"count":0,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts\/44067\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/media\/44068"}],"wp:attachment":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=44067"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=44067"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=44067"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}\u2018All these people are staring\u2019<\/h2>\n
Legal stress<\/h2>\n