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AirbusOnly
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Nine-year-old Girl Dies During Flight To Germany

Tue Mar 01, 2016 3:37 pm

This sad incident happened and effected LH 727 this morning:


http://www.dailymail.co.uk/news/arti...ring-sudden-medical-emergency.html
 
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lesfalls
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RE: Nine-year-old Girl Dies During Flight To Germany

Tue Mar 01, 2016 3:52 pm

RIP   . It really made me cry when reading the article.
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DocLightning
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RE: Nine-year-old Girl Dies During Flight To Germany

Tue Mar 01, 2016 3:57 pm

Certainly very unusual. She might have had a viral myocarditis, which can be silent until you suddenly die. Or a heretofore undetected arrhythmia, which can also be silent until you suddenly die. Obviously, there is no information, so I'm just speculating. I'm thinking allergic reaction is less likely because the article would probably have mentioned that she had trouble breathing or something.
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avi8
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RE: Nine-year-old Girl Dies During Flight To Germany

Tue Mar 01, 2016 4:27 pm

It could have been an unknown allergic reaction. A very sad story.
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diverdave
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RE: Nine-year-old Girl Dies During Flight To Germany

Tue Mar 01, 2016 5:35 pm

Quoting DocLightning (Reply 2):
Certainly very unusual. She might have had a viral myocarditis, which can be silent until you suddenly die. Or a heretofore undetected arrhythmia, which can also be silent until you suddenly die. Obviously, there is no information, so I'm just speculating. I'm thinking allergic reaction is less likely because the article would probably have mentioned that she had trouble breathing or something.

Do passenger aircraft carry the portable defibrillators?

David
 
CRJ900
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RE: Nine-year-old Girl Dies During Flight To Germany

Tue Mar 01, 2016 6:24 pm

Quoting diverdave (Reply 4):
Do passenger aircraft carry the portable defibrillators?

That is up to the airline to decide. Where I work, we have one defibrilator on every aircraft (and they are used regularly, too...)
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georgiaame
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RE: Nine-year-old Girl Dies During Flight To Germany

Tue Mar 01, 2016 7:19 pm

Absolutely horrible situation, it doesn't get much worse than this. 9 year old kids generally don't just up and die. I can't begin to imagine what might have happened.
"Trust, but verify!" An old Russian proverb, quoted often by a modern American hero
 
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DocLightning
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RE: Nine-year-old Girl Dies During Flight To Germany

Tue Mar 01, 2016 7:45 pm

Quoting diverdave (Reply 4):

Do passenger aircraft carry the portable defibrillators?

AFAIK, most do. But in a viral myocarditis or the congenital arrhythmias, they might not be able to find a shockable rhythm.
-Doc Lightning-

"The sky calls to us. If we do not destroy ourselves, we will one day venture to the stars."
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INNflyer
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RE: Nine-year-old Girl Dies During Flight To Germany

Tue Mar 01, 2016 7:57 pm

Lufthansa aircraft are very well equipped with emergency equipment- defibrillator, oxygen, drugs. Also, they have the "Doctor on board" program- you can file your medical license with them, and occasionally get asked by the purser to take a look at somebody since they know who you are and what you can do. No more public announcement neccesary such as "is there a physician aboard the aircraft?". I responded several times as well before the "Doctor on board" program to medical emergencies aboard LH flights and usually there are several physicians among the 200-300 passengers aboard a given widebody aircraft. If an eight year old goes into full cardiac arrest (without, which could happen, an obvious reason such as aspirating food into the trachea), there is something major wrong. In that case, resuscitation chances are rather slim, since the body of a child is able to compensate much more than an adult. So on any given LH flight between China and Munich I would be very surprised if there would be no immediate personal access to a physician aboard the plane. They can not do more than this plus an immediate emergency landing, which was performed. But a very sad case indeed.
 
DTWPurserBoy
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RE: Nine-year-old Girl Dies During Flight To Germany

Tue Mar 01, 2016 8:39 pm

DL also has defibrillators and extensive medical kits including drugs. Many flight attendants are trained RN's but are not assigned flights based on the qualification.

We also have instant contact anywhere in the world with the University of Pittsburgh Medical Center for real time medical advice. The B777 fleet as an outlet about every three rows where a flight attendant or a trained medical professional can hook up with special headsets includng a microphone right from the cabin rather than going through the cockpit radios. It has saved many lives.

My condolences to the young lady's family and the crew. It deeply affects them when an incident like this occurs.
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Mortyman
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RE: Nine-year-old Girl Dies During Flight To Germany

Tue Mar 01, 2016 9:35 pm

Sad story 


Norwegian has defibrillators on all aircraft. SAS on all long haul, but not on all short haul aircraft ( info from 2014 article )

http://www.check-in.dk/norwegian-har...testartere-i-alle-fly#.VtYKPeT2Zpg
 
AirbusOnly
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RE: Nine-year-old Girl Dies During Flight To Germany

Tue Mar 01, 2016 9:49 pm

Just an assumption: maybe it happened because of the insufficient Support at Krasnoyark, Russia? Was it the right decision to divert just to THAT Airport?
Only an issue....
 
Mortyman
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RE: Nine-year-old Girl Dies During Flight To Germany

Tue Mar 01, 2016 9:52 pm

Quoting AirbusOnly (Reply 11):
insufficient

From the article it seems that there were no lack of medical support in Russia.
 
Armodeen
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RE: Nine-year-old Girl Dies During Flight To Germany

Tue Mar 01, 2016 10:23 pm

Quoting AirbusOnly (Reply 11):

Are you suggesting they should fly further with somebody in cardiac arrest on board?

Running an arrest is a simple thing that you would hope that any regional ED could cope with. They might not see many paediatric arrests but the principles are the same and heavily rooted in protocol anyway.

Condolences to the family and I hope all involved get the support they will probably need.
 
BoeingGuy
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RE: Nine-year-old Girl Dies During Flight To Germany

Tue Mar 01, 2016 10:35 pm

Quoting AirbusOnly (Reply 11):
Just an assumption: maybe it happened because of the insufficient Support at Krasnoyark, Russia? Was it the right decision to divert just to THAT Airport?
Only an issue....

Where did you expect them to go? They were over Siberia, not California.

I agree this is very sad. Reminds me of the CRJ that diverted into MKE several years ago with an infant who ended up passing. Again, the crew did everything they possibly could.
 
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CrimsonNL
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RE: Nine-year-old Girl Dies During Flight To Germany

Tue Mar 01, 2016 10:44 pm

Quoting AirbusOnly (Reply 11):

It's the largest city for hundreds of kilometers in Siberia. With a million inhabitants there's no reason to think there's no adequate medical support available there.

Martijn
Always comparing your flown types list with mine
 
bennett123
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RE: Nine-year-old Girl Dies During Flight To Germany

Tue Mar 01, 2016 11:37 pm

Not clear how long between the incident and landing.
 
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NYPECO
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RE: Nine-year-old Girl Dies During Flight To Germany

Wed Mar 02, 2016 1:46 am

I'm guessing it was an allergic reaction.
 
YYZAMS
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RE: Nine-year-old Girl Dies During Flight To Germany

Wed Mar 02, 2016 3:49 am

Very sad indeed. Though the news source is always cringeworthy especially when it shows a picture of MUC and a DL L1011
 
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RWA380
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RE: Nine-year-old Girl Dies During Flight To Germany

Wed Mar 02, 2016 4:20 am

Quoting DocLightning (Reply 2):
Certainly very unusual. She might have had a viral myocarditis, which can be silent until you suddenly die.

Your professional input is very appreciated in situations like this, it helps resolve a lot of speculations normally.

Quoting DTWPurserBoy (Reply 9):
DL also has defibrillators and extensive medical kits including drugs. Many flight attendants are trained RN's but are not assigned flights based on the qualification

I know at one time Flight Attendants were required to be Nurses, it's nice to know that there are some flying nurses with us these days, when now, the best one can expect is a fake smile & a disappearing act during the flight.

Quoting INNflyer (Reply 8):
"is there a physician aboard the aircraft?".

My Dr's number onefear while flying, yet she'll be the first up everytime. I think there have been cases where Dr's who aided people have been sued later on for one thing or another, I think that is the only thing that would make a professional Dr take pause, hoping another person will be on board to help.

I 100% agree that this is a very sad case & my heart goes out to the entire family in the loss of such a young soul, RIP Angel!
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DocLightning
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RE: Nine-year-old Girl Dies During Flight To Germany

Wed Mar 02, 2016 5:08 am

Quoting Armodeen (Reply 13):

Are you suggesting they should fly further with somebody in cardiac arrest on board?

Running an arrest is a simple thing that you would hope that any regional ED could cope with. They might not see many paediatric arrests but the principles are the same and heavily rooted in protocol anyway.

Yeah, if I'm on the deck doing compressions and running a "code," (as best as one can in an airplane), we're landing.

Right. Now.

Quoting RWA380 (Reply 19):

Your professional input is very appreciated in situations like this, it helps resolve a lot of speculations normally.

  

Quoting RWA380 (Reply 19):

My Dr's number onefear while flying, yet she'll be the first up everytime. I think there have been cases where Dr's who aided people have been sued later on for one thing or another, I think that is the only thing that would make a professional Dr take pause, hoping another person will be on board to help.

We're well-protected by good samaritan laws, contrary to popular belief (even among doctors).

And... if you worry about getting sued then that means that you are thinking about yourself before you think about the patient. If you take good care of your patients, then the lawsuits take care of themselves.

I have been called to respond on an airplane once. I was flying from JFK to SFO on a DL 757 in 2007. I was at this point a senior Pediatric resident. When I boarded the aircraft, I saw that in the first row of Y there was a very old woman wearing oxygen who had what I call a "Positive Q Sign," meaning her mouth was hanging open and her tongue was hanging out. This sign is commonly seen at the end of life and indicates a persistently decreased level of consciousness. I predicted that somewhere over Nebraska, she would decompensate, they would call for a doctor, I'd respond, and being a pediatrician with no idea what to do with an elderly lady on oxygen, strongly recommend that the captain land us. Right. Now. So I braced for being quite late on this already delayed flight to SFO.

Sure enough, over Western Nebraska *DING!* "Ladies and gentlemen, if there is a doctor on board or someone with medical training, would you please identify yourself by ringing the call button?"

::Oh shit! Here we go!:: I rang my call button.

The patient, it turned out, was a 20mo boy who had developed acute-onset vomiting and diarrhea about 20 minutes before. And this is right up my alley. I know exactly what to do for a child with acute gastroenteritis. So I sent the F/A to get a liter of water and mix enough salt to make 1 tsp and 24 packs of sugar into that liter, which is the WHO Oral Rehydration Solution. And then I got a 5cc syringe out of the medical kit and instructed the parents to give the child 5cc every 5 minutes. I then talked with the captain on the phone and told him that I had the situation under control and I saw no reason to divert, but if maybe he could expedite our arrival into SFO and have medical transport waiting, that would help, and I'd get back to him if anything changed. I checked on my little patient every 30 or so minutes and made sure that his vitals weren't getting worse, updated the captain a few times. We arrived about 10 minutes before schedule into SFO, EMS met the aircraft and took him to an emergency room. One of the F/A's pulled me aside and got my information.

I got a letter from thanking me profusely for my expert medical assistance and a shockingly huge mileage dump into my SkyMiles account worth two domestic r/t tickets. The family somehow figured out who I was and called my residency program director and sang my praises.

Never heard a peep out of the little old lady.
-Doc Lightning-

"The sky calls to us. If we do not destroy ourselves, we will one day venture to the stars."
-Carl Sagan
 
cschleic
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RE: Nine-year-old Girl Dies During Flight To Germany

Wed Mar 02, 2016 5:21 am

Quoting DocLightning (Reply 20):

Fascinating story, thanks for sharing. I've been reading your posts for years and didn't realize you're a physician.
 
PlaneInsomniac
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RE: Nine-year-old Girl Dies During Flight To Germany

Wed Mar 02, 2016 8:19 am

Local news indicate the girl had a pre-existing medical condition ("an einer Vorerkrankung gelitten"):

http://www.merkur.de/welt/maedchen-s...ghai-nach-muenchen-zr-6170215.html
Am I cured? Slept 5 hours on last long-haul flight...
 
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RWA380
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RE: Nine-year-old Girl Dies During Flight To Germany

Wed Mar 02, 2016 8:53 am

Quoting DocLightning (Reply 20):
And... if you worry about getting sued then that means that you are thinking about yourself before you think about the patient. If you take good care of your patients, then the lawsuits take care of themselves

I understand, which is why my Dr does respond because she is in it to help people, I'd count her as a caring physician & medical advocate.

Quoting DocLightning (Reply 20):
We're well-protected by good samaritan laws, contrary to popular belief (even among doctors).

Good to know, I knew something like this existed, I am not very informed about what is covered, my cousin is a first responder to major car accidents mostly, as he also is a crash scene investigator & he was explaining the Oregon laws in this area & why people should not hesitate to jump in to help, if they are knowledgeable in what to properly do to potentially save a life.

Quoting DocLightning (Reply 20):
The patient, it turned out, was a 20mo boy who had developed acute-onset vomiting and diarrhea about 20 minutes before. And this is right up my alley. I know exactly what to do for a child with acute gastroenteritis. So I sent the F/A to get a liter of water and mix enough salt to make 1 tsp and 24 packs of sugar into that liter, which is the WHO Oral Rehydration Solution. And then I got a 5cc syringe out of the medical kit and instructed the parents to give the child 5cc every 5 minutes. I then talked with the captain on the phone and told him that I had the situation under control and I saw no reason to divert, but if maybe he could expedite our arrival into SFO and have medical transport waiting, that would help, and I'd get back to him if anything changed. I checked on my little patient every 30 or so minutes and made sure that his vitals weren't getting worse, updated the captain a few times. We arrived about 10 minutes before schedule into SFO, EMS met the aircraft and took him to an emergency room. One of the F/A's pulled me aside and got my information

Amazing story Doc & luckily a pediatric Doctor was there for that young lad. I was so bad off with stomach ulcers as a 3y/o that when we landed in Jo'burg after making the trek from LAX via DAL, ATL, JFK & GIG I was taken directly to the hospital for severe dehydration. I luckily do not remember that part, but I do remember seeing the Christ statue in Rio & wishing he'd take me. I'll never forget this WHO mixture you just described, it may come in handy.

Quoting cschleic (Reply 21):
Fascinating story, thanks for sharing. I've been reading your posts for years and didn't realize you're a physician.

It took me a while of reading Doc's posts, but he stepped into some thread where speculation had gone rampant about all the possibilities & Doc came in & nicely explained my most of them were bull squirt. I have had respect for him since.
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JohnGalt
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RE: Nine-year-old Girl Dies During Flight To Germany

Wed Mar 02, 2016 1:48 pm

I don't know about internationally, but for U.S. Part 121 air carriers (with an F/A and aircraft >7,500 pounds), an AED is a requirement as of 2004.

------------

§121.803 Emergency medical equipment.

(c) For treatment of injuries, medical events, or minor accidents that might occur during flight time each airplane must have the following equipment that meets the specifications and requirements of appendix A of this part:

...

(4) In airplanes for which a flight attendant is required and with a maximum payload capacity of more than 7,500 pounds, an approved automated external defibrillator as of April 12, 2004.


------------

Also of interest to this conversation is 121.805, which covers "crewmember training for in-flight medical events". This, in part, states "the crewmember instruction, performance drills, and recurrent training required under this section are not required to be equivalent to the expert level of proficiency attained by professional emergency medical personnel."

I would link to it, but the electronic CFR is constantly updated and does not link well.
 
DTWPurserBoy
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RE: Nine-year-old Girl Dies During Flight To Germany

Wed Mar 02, 2016 2:10 pm

Quoting DocLightning (Reply 20):
The patient, it turned out, was a 20mo boy who had developed acute-onset vomiting and diarrhea about 20 minutes before. And this is right up my alley. I know exactly what to do for a child with acute gastroenteritis. So I sent the F/A to get a liter of water and mix enough salt to make 1 tsp and 24 packs of sugar into that liter, which is the WHO Oral Rehydration Solution. And then I got a 5cc syringe out of the medical kit and instructed the parents to give the child 5cc every 5 minutes. I then talked with the captain on the phone and told him that I had the situation under control and I saw no reason to divert, but if maybe he could expedite our arrival into SFO and have medical transport waiting, that would help, and I'd get back to him if anything changed. I checked on my little patient every 30 or so minutes and made sure that his vitals weren't getting worse, updated the captain a few times. We arrived about 10 minutes before schedule into SFO, EMS met the aircraft and took him to an emergency room. One of the F/A's pulled me aside and got my information.

FYI--We also carry 2 500cc bags of normal saline onboard every aircraft and the means to start an IV--not easy on a bouncing airplane. I have had to do it twice (both times for suspected MI's (heart attacks) and both times I ran out before landing. I kept pushing for them to switch to 2 1 liter bags of NS but to the best of my knowledge it was never done.
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Semaex
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RE: Nine-year-old Girl Dies During Flight To Germany

Wed Mar 02, 2016 2:24 pm

This is indeed a very tragic event. It must have a been a cold cold atmosphere on the way to Munich after this event.

From a Dispatcher's point of view, there is hardly anything as complicated to treat with on a beaurocratic level than passengers being born or passing away inflight.

I'm sure LH staff performed above standard in this situation. Their medical training is quite extensive. And as mentioned before, they have a "Doc on Board" program.
// You know you're an aviation enthusiast if you look at your neighbour's cars and think about fleet commonality.
 
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DocLightning
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RE: Nine-year-old Girl Dies During Flight To Germany

Wed Mar 02, 2016 5:04 pm

Quoting RWA380 (Reply 23):
I'll never forget this WHO mixture you just described, it may come in handy.

The recipe is:
1 liter of water
1 tsp (5mL) of salt
8 Tbsp (1 Tbsp=15mL, 8 Tbsp=120mL) of sugar

Quoting Semaex (Reply 26):

From a Dispatcher's point of view, there is hardly anything as complicated to treat with on a beaurocratic level than passengers being born or passing away inflight.

I live in terror of having to deliver a baby somewhere over the middle of an ocean. I haven't delivered a baby since 2003.

Quoting DTWPurserBoy (Reply 25):

FYI--We also carry 2 500cc bags of normal saline onboard every aircraft and the means to start an IV--not easy on a bouncing airplane.

I seem to remember that they didn't have a 25ga angiocath, but either way, an IV is an invasive procedure and in gastroenteritis oral rehydration is preferable unless the patient really cannot tolerate it.
-Doc Lightning-

"The sky calls to us. If we do not destroy ourselves, we will one day venture to the stars."
-Carl Sagan
 
TC957
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RE: Nine-year-old Girl Dies During Flight To Germany

Wed Mar 02, 2016 6:25 pm

I think KJA was also chosen as a suitable diversion point since LH Cargo regularly fly there so LH would have had some ground handling presence there to help with this emergency.
 
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DocLightning
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RE: Nine-year-old Girl Dies During Flight To Germany

Thu Mar 03, 2016 1:39 am

Quoting PlaneInsomniac (Reply 22):

Local news indicate the girl had a pre-existing medical condition ("an einer Vorerkrankung gelitten"):

http://www.merkur.de/welt/maedchen-s...ghai-nach-muenchen-zr-6170215.html

In that case, all bets are off. And I don't read Germish, so...
-Doc Lightning-

"The sky calls to us. If we do not destroy ourselves, we will one day venture to the stars."
-Carl Sagan
 
N1120A
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RE: Nine-year-old Girl Dies During Flight To Germany

Thu Mar 03, 2016 7:43 am

How very sad.

Quoting diverdave (Reply 4):
Do passenger aircraft carry the portable defibrillators?

The vast majority do. Lufthansa certainly do.

Quoting DTWPurserBoy (Reply 9):
Many flight attendants are trained RN's

"Many" is relative. It is likely less than 1%.
Mangeons les French fries, mais surtout pratiquons avec fierte le French kiss
 
PlaneInsomniac
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RE: Nine-year-old Girl Dies During Flight To Germany

Thu Mar 03, 2016 9:24 am

Quoting DocLightning (Reply 29):
Quoting PlaneInsomniac (Reply 22):

Local news indicate the girl had a pre-existing medical condition ("an einer Vorerkrankung gelitten"):

http://www.merkur.de/welt/maedchen-s...ghai-nach-muenchen-zr-6170215.html

In that case, all bets are off. And I don't read Germish, so...

According to the more detailed reporting of tz, Lufthansa has stated that the girl was actually suffering from a "serious existing illness [...] However, the condition of the girl rapidly deteriorated already during the first third of the flight [...]":
https://www.tz.de/welt/maedchen-stirbt-flug-shanghai-nach-muenchen-lufthansa-aeussert-sich-tz-6172531.html

So it seems they were aware of the girl's condition before the flight already. Actually, it sounds like they may have been on their way to get treatment in Europe.
Am I cured? Slept 5 hours on last long-haul flight...
 
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Aeroflot777
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RE: Nine-year-old Girl Dies During Flight To Germany

Thu Mar 03, 2016 10:19 am

Quoting AirbusOnly (Reply 11):
Just an assumption: maybe it happened because of the insufficient Support at Krasnoyark, Russia? Was it the right decision to divert just to THAT Airport?

A large city in Russia with over a million people wold have "insufficient support"? Give me a break. Seems like you know nothing of Krasnoyarsk, but are ready to make assumptions.

RIP to the girl, tragic event. Must have been a sad rest of the flight to MUC, for everyone involved.

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