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climbing230
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About Medical Diversions - What Countries Pilots Prefer To Divert? Are These The Same As The Alternate Airport?

Thu Jul 29, 2021 4:46 am

Hello there.

First of all please delete this thread if this was already discussed before.

QUESTION :

How do medical diversions work? In case of a passenger needing an immediate attention(like surgery or ICU care) then is the passenger taken/escorted out of the airport terminal altogether and how does the immigration works? For example : I have heard of a Jet Airways, Boeing 737 flight making an emergency medical diversion to Karachi sometime back en-route DEL-DOH. What if a situation arises
when there is a mandatory need to de-board all passengers in a third country (or the just the patient and his family member) and how do visas come into picture in such cases.

--- Thanking You

Pramod, Hyderabad.
Last edited by SQ22 on Sat Jul 31, 2021 4:55 am, edited 2 times in total.
Reason: Typo fixed
 
FGITD
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Re: ABOUT MEDICAL DIVERSIONS - WHAT COUNTRIES PILOTS PREFER TO DIVERT? ARE THESE SAME AS THE ALTERNATE AIRPORT?

Thu Jul 29, 2021 6:04 am

Every medical I’ve handled has been pretty straightforward. But I work on the ground, so the decision making in the cockpit I’ll leave to others to explain

We get notified but our central control that a medical is coming in, we advise the airport authority with all the info we have, and they pass it on to the fire/medical team. Passenger’s age, ailment, how/if they’re already being treated, family onboard, etc. We also advise customs with all the info we have.

Plane comes in, we handle it like normal, until we open the door, then it’s all on the medical team. They asses the pax, get them out and usually onto a stretcher and haul them through the terminal to an ambulance waiting curbside.

Customs generally don’t want people to die because of them. They’ll handle everything on their end but deal with the visa/paperwork problem after the fact. They pretty much always advise us however that no one but the sick pax and accompanying family are allowed off.

As traumatic as it is for the people involved, medicals were always our easiest diversions.
 
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Starlionblue
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Re: ABOUT MEDICAL DIVERSIONS - WHAT COUNTRIES PILOTS PREFER TO DIVERT? ARE THESE SAME AS THE ALTERNATE AIRPORT?

Thu Jul 29, 2021 7:04 am

The person with a medical issue him/herself is typically a non-issue when it comes to immigration. A solution will be found.

For the rest of the pax, of whom a number might not have permission to enter, the best is a
"fuel and go" if possible within duty limits. Otherwise pax and crew might have to stay on board or airside until a solution is found. This could be a "rescue flight" or simply another crew flown out.

In some cases, where the diversion is close to destination, pax with the permission to enter might do so and continue overland, whilst others might wait on board/airside

These considerations enter into play with many diversions, but in the specific medical emergency case, you need to do what is best for the sick passenger. Figure the rest out later.
 
mxaxai
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Re: ABOUT MEDICAL DIVERSIONS - WHAT COUNTRIES PILOTS PREFER TO DIVERT? ARE THESE SAME AS THE ALTERNATE AIRPORT?

Fri Jul 30, 2021 7:31 pm

FGITD wrote:
Plane comes in, we handle it like normal, until we open the door, then it’s all on the medical team. They asses the pax, get them out and usually onto a stretcher and haul them through the terminal to an ambulance waiting curbside.

What I've seen is that the aircraft is instructed to vacate the runway and stop rather than taxi to a gate. It would then be met with stairs by the medical team right on the taxiway, to carry the pax down to the waiting ambulance.

A related question, if I may ask: When deciding where to divert, how much of a role does the medical infrastructure at the diversion airport play? For example, if you're over Mongolia, you could either go to Ulan Bator, which has hospitals but perhaps not that much experience with certain illnesses nor the most modern equipment, or you could fly another hour to Beijing, which has all the bells and whistles.
 
GalaxyFlyer
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Re: About Medical Diversions - What Countrie Pilots Prefer To Divert? Are These The Same As The Alternate Airport?

Fri Jul 30, 2021 9:24 pm

We, and many bizjets and airlines, use a company called MedLink out of a PHX hospital. Crew calls in, identifying an emergency, a doctor is on call and based on symptoms and patient information, makes recommendations and calls ahead to the receiving airport/hospital. They have a very database, try to get the plane to the nearest location that has the required care. We had a heart attack patient on board recently. All handled quickly, patient was in OR getting a stent in an hour.
 
flipdewaf
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Re: About Medical Diversions - What Countrie Pilots Prefer To Divert? Are These The Same As The Alternate Airport?

Fri Jul 30, 2021 9:33 pm

Saw something of this nature on a bbc documentary a few years ago. I believe this is a short excerpt: https://youtu.be/io1YaS7GDbw

Fred


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JAGflyer
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Re: About Medical Diversions - What Countrie Pilots Prefer To Divert? Are These The Same As The Alternate Airport?

Sat Jul 31, 2021 3:52 pm

GalaxyFlyer wrote:
We, and many bizjets and airlines, use a company called MedLink out of a PHX hospital. Crew calls in, identifying an emergency, a doctor is on call and based on symptoms and patient information, makes recommendations and calls ahead to the receiving airport/hospital.


This is the procedure at my airline. As a dispatcher, the crew will call us in the operations center and we'll conference in the Medlink service. We listen to the call and advise other operational departments about what's happening/will happen so that they can start getting things going with regards to handling/customs/etc. The final decision to divert is up to the captain however if Medlink advises them to divert I cannot see him/her refusing to. Airports have plans in place for how to handle diversions with regards to gates, customs, etc so once the handling company advises them everything gets taken care of. There have been cases of airlines having to divert to hostile nations (ie. an American carrier diverting to Iran) where they received a welcome with open arms. When it comes to medical/emergency diversions it's pretty unheard of to have any issues due to customs/landing rights. The biggest issue is how to deal with the aircraft/crew/passengers if the diversion happens to put the plane over it's max landing weight. In those cases a maintenance inspection is required and it can take hours to find an approved company/fly in a mechanic from an outstation.
 
e38
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Re: About Medical Diversions - What Countrie Pilots Prefer To Divert? Are These The Same As The Alternate Airport?

Sun Aug 01, 2021 6:51 pm

JAGflyer wrote:
There have been cases of airlines having to divert to hostile nations (ie. an American carrier diverting to Iran) where they received a welcome with open arms. When it comes to medical/emergency diversions it's pretty unheard of to have any issues due to customs/landing rights. The biggest issue is how to deal with the aircraft/crew/passengers if the diversion happens to put the plane over it's max landing weight. In those cases a maintenance inspection is required and it can take hours to find an approved company/fly in a mechanic from an outstation.


I agree with the information provided above by GalaxyFlyer and JAGflyer.

My company uses a similar procedure; we have a contract with a major hospital network that has physicians on duty 24 hours a day that can provide the dispatcher and pilots advice on the most suitable location that can provide adequate care. In general, it is a three-way conference--captain, physician, and dispatcher (with input from maintenance control and meteorology) on the most suitable destination.

Alternate airports and emergency airports are not necessarily the same. Alternate airports generally have facilities to support the aircraft--passenger and ground support personnel, fueling capability, compatible tow bars, etc., while emergency airports simply have runway length sufficient for the particular aircraft and airport rescue and fire fighting (ARFF) capability.

With regard to JAGflyer's reference above, "an American carrier diverting to Iran," the reference is to Northwest flight 41 from Mumbai to Amsterdam on June 19, 2005. There are numerous accounts of this event on the internet, it seems like the biggest challenges the crew faced were not passenger issues--they were well taken care of by the Iranians--but operational issues--getting the aircraft fueled, filing the flight plan, signing off the maintenance release, and, at that time, communicating with the company back in the U.S.

e38
 
GalaxyFlyer
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Re: About Medical Diversions - What Countries Pilots Prefer To Divert? Are These The Same As The Alternate Airport?

Sun Aug 01, 2021 8:45 pm

Yes, I flew with a Kuwaiti national, based in Dubai, that had to mechanical divert in a Challenger into Tehran. The divert wasn’t an issue, getting clearances for tech, parts support, ramp approval and the like took a week for a two hour repair.
 
ecbomberman
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Re: About Medical Diversions - What Countries Pilots Prefer To Divert? Are These The Same As The Alternate Airport?

Mon Aug 02, 2021 12:51 pm

I'd suppose if you are flying intra E.U then it's not a huge problem. If it is an into flight I'd hazard a guess that they'd divert to an airport that they fly into as well where they have all the agents to look after things.

Someone mentioned about diverting to Iran. If the nation gets along with Iran, fair enough, but don't expect El Al getting much help from Muslim countries. Some Muslim country's passport even explicitly say you can go to any countries except Israel.
 
FGITD
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Re: About Medical Diversions - What Countries Pilots Prefer To Divert? Are These The Same As The Alternate Airport?

Mon Aug 02, 2021 2:13 pm

ecbomberman wrote:
I'd suppose if you are flying intra E.U then it's not a huge problem. If it is an into flight I'd hazard a guess that they'd divert to an airport that they fly into as well where they have all the agents to look after things.

Someone mentioned about diverting to Iran. If the nation gets along with Iran, fair enough, but don't expect El Al getting much help from Muslim countries. Some Muslim country's passport even explicitly say you can go to any countries except Israel.



In the case of El Al, the most likely barrier to them diverting to Iran would be their own security protocols. Iran would almost definitely accept the diversion/render service, as much as the govt might not be thrilled to do so

But El Al security would probably rather have the passenger die than divert to Iran and invoke other security risks.

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