Airliners.net

Hello all - with all the discussion about the passenger dying on the AA flight earlier, I was wondering what the typical med-kit onboard an aircraft consisted of, and also (if anyone knows) if an non-rebreather mask is carried with the medical O2, and why the flow rate in onboard canisters is so much lower than their terrestrial counterparts. Thanks!

There is no medical O2 on the aircraft, just aviator's breathing oxygen. The regulator on the portable bottle is designed to get the maximum amount of time, at a rate (2-4 lpm) that can sustain life, out of a relatively small (11 cubic feet) bottle.

I haven't looked at an aircraft medical kit in a long time, but I don't recall a non-rebreather, nor a regulator that can supply 15+ lpm. The medical kit, as opposed to the first aid kit, has varied contents depending on the operator and what the medical control authorizes. The kit I recall, over 18 years ago (we don't carry them on cargo jets), had a placard which limited its use to a doctor. It contained a BP cuff, various prepackaged drugs and other items. The contents have surely changed over the years.

The first aid kit has band aids, cold packs, bandages and ammonia capsules, among other basic first aid supplies.

This is a great thread with a lot of knowledgeable posters on the subject. Its actually a pretty interesting read:
Protocol When "medical Emergency" On Board? (by BWI5OH Feb 2 2008 in Civil Aviation)

Hello

It greatly depends on the airline, however all British Airways long haul aircraft carry a full paramedic kit that has drugs in it that will help save a life in the event of a full medical emergency.

The aircraft also carries oxygen for medical use and also a defibrillator for use in the most dire of situations.

I hate to say it but some airlines (BA and VS included) often carry a type of body bag, just incase…

Kimberly.

There is a regulatory requirement that all commercial Aircraft are supposed to be equipped with First Aid Kits & Physicians kit depending on the Capacity of the Aircraft concerned.There Kits are equipped with the needed drugs/equipment/materials to treat a medical situation in flight.

regds
MEL

Hello

There is only a recommendation that aircraft should carry defibrillator‘s, there is no FAA or CAA law saying they have to – so while airlines like BA and VS do, certain American carriers and British charter airlines don’t always carry them on all long haul flights and hardly ever on short haul flights (BA don’t tend to carry defibrillators on short haul aircraft either).

You are correct about the first aid kits, however the ‘paramedic’ kits are not required by law. They carry many more drugs which can be used in a number of circumstances from near death to an incident which is causing great pain, to panic attacks to a minor reaction to a certain type of food (not anaphylactic shock) and of course to major allergic reactions.

It also comes down to the training of the crew, for example on each British Airways long haul flights there are always two fully trained first aid’s crew, one of which is trained a to an equivalent level of a Paramedic Technician (BA paid for me to become a qualified Paramedic which means I can administer controlled drugs and make medical decisions) which comes in handy when your four hours away form help on the ground.

I always hate it when a passenger dies on me, but, all you can do is your best to keep them alive for as long as possible, but it can be had dealing with not only the medical emergency but also dealing with passengers who seem to want to watch and also the family or friends who are so alarmed they are nearing medical help to!

Kimberly

Quoting Kimberlyrj (Reply 5): There is only a recommendation that aircraft should carry defibrillator‘s, there is no FAA or CAA law saying they have to – so while airlines like BA and VS do, certain American carriers and British charter airlines don’t always carry them on all long haul flights and hardly ever on short haul flights (BA don’t tend to carry defibrillators on short haul aircraft either). You are correct about the first aid kits, however the ‘paramedic’ kits are not required by law. They carry many more drugs which can be used in a number of circumstances from near death to an incident which is causing great pain, to panic attacks to a minor reaction to a certain type of food (not anaphylactic shock) and of course to major allergic reactions.

You might want to take a look at the thread I posted earlier, it might clear up some confusion you might have as to what is and isn't required to be carried per the FAA.

I don't know about CAA, but the FAA does require an Emergency Medical Kit and a defibrillator on board all aircraft that require a flight attendant and have a payload capacity above 7,500 lbs.

I am pilot for a short haul commuter and we carry what is listed below, even though we are always within a few minutes of a town or city with some sort of emergency care.

Following are the regs:

CFR 14 Part 121.803 (c)

(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:

(1) Approved first-aid kits.

(2) In airplanes for which a flight attendant is required, an approved emergency medical kit.

(3) In airplanes for which a flight attendant is required, an approved emergency medical kit as modified effective April 12, 2004.

(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.

CFR 14 Part 121 Appendix A

Appendix A to Part 121—First Aid Kits and Emergency Medical Kits
Approved first-aid kits, at least one approved emergency medical kit, and at least one approved automated external defibrillator required under §121.803 of this part must be readily accessible to the crew, stored securely, and kept free from dust, moisture, and damaging temperatures.

First-aid Kits

1. The minimum number of first aid kits required is set forth in the following table:

No. of passenger seats No. of first-aid kits
0–50 1
51–150 2
151–250 3
More than 250 4

2. Except as provided in paragraph (3), each approved first-aid kit must contain at least the following appropriately maintained contents in the specified quantities:

Contents Quantity
Adhesive bandage compresses, 1-inch 16
Antiseptic swabs 20
Ammonia inhalants 10
Bandage compresses, 4-inch 8
Triangular bandage compresses, 40-inch 5
Arm splint, noninflatable 1
Leg splint, noninflatable 1
Roller bandage, 4-inch 4
Adhesive tape, 1-inch standard roll 2
Bandage scissors 1

3. Arm and leg splints which do not fit within a first-aid kit may be stowed in a readily accessible location that is as near as practicable to the kit.

Emergency Medical Kits

1. Until April 12, 2004, at least one approved emergency medical kit that must contain at least the following appropriately maintained contents in the specified quantities:

Contents Quantity
Sphygmomanometer 1
Stethoscope 1
Airways, cropharyngeal (3 sizes) 3
Syringes (sizes necessary to administer required drugs) 4
Needles (sizes necessary to administer required drugs) 6
50% Dextrose injection, 50cc 1
Epinephrine 1:1000, single dose ampule or equivalent) 2
Diphenhydramine HC1 injection, single dose ampule or equivalent 2
Nitroglycerin tablets 10
Basic instructions for use of the drugs in the kit 1
protective nonpermeable gloves or equivalent 1 pair

2. As of April 12, 2004, at least one approved emergency medical kit that must contain at least the following appropriately maintained contents in the specified quantities:

Contents Quantity
Sphygmonanometer 1
Stethoscope 1
Airways, oropharyngeal (3 sizes): 1 pediatric, 1 small adult, 1 large adult or equivalent 3
Self-inflating manual resuscitation device with 3 masks (1 pediatric, 1 small adult, 1 large adult or equivalent) 1:3 masks
CPR mask (3 sizes), 1 pediatric, 1 small adult, 1 large adult, or equivalent 3
IV Admin Set: Tubing w/ 2 Y connectors 1
Alcohol sponges 2
Adhesive tape, 1-inch standard roll adhesive 1
Tape scissors 1 pair
Tourniquet 1
Saline solution, 500 cc 1
Protective nonpermeable gloves or equivalent 1 pair
Needles (2–18 ga., 2–20 ga., 2–22 ga., or sizes necessary to administer required medications) 6
Syringes (1–5 cc, 2–10 cc, or sizes necessary to administer required medications) 4
Analgesic, non-narcotic, tablets, 325 mg 4
Antihistamine tablets, 25 mg 4
Antihistamine injectable, 50 mg, (single dose ampule or equivalent) 2
Atropine, 0.5 mg, 5 cc (single dose ampule or equivalent) 2
Aspirin tablets, 325 mg 4
Bronchodilator, inhaled (metered dose inhaler or equivalent) 1
Dextrose, 50%/50 cc injectable, (single dose ampule or equivalent) 1
Epinephrine 1:1000, 1 cc, injectable, (single dose ampule or equivalent) 2
Epinephrine 1:10,000, 2 cc, injectable, (single dose ampule or equivalent) 2
Lidocaine, 5 cc, 20 mg/ml, injectable (single dose ampule or equivalent) 2
Nitroglycerin tablets, 0.4 mg 10
Basic instructions for use of the drugs in the kit 1

3. If all of the above-listed items do not fit into one container, more than one container may be used.

Automated External Defibrillators

At least one approved automated external defibrillator, legally marketed in the United States in accordance with Food and Drug Administration requirements, that must:

1. Be stored in the passenger cabin.

2. After April 30, 2005:

(a) Have a power source that meets FAA Technical Standard Order requirements for power sources for electronic devices used in aviation as approved by the Administrator; or

(b) Have a power source that was manufactured before July 30, 2004, and been found by the FAA to be equivalent to a power source that meets the Technical Standard Order requirements of paragraph (a) of this section.

3. Be maintained in accordance with the manufacturer's specifications.

[Doc. No. FAA–2000–7119, 66 FR 19044, Apr. 12, 2001, as amended by Amdt. 121–280, 69 FR 19762, Apr. 14, 2004; Amdt. 121–309, 70 FR 15196, Mar. 24, 2005]

Checko

Quoting TheGreatChecko (Reply 6): You might want to take a look at the thread I posted earlier, it might clear up some confusion you might have as to what is and isn't required to be carried per the FAA

You may have heard of the CAA, that’s who we comply with and yes while airlines need to carry certain drugs and facilities and certain equipment is optional but most of it useless if the crew is not fully medically trained. I can reassure you most American cabin crew are not trained in how to insert a canular and I don’t think they would be authorized to administer hardly any of the drugs that are carried.

Airlines will always call on Doctor, or persons of medicine to come forward, however often when they help they are totally uninsured and over the past few years there have been many court cases and in some cases in the UK Doctors have been struck off the medical register.

My mother who is a surgeon always say’s that the person would have to be minutes from dieing being she would come forward, an opinion which seems to shared with a lot of Doctors and other medically trained staff I have spoken to over the years.

I’m sorry I missed your informative post before, please except my warmest apologies

Kimberly

Quoting Kimberlyrj (Reply 7): I can reassure you most American cabin crew are not trained in how to insert a canular and I don%u2019t think they would be authorized to administer hardly any of the drugs that are carried.

You are correct, they aren't nor are they required to be trained to that level.

Opening the EMK would require orders from online medical control (MedLink, STAT-MD), a physician being onboard, or a captain's order if the first two cannot be reached.

Yes, I've heard of CAA and many other alphabet soup organizations.

I cannot find anything in the CAA regs that specifically require anything beyond a basic first aid kit and would be most appreciative if someone could either post the appropriate regs or point me in the right direction.

As an aside, I'm hoping the sarcasm I'm sensing is unfounded.

This is a discussion board and sometimes, myself included, may post some things that are incorrect. Also, since this is Tech/Ops not the general board, technical correctness is highly valued. We are all here to point each other in the direction of the proper information and correct anything that may not be true. Since you brought up American carriers, I brought up the FAA requirements, nothing more, nothing less.

Cheers  

Checko

Quoting Kimberlyrj (Reply 3): I hate to say it but some airlines (BA and VS included) often carry a type of body bag, just incase…

Surely, there must be some great stories of practical jokes among crewmembers involving such equipment....

2H4

Hey all

Bit of a long ish post, but funny (in a dark way I guess)

Quoting 2H4 (Reply 9): Surely, there must be some great stories of practical jokes among crewmembers involving such equipment....

We had a new pilot, first day of flying passengers on a Boeing 767… I blackmailed one of the pursers into getting into the body bag. While we where taxing I asked the commander (who was in on the joke) if I could store something in the flight deck during take off.

We brought in the purser (in the body bag) and put some tomato ketchup on the body bag, with some ‘bloody’ hair coming out the top.

30 minutes into the flight the First Officer looked around for the first time and screamed like a girl! Commander recording it on him camera lol. It is normal on crew members first day to play jokes all the time, it’s like a warm welcome!

We did have a passenger who died on a flight two months ago, luckily he died in his sleep and was 89 years old. We removed him from his seat on the top deck of the B744, put him in the body bag, secured it all up and placed him in the lavatory (on the upper deck).

Crew member on duty up there was in the crew rest area while this was being done, so she thought we had put the body down stairs not up stairs.

Captain warned me that the approach and landing was going to be bumpy due to weather and cross winds on landing so instructed my pursers.

15 minutes before landing I took my seat at left 2 along with the most junior crew member and the four crew up stairs were also sat in their seats (two by the upper exits and two at the top of the stairs leading to the main deck).

The approach was rough as hell and the when we landed the aircraft landed heavily on its left gear and then jerked very hard to the right and then left again. Normally at this stage you hear the reverse thrust but no, I heard a ‘BANG’ then one of my crew upstairs shooting “S*#ti%G HELL” just as my junior crew member looked around the corner and said “the dead guy is coming down the stairs”. I thought God, he is alive and not seated for landing – I’m going to loose my job!

The lavatory door had not only opened but given way under the heavy weight of the dead passenger and he had managed to slide to the top of the stairs and then came shooting down as the pilots were slowing after touch down.

If that was not bad enough the body hit the bulk head with a lot of force and most of club turned around and looked horrified not only the body bag but also the TORN body bad showing the guys face and arm!

It would not have been so bad, but the pilots had not used any reverse thrust, so the cabin was quiet, well apart from the dead body being thrown down the stairs and passengers all chatting about what was going on.

Many many more stories! Lol

Kimberly.

Quoting Kimberlyrj (Reply 10):

Note to self: Never, under any circumstances, cross Kimberlyrj.

2H4

Quoting TheGreatChecko (Reply 8): I cannot find anything in the CAA regs that specifically require anything beyond a basic first aid kit and would be most appreciative if someone could either post the appropriate regs or point me in the right direction

You may find it under another name than "Emergency Medical Kit", which is the American terminology. Some carriers say "Doctor's Kit" instead. For Europe, you will find the requirements of the kit under JAA regulations, under JAR-OPS 1.755 . Most EU carriers have to comply with JAA regulations.

Quoting Kimberlyrj (Reply 10): placed him in the lavatory (on the upper deck).

I always thought the lavatory was the best place to put a deceased passenger, until someone warned me that the lavatory was not manufacturer approved for any form of stowage during take off and landing...now I know can take that warning seriously. 

Hello

Quoting 2H4 (Reply 11): Note to self: Never, under any circumstances, cross Kimberlyrj

I'm a nice gal, just love playing jokes and making the skies a little more fun to fly in! You can have safety and fun working at the same time, crew enjoy themselves and the passengers pick up on it and enjoy themselves.

Quoting MarkHKG (Reply 12): I always thought the lavatory was the best place to put a deceased passenger, until someone warned me that the lavatory was not manufacturer approved for any form of stowage during take off and landing...now I know can take that warning seriously

Oh yes, we knew it but that’s what is recommended. Even after this incident and I have heard of quite a few other incidents BA are still saying ‘body bags to be place in the lavatory and the door is to be locked at all times. A sign is to be placed on the door saying “strictly no entry – bio hazard” (a sign we carry ready for use in the cabin).

Kimberly

Quoting Fr8Mech (Reply 1): There is no medical O2 on the aircraft

Every commercial aircraft I've ever worked on had O2 available for medical use.

Quoting Kimberlyrj (Reply 7): My mother who is a surgeon always say’s that the person would have to be minutes from dieing being she would come forward, an opinion which seems to shared with a lot of Doctors and other medically trained staff I have spoken to over the years.

That is rather sad. My stepmother who is a doctor and my Mother who is an experienced emergency room nurse have both encountered medical emergencies outside of work and have always stepped up to the plate. They do the right thing even though they know we live in a litigious society.

Quoting Kimberlyrj (Reply 7): You may have heard of the CAA, that’s who we comply with

Yes, we've heard of the the CAA. However, you made certain claims about the FAA and American carriers which are incorrect (see below)

Quoting Kimberlyrj (Reply 5): There is only a recommendation that aircraft should carry defibrillator‘s, there is no FAA or CAA law saying they have to

It is not a recommendation in the US, the FAA REQUIRES this equipment.

Quoting Kimberlyrj (Reply 5): so while airlines like BA and VS do, certain American carriers and British charter airlines don’t always carry them on all long haul flights and hardly ever on short haul flights (BA don’t tend to carry defibrillators on short haul aircraft either).

Every passenger aircraft in the US over 7,500 payload requiring an FA onboard has them. This includes American charter aircraft, I've worked for 2 American charter companies. It also includes short haul aircraft. I used to work for a regional carrier as well.

Quoting Kimberlyrj (Reply 5): however the ‘paramedic’ kits are not required by law.

They are on commercial passenger aircraft operating under FAA regulations.

Quoting Kimberlyrj (Reply 7): while airlines need to carry certain drugs and facilities and certain equipment is optional but most of it useless if the crew is not fully medically trained. I can reassure you most American cabin crew are not trained in how to insert a canular and I don’t think they would be authorized to administer hardly any of the drugs that are carried.

I disagree. It those items are not useless just because the crew has not been trained specifically to use them. There are often medically qualified passengers onboard and many of the items can be used in dire situations with medlink talking the crew through it. Per the FAA any crew member may access and use the contents of the EEMK if directed by the CA or Medlink. Obviously the decision to use this stuff is not taken lightly. The crew would only use these items if there was no alternative.

While the JAA in 2008 updated their requirements for the onboard EMK, they are still not requiring AEDs on board. It's amazing that, in comparison, the FAA is pretty progressive on the issue.  

JAA EMK Requirements:
http://www.jaa.nl/secured/Operations...0&%20Emergency%20Medical%20Kit.pdf

Quoting IAirAllie (Reply 14): I disagree. It those items are not useless just because the crew has not been trained specifically to use them. There are often medically qualified passengers onboard and many of the items can be used in dire situations with medlink talking the crew through it. Per the FAA any crew member may access and use the contents of the EEMK if directed by the CA or Medlink. Obviously the decision to use this stuff is not taken lightly. The crew would only use these items if there was no alternative.

So you can give the drugs and give injections if medlink tells you to?

Quoting Markhkg (Reply 15): While the JAA in 2008 updated their requirements for the onboard EMK, they are still not requiring AEDs on board. It's amazing that, in comparison, the FAA is pretty progressive on the issue. Smile JAA EMK Requirements: http://www.jaa.nl/secured/Operations...t.pdf

AED's should be required on all airplane by all aviation organizations. They give Cardiac Arrest victims a really good chance of survival and once you've had a little bit of training they're not hard to use at all. The first time I saw one I was shocked and so confused on how to do it but once I took a training class on it, which all F/As do, it was really easy to use.

Quoting M11Stephen (Reply 16): So you can give the drugs and give injections if medlink tells you to?

That is my understanding though that is really really unlikely. Medlink accepts liability for any of their instructions so they aren't going to make decisions like that lightly.

There are very few medications Medlink would need a cabin crewmember to give, but I'm certain the cabin crewmember can easily give them.


The four most important drugs in the EMK in my opinion are relatively easy to give:
-Albuterol for Asthma uses a Metered Dose Inhaler which most asthmatics are very familar with.
-For a diabetic emergency Medlink will probably recommend orange juice or soda from the galley rather than the IV Dextrose 50%. If you look at a can of cola, it has like 39 grams of sugar in it! The vial of 50ml Dextrose 50% only has 25 grams of dextrose in comparison. Sugar is sugar...
- For a severe allergic reaction, the administration of the injectable epinephrine 1:1000 is relatively easy to walk through in terms of drawing up the meds from the vial and injecting it into the shoulder. It would be easier if was an Epi-Pen but they are only standard in the EEMK for Medaire.
- For cardiac chest pain, the aspirin and Nitro are really easy to give since it's just by mouth (ASA is swallowed, NTG is under the tongue).

The rest of the medications, like Lidocaine and Atropine, requires the use of an IV which Medlink won't be teaching over the radio system. Honestly though, when a patient is this sick, even these meds aren't the magic bullet into bringing the patient back.

I guess my point is that the cabin crew can easily give most of these medications without a paramedic, RN or MD license.   One study I read stated that 86% of in-flight medical emergencies on commercial aircraft have on-board medical professionals interestingly enough. A F/A I was in school with once turned out to be an Emergency Department nurse!

Quoting M11Stephen (Reply 16): I was shocked

Oh, a defibrillation joke, how funny. 

Quoting Markhkg (Reply 18): For a diabetic emergency Medlink will probably recommend orange juice or soda from the galley rather than the IV Dextrose 50%

Most soda’s today contain high fructose corn syrup, not sugar, would this be okay to administer in a diabetic emergency.

Quoting Jetstar (Reply 19): high fructose corn syrup, not sugar

Fructose is still classified as a sugar -- even HFCS -- so it would still be fine in a diabetic emergency so long as the patient was able to swallow it. (You wouldn't want to force something down someone's throat if they can't protect their airway.) I haven't come across any research to say that HFCS can't be used for a diabetic emergency.

In fact, any type of carbohydrate can be live-saving for hypoglycemia if you don't have pure sugar on hand.

The thing to avoid though is all of those sugar-less drinks with the new brand-names of artificial sweeteners that people don't recognize, like containing Acesulfame and Sucralose. Those won't do any hypoglycemic patient any good.

Quoting Markhkg (Reply 18): A F/A I was in school with once turned out to be an Emergency Department nurse!

We have a pilot who flies with us for "fun" his full time job is an ER doc. We also have lots of former RN's, EMT's, Military Medics, and so on that fly with us as FA's.

Fortunately in every medical emergency I've encountered we've had at least one Doc onboard.

Quoting Fr8Mech (Reply 1): There is no medical O2 on the aircraft, just aviator's breathing oxygen. The regulator on the portable bottle is designed to get the maximum amount of time, at a rate (2-4 lpm) that can sustain life, out of a relatively small (11 cubic feet) bottle.

Aviator´s breathing oxygen and medical oxygen are almost the same. The only difference is that aviator´s oxygen is especially filtered to reduce the moisture content, to prevent the oxygen pressure regulating valves from freezing shut in unheated aircraft at high altitude. For the rest the specs on purity are the same.

Jan

Quoting IAirAllie (Reply 21): We have a pilot who flies with us for "fun" his full time job is an ER doc. We also have lots of former RN's, EMT's, Military Medics, and so on that fly with us as FA's. Fortunately in every medical emergency I've encountered we've had at least one Doc onboard.

What airline do you work for? It seems like for some reason you work for Pace Airlines, I don't know why I think that lol.

Quoting M11Stephen (Reply 23): What airline do you work for? It seems like for some reason you work for Pace Airlines, I don't know why I think that lol.

Nope, I can't really say who I work for. I don't want any possible confusion in people identifying my personal thoughts and opinions with my employer. ie I like my job and don't want to be fired for expressing controversial thoughts. I think it can probably be easily deduced if one had the inclination to read all my past posts though.

Quoting Kimberlyrj (Reply 7): You may have heard of the CAA, that’s who we comply with and yes while airlines need to carry certain drugs and facilities and certain equipment is optional but most of it useless if the crew is not fully medically trained.

But you said the FAA or CAA...

Quoting Kimberlyrj (Reply 5): There is only a recommendation that aircraft should carry defibrillator‘s, there is no FAA or CAA law saying they have to

We've all heard of the CAA.

Quoting Kimberlyrj (Reply 7): My mother who is a surgeon always say’s that the person would have to be minutes from dieing being she would come forward, an opinion which seems to shared with a lot of Doctors and other medically trained staff I have spoken to over the years.

I have had several medical emergencies and never had a problem getting medically qualified volunteers, thankfully. Why did your Mom become a doctor if not to help people in distress?

I've opened many a medical kit in flight, and as I've written in the past, it is scary as s**t. Reply #6 comes about as close as I can recall to drugs on board. I've learned that when I fly, I bring my own albuterol, just to be safe in an asthma attack, as well as my own stethoscope. You can't hear diddly squat with the toy that is packed on board. Getting a blood pressure is always exciting, again, because you really can't hear the brachial pulse. More often than not, I've relied on a palpable pulse pressure for a crude guestimate of systolic pressure, and haven't killed anyone, yet. As I recall, it is a non rebreathing mask, which is fine in most instances, and giving any oxygen at 5-8000' ambient cabin pressure is better than none. As an internist, I'm usually more concerned with my drug supply, or lack there of, than the type of mask and flow rates. The onboard defibrillator (if the Continental ground medical people let you open it, I'm still angry with them over a North Atlantic incident about 2 years ago), will give you a crude EKG tracing. At least you can see an ST wave elevation suggestive of some types of infarction.

My bottom line is that you need O2, adrenalin, atropine, and injectable antihistamine, albuterol, and IV fluids. And you need to get down as quickly as possible once any of those drugs have been administered. Happily, and for unclear reasons, I have not been pressed into action during any of my past 3 trans Atlantic trips. Which means I'm overdue... Hope this helps

Quoting Kimberlyrj (Reply 5): It also comes down to the training of the crew, for example on each British Airways long haul flights there are always two fully trained first aid’s crew, one of which is trained a to an equivalent level of a Paramedic Technician (BA paid for me to become a qualified Paramedic which means I can administer controlled drugs and make medical decisions) which comes in handy when your four hours away form help on the ground.

Does a paramedic there require as much training as here in NY?

Wouldnt an EMT training sufice?

Quoting HAWK21M (Reply 4): There is a regulatory requirement that all commercial Aircraft are supposed to be equipped with First Aid Kits & Physicians kit depending on the Capacity of the Aircraft concerned.There Kits are equipped with the needed drugs/equipment/materials to treat a medical situation in flight.

What kind of drugs can you administer?

Quoting Jetstar (Reply 19): Most soda’s today contain high fructose corn syrup, not sugar, would this be okay to administer in a diabetic emergency.

If the patient is conscious enough to protect his airway, then it is preferable to administer sugar by mouth than by IV. Glucose is the ideal sugar, but any digestible simple carbohydrate (fructose, sucrose, etc.) will work just fine.

If the patient's mental status is depressed to the point where you are concerned that the patient might aspirate something given by mouth into his lungs, then you should place an IV and administer glucose by that route.

Thanks Doc maybe someday that information will safe a life on a flight somewhere.

If they have tablets, the dose is three or four tablets. If a diabetic has decreased mental status, assume the sugar is low. You don't need a fingerstick to confirm that.

If a high-sugar juice is available, give four ounces of it.

Ultimately, as a physician who has responded to multiple medical emergencies in inconvenient settings, here is my job:

1) stay calm
2) take charge
3) delegate jobs ("You, please go call 911." "You, go stand on the street. When the ambulance comes, bring them here." "You, go through her purse and see if you can figure out who she is.")
4) Keep the patient alive and do nothing more than is absolutely necessary to keep the patient alive until the professionals get there. (Including moving the patient out of danger if necessary, etc.)

In other words, if the blood is going round-and-round and the air is going in-and-out and I don't have any reason to suppose that might cease to be the case, then my work is done and I just sit with the patient until help arrives. Anything else I do is likely to harm the patient.

Quoting PGNCS (Reply 25): I have had several medical emergencies and never had a problem getting medically qualified volunteers, thankfully. Why did your Mom become a doctor if not to help people in distress?

Her fear is that in this litigious society, she may have to defend herself in court. Good Samaritan laws will normally protect her, the hassle of defending sucks.

Several years ago, saw a guy get hit on the interstate. I pulled over, along with (what turned out to be a trauma nurse) and 2 others. We performed CPR until EMS arrived. The guy died while we were working him. I wound up giving a deposition in a potential wrongful death suit. It didn't go anywhere, but a little scary.

Quoting DocLightning (Reply 31): In other words, if the blood is going round-and-round and the air is going in-and-out and I don't have any reason to suppose that might cease to be the case, then my work is done and I just sit with the patient until help arrives. Anything else I do is likely to harm the patient.

That Doc, is great advice. Too many folks feel that THEY HAVE TO DO SOMETHING. Sometimes the best something is nothing.

I've been with BA for 15 years as an in charge cabin crew member & have also been involved with safety training over the years & I'd just like to dispel a few myths that have cropped up on this thread.......

Quoting Kimberlyrj (Reply 3): I hate to say it but some airlines (BA and VS included) often carry a type of body bag, just incase…

BA certainly DO NOT carry body bags......

Quoting Kimberlyrj (Reply 5): It also comes down to the training of the crew, for example on each British Airways long haul flights there are always two fully trained first aid’s crew, one of which is trained a to an equivalent level of a Paramedic Technician (BA paid for me to become a qualified Paramedic which means I can administer controlled drugs and make medical decisions) which comes in handy when your four hours away form help on the ground.

All crew are trained to the same level - there is no "Paramedic Technician" level of crew - the only controlled drigs that can be administered are oral painkillers & epipen administered adrenaline - under no circumstances can we administer any drugs by injection - whatever our training previous to joining the airline.

Quoting Kimberlyrj (Reply 7): I can reassure you most American cabin crew are not trained in how to insert a canular and I don’t think they would be authorized to administer hardly any of the drugs that are carried.

Neither are BA crew trained to insert them.........

Quoting Kimberlyrj (Reply 7): Airlines will always call on Doctor, or persons of medicine to come forward, however often when they help they are totally uninsured and over the past few years there have been many court cases and in some cases in the UK Doctors have been struck off the medical register.

They are FULLY indeminified by BA (& all other British airlines.....) should they choose to volunteer their services - IF any UK Doctors have been struck off the register having intervened on a UK registered aircraft it would have been due to professional negligence NOT due to lack of insurance.

Quoting Kimberlyrj (Reply 13): Oh yes, we knew it but that’s what is recommended. Even after this incident and I have heard of quite a few other incidents BA are still saying ‘body bags to be place in the lavatory and the door is to be locked at all times. A sign is to be placed on the door saying “strictly no entry – bio hazard” (a sign we carry ready for use in the cabin).

What body bags??? We certainly do not carry "No Entry - Bio Hazard" signs on BA aircraft......nor do we drag corpses through the cabin to a lavatory that could be some distance away......

Quoting Fr8Mech (Reply 32): Quoting PGNCS (Reply 25): I have had several medical emergencies and never had a problem getting medically qualified volunteers, thankfully. Why did your Mom become a doctor if not to help people in distress? Her fear is that in this litigious society, she may have to defend herself in court. Good Samaritan laws will normally protect her, the hassle of defending sucks.

I understand her concern, but it isn't unreasonable to expect physicians to assist someone having a medical emergency. Certainly in the times I have had a medical problem onboard, the call has been promptly answered, normally by more than one qualified person. I think it's the height of irresponsibility for a doctor to refuse to treat a patient in an emergency.

http://www.pbs.org/wgbh/nova/doctors/oath_classical.html