Flight Training - January 2013 - 34

On March 27, 2012, a JetBlue pilot in command of a flight from New York to Las Vegas had a mental breakdown. After being ejected from the cockpit, he had to be restrained by passengers. The airplane made a safe although unexpected landing in Amarillo, Texas. On March 9, 2012, an American Airlines flight attendant had a mental collapse shortly before takeoff and had to be restrained by passengers and crew. Private pilots carry a medical certificate along with their pilot certificate. They’re screened pretty well to make sure they are physically and mentally capable for the responsibilities of flying. There are rules in commercial aviation, such as cockpit crews not eating at the same time to avoid the potential of disabling food poisoning. So medical emergencies involving cockpit or cabin crew are exceedingly rare. Rare, but not unknown. And medical issues involving passengers are much more common than most people expect. More than 22,000 times in 2011, air crews called an emergency room that specializes in in-flight medical emergencies.

That’s an average of more than 60 times a day. Every day. What do you do when you are a mile above the nearest ambulance?
IS THERE A DOCTOR ON BOARD? I was on a late-night flight from Amsterdam to Minneapolis, in the very last row so I could be near the coffee and conversation in the galley. After dinner, as everyone settled in to a movie or fitful sleep, a flight attendant’s voice came over the PA system. “Attention, everyone,” she said, “we have a medical emergency on board. If there is a physician on board, please make yourself known to the cabin crew.” Two or three people stood up. A flight attendant removed a metal case from a panel in the galley wall, and they all moved forward. Whispers of “heart attack” and “seizure” and “epilepsy” and “diabetes” jumped the aisles, but no one really had a clue. There was a gathering near an exit row, but no panic. No one screamed. After a while, the doctors returned to their seats, and the crew re-stowed the case. The patient was fine—or fine enough. There was a bit of gallows humor from the cabin crew, and some debate about whether or not a seal had been broken on the case, but the weather was clear and Minneapolis was waiting. On the ground, however, I couldn’t stop wondering. In a coffee shop, I stopped another pilot. “What do you do?” I asked. “What are the rules for a medical emergency? How do you decide between returning, continuing, diverting or something else?” More important, I wondered, what I would do if a passenger in my rented Cessna 172 suddenly had a medical emergency? COMMERCIAL AVIATION. Because no one knew how the general population would take to flying, the first commercial flight attendants were registered nurses. That idea quickly proved itself unwarranted, but because of the sheer number of bodies in the sky, medical emergencies on commercial flights are not uncommon. As the flying population ages, the problems become more diverse. Airlines are not required to keep or publish data about medical emergencies in flight. However, the website for the British Medical Journal, in a 2000 article, states, “The commonest reasons for diversion in a recent U.S. study were cardiac incidents (28 percent), neurological problems (20 percent), and food poisoning (20 percent). Other reports have cited severe and uncontrollable pain or bleeding; major injury with shock; impending birth; and uncontrollable mental disturbance.” MedLink, a service of MedAire Inc., handles more than 22,000 in-flight air-to-ground medical advisory calls annually—22,594 in 2011. More than 65 commercial airlines as well as private owners, fractional owners, and a good many Fortune 100 companies pay a membership fee and then have access to doctors practicing in the emergency

MORE SERIOUS MEDICAL ISSUES CAN ARISE AT ANY TIME, IN ANY PLACE, WITH ANYONE.

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Flight Training - January 2013

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