Flight Training - January 2013 - 35

department of Banner Good Samaritan Medical Center, a Level I Trauma Center in Phoenix, Arizona. According to Heidi MacFarlane, vice president of strategic development, and Erin Mitchell, manager for marketing and corporate communications, the calls run the range from questions about medications to how to handle a sudden cardiac arrest. Thirty-seven percent of the 2011 calls were regarding neurological/neurosurgical issues. Twentyfive percent concerned gastrointestinal questions. Nine percent relayed respiratory concerns, while only 7 percent involved cardiac issues and only 3 percent involved psychiatric problems. Other issues that prompted a call included allergies, orthopedics, ENT, infectious diseases, and trauma. The doctors on the ground have access to the airline database regarding medical equipment on board and guide the cabin crew through whatever medical procedures are necessary. If a diversion is the best option, they can advise which alternate destination has the most immediate and appropriate level of care for the situation.
GENERAL AVIATION. But what about those of us who fly low and slow, who take friends and coworkers for rides, who don’t have a cabin crew or a flight nurse to help if someone gets sick? Motion sickness is the most common medical challenge a passenger in a private airplane will face. And there is a little bag in the airplane (or at least there should be) that does not solve the issue but will accommodate the symptoms very nicely. There are stories, urban legends perhaps, that hint at larger issues. A 98-pound Air Force flight instructor has to reach over and break the nose of a hulking cadet who has a panicked death-grip hold on the stick. A purse strap had to be wrapped around the hands, arms, and neck of a passenger to get them off the controls. Still, more serious medical issues can arise at any time, in any place, with anyone. It could be a panic attack, a heart attack, a seizure, or something as simple as choking. Just like imagining what might go wrong with the engine helps us plan for the emergency we hope will never happen, imagining what might go wrong with the friend in the next seat helps us plan for the best course of action. Tim Meyer is the director of emergency air transport for Sanford Health Systems in Fargo, North Dakota, and oversees a fleet of fixed wing and helicopter medical aircraft. His passengers are, by definition, in the midst of a critical medical situation. However, he says, “We are never in a situation where we have a passenger who might interfere with piloting the aircraft because we have medical staff on board. We have flight paramedics and flight nurses on every flight.” Meyer is also a pilot. Because of his experience with air ambulances, I asked him to imagine what might happen if a passenger in a small airplane had a sudden issue. “It’s possible,” he said, “if the passenger was having some type of seizure, they might stretch and stand really hard on the rudder pedals. It’s possible they might bang against the door and pop it open. Anything’s possible.” The advice is pretty simple. No matter what the medical emergency may be, you cannot help the person until you are on the ground. If you are flying you cannot perform the Heimlich maneuver or CPR. This isn’t a matter of law. It’s a matter of fact. If your passenger has fainted, you have no idea why. It could be nothing at all. It could be serious. The “golden window” for a patient with sudden cardiac arrest is between six and 10 minutes. “The important thing,” Meyer says, “is that a passenger with a medical issue is going to take your attention away from flying the airplane. Remem-

ber the three-step thing we all learn first—aviate, navigate, communicate. You have to fly first. Just land the airplane.” Just as a Coast Guard rescue swimmer sometimes has to dunk or strike a panicked person in the water in order to facilitate the rescue, you might have to take drastic measures to get someone who has grabbed the controls to let them go. It’s a pretty sure bet that whatever you do for the person next to you will be easier to fix than a crashed airplane.
AIR TRAFFIC CONTROL. Should the pilot of a private aircraft declare an emergency if there is a medical issue? From the FAA operations point of view, an emergency is an emergency—it doesn’t matter if it’s mechanical or medical. The whole purpose of declaring an emergency is to gain access to the most immediate and efficient help and clearance possible. According to Robin Mugavero, air traffic manager in Fargo, North Dakota, once a pilot declares an emergency, ATC will do whatever the pilot wants. Depending on the situation, the pilot can turn back, land immediately, or proceed to a destination. It doesn’t matter if the airplane is a commercial flight or a Cessna 150. Once you say you have a problem, ATC’s job is to get you down safely. ATC does not give medical advice. NRST. You cannot attend to a passenger and fly any airplane at the same time. It’s that simple. Hit the NRST button (nearest airport). If you’re flying in an area with a tower, which means a fair bit of traffic, declare an emergency. Land at the very first strip. It doesn’t matter where. If a town is big enough for an airport it is probably big enough for some type of emergency service. There is going to be an EMT, a first responder, a county sheriff, or a medically trained volunteer fire department if not a full-size ambulance service. Dialing 911 on a cellphone will bring at least one of these right to the door of your airplane. You do your passenger the very best service by landing.
W. Scott Olsen is an English professor at Concordia College in Moorhead, Minnesota.
JANUARY 2013 FLIGHT TRAINING / 35

Flight Training - January 2013

Table of Contents for the Digital Edition of Flight Training - January 2013