In-flight Medical Emergencies
Am Fam Physician. 2021 May 1;103(9):547-552.
Author disclosure: No relevant financial affiliations.
In 2018, approximately 2.8 million passengers flew in and out of U.S. airports per day. Twenty-four to 130 in-flight medical emergencies are estimated to occur per 1 million passengers; however, there is no internationally agreed-upon recording or classification system. Up to 70% of in-flight emergencies are managed by the cabin crew without additional assistance. If a health care volunteer is requested, medical professionals should consider if they are in an appropriate condition to render aid, and then identify themselves to cabin crew, perform a history and physical examination, and inform the cabin crew of clinical impressions and recommendations. An aircraft in flight is a physically constrained and resource-limited environment. When needed, an emergency medical kit and automated external defibrillator are available on all U.S. aircraft with at least one flight attendant and a capacity for 30 or more passengers. Coordinated communication with the pilot, any available ground-based medical resources, and flight dispatch is needed if aircraft diversion is recommended. In the United States, medical volunteers are generally protected by the Aviation Medical Assistance Act of 1998. There is no equivalent law governing international travel, and legal jurisdiction depends on the patient's and medical professional's countries of citizenship and the country in which the aircraft is registered.
Approximately 2.8 million passengers flew in and out of U.S. airports per day in 2018.1 An overhead announcement requesting medical assistance at cruising altitude presents a unique situation for any health care professional given the physically constrained, resource-limited environment. The term “in-flight medical event” is often used interchangeably with “in-flight medical emergency” and includes a spectrum of conditions, ranging from minor to serious.2 There is no internationally agreed-upon recording and classification system for in-flight medical emergencies, and prevalence estimates vary between 24 and 130 emergencies per 1 million passengers.3–5
SORT: KEY RECOMMENDATIONS FOR PRACTICE
A = consistent, good-quality patient-oriented evidence; B = inconsistent or limited-quality patient-oriented evidence; C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. For information about the SORT evidence rating system, go to https://www.aafp.org/afpsort.
SORT: KEY RECOMMENDATIONS FOR PRACTICE
|Clinical recommendation||Evidence rating||Comments|
Medical volunteers onboard the aircraft should consider ethical factors (e.g., appropriate physical and mental condition to render aid, practice within scope of expertise) in response to a request for medical assistance from a cabin crewmember.2,7,8
Expert opinion in the absence of clinical trials
Existing legislation and legal precedence in the absence of clinical trials
Referencesshow all references
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