What happens when you are the doctor on the airplane? • Hacker News Board

Re: What happens when you are the doctor on the airplane?

#41

Post by supwiggles » Thu, Dec 27, 2012, 5:02 PM UTC

btilly wrote: post #29

JshWright wrote: post #16

The medical director of my paramedic program used to work for a hospital that provided medical control for a number of major airlines (generally speaking, even when they ask for a physician on a plane, they're also calling the airline's 'on call' doctor as well). His scariest stories weren't due to the criticality of the patient, but rather the incompetence of the provider on board the plane (to the point that he, on…

My wife told me about a famous dermatologist who flies in dread of getting that call and there being no other doctor available. When med school was 40 years ago, you're not necessarily going to be comfortable handling, say, a heart attack.

One of my paramedic instructors told me a pretty funny story.

Apparently they were on shift one Saturday afternoon, when a call came through for a Code 2 (Cardiac Arrest) at a local racecourse.

Anyway, it was about 15 minutes away so they took off in a hurry, all the while receiving notes on their terminal regarding the job. Apparently it went along the lines of this:

Initial: Unknown Age, Cardiac Arrest, Racecourse etc Update: CPR in Progress Update: Doctor has self accounced at scene. Update: Doctor has called patient as deceased. CPR ceased.

It took another 5 minutes for the paramedics to get to the racecourse, and they still unloaded their gear and made their way to the patient. When asking for the doctor, they found that it was actually the racecourse veterinarian who had made the call.

Re: What happens when you are the doctor on the airplane?

#42

Post by lurkinggrue » Thu, Dec 27, 2012, 5:09 PM UTC

Oh stewardess, I speak jive.

Re: What happens when you are the doctor on the airplane?

#43

Post by ubernostrum » Thu, Dec 27, 2012, 5:11 PM UTC

e40 wrote: post #37

miles_matthias wrote: post #31

Okay, I'll share random doctor flight story - last week some family friends were flying to Hawaii for vacation, and a man across the isle said he had been on vacation for several weeks and didn't bring enough heart medicine. He said he would just get some more when he got home, but halfway through the flight he slumped down in his chair, unresponsive. There was a doctor on the flight that used a stethoscope to find t…

It's a little surprising to me they didn't even attempt CPR.

Remember that CPR will not restart a stopped heart. CPR's only use is to maintain some blood/air flow until you can get to a defibrillator or life-support machinery, in hopes of preventing damage to the brain or other vital bits.

And unless it's started pretty much immediately, it won't even accomplish that, which makes it futile.

Re: What happens when you are the doctor on the airplane?

#44

Post by stephencanon » Thu, Dec 27, 2012, 5:11 PM UTC

pavel_lishin wrote: post #30

joezydeco wrote: post #21

I'm curious if insulin is a standard part of the medkit. I was on a transatlantic crossing once with a coworker who went into diabetic shock (that's another long story). A nurse was onboard the flight but no insulin. We had to divert and my coworker was laid up in a Newfoundland hospital for 3 days.

Why would a diabetic person not travel with insulin?

Stupid diabetics exist, just like in the rest of the population (though it sounds like the diabetic in this case was just unlucky, from the grandparent's followup).

Re: What happens when you are the doctor on the airplane?

#45

Post by cynwoody » Thu, Dec 27, 2012, 5:13 PM UTC

melvinram wrote: post #3

I'm confused. Why is this on HN?

Because hackers use their wits and experience to deal with strange circumstances under less than ideal conditions. As do docs on planes.

It's a first-rate submission.

Re: What happens when you are the doctor on the airplane?

#46

Post by JshWright » Thu, Dec 27, 2012, 5:14 PM UTC

joezydeco wrote: post #21

I'm curious if insulin is a standard part of the medkit. I was on a transatlantic crossing once with a coworker who went into diabetic shock (that's another long story). A nurse was onboard the flight but no insulin. We had to divert and my coworker was laid up in a Newfoundland hospital for 3 days.

Insulin isn't something you need acutely. Insulin is used to treat _hyper_glycemia (blood sugar too high). This is a gradually developing condition, and someone couldn't go from 'normal' to 'critically ill' over the course of a flight. EDIT: reading your description below regarding the stolen meds, this seems reasonable. He likely _was_ experiencing some symptoms of hyperglycemia even as you were boarding.

The most common type of 'diabetic shock' is _hypo_glycemia (blood sugar too low). The treatment for this is simply sugar (if the patient is conscious, they can take it orally, if they're unconscious, then they need an IV with Dextrose).

I suspect most airline medkits carry dextrose (the one mentioned in the article did). I would imagine many of them carry glucagon as well (glucagon can be injected into the muscle, which is quicker and easier than establishing an IV, and it signals the liver to release its glycogen stores (by breaking it down into glucose (sugar))).

I imagine insulin is very rare. It doesn't keep for terribly long, most types need to be refrigerated, and the most common use cases are for things that don't come on 'suddenly' (generally someone experiencing severe hyperglycemia has had symptoms for hours or even days).

Re: What happens when you are the doctor on the airplane?

#47

Post by JshWright » Thu, Dec 27, 2012, 5:18 PM UTC

omegant wrote: post #22

I have had several medical emergencies onboard as a pilot. One thing I constantly say to physician friends (my wife is a doctor), is that we (the crew) expect from them to make as fast assessment of the situation as possible. For example in my company we don´t have an online doctor to ask for help, so the volunteer has to take care of the situation. Recognizing the problem as soon as possible and prescribing the nece…

Do you have access to an on-call physician? Would a provider at some level less then 'physician' (e.g. nurse practitioner or paramedic) be able to use the kit if they're in contact with a physician?

It would be extremely frustrating to watch someone die (or at least get sicker), knowing there was equipment on board that could help them...

Re: What happens when you are the doctor on the airplane?

#48

Post by pyre » Thu, Dec 27, 2012, 5:21 PM UTC

supwiggles wrote: post #41

btilly wrote: post #29

Earlier quoted context omitted.

My wife told me about a famous dermatologist who flies in dread of getting that call and there being no other doctor available. When med school was 40 years ago, you're not necessarily going to be comfortable handling, say, a heart attack.

One of my paramedic instructors told me a pretty funny story. Apparently they were on shift one Saturday afternoon, when a call came through for a Code 2 (Cardiac Arrest) at a local racecourse. Anyway, it was about 15 minutes away so they took off in a hurry, all the while receiving notes on their terminal regarding the job. Apparently it went along the lines of this: Initial: Unknown Age, Cardiac Arrest, Racecourse…

Are you implying that the emergency call was for a horse/dog in cardiac arrest, or just that the racecourse vet was the 'doctor' performing on the human?

Re: What happens when you are the doctor on the airplane?

#49

Post by cynwoody » Thu, Dec 27, 2012, 5:24 PM UTC

aleyan wrote: post #26

yycom wrote: post #7

Unreadable on mobile (pre text or something preventing reflow). And no byline or date, so completely useless. Fuck off basically.

Outside of the parent's bad attitude, he does have a good point. No timestamp on the article makes it hard for me to place the story in context. It is one of my pet peeves when I come across some morsel of information online but I can't evaluate if it is still applicable because there is no timestamp anywhere.

That's a pet peeve of mine, also. There's usually a date, but often not near the top and/or not in a standard format. Then there are these sites that use relative times, e.g., 0 minutes ago, or 865 days ago ...

Here is blog owner's About page, last updated January 27, 2012: http://www.cockeyed.com/personal/about.html.

Re: What happens when you are the doctor on the airplane?

#50

Post by snowwrestler » Thu, Dec 27, 2012, 5:26 PM UTC

e40 wrote: post #37

miles_matthias wrote: post #31

Okay, I'll share random doctor flight story - last week some family friends were flying to Hawaii for vacation, and a man across the isle said he had been on vacation for several weeks and didn't bring enough heart medicine. He said he would just get some more when he got home, but halfway through the flight he slumped down in his chair, unresponsive. There was a doctor on the flight that used a stethoscope to find t…

It's a little surprising to me they didn't even attempt CPR.

Or hook up an AED.