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What happens when you are the doctor on the airplane?

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

#71

Post by mitchh »

pavel_lishin wrote: post #57
joezydeco wrote: post #35

Earlier quoted context omitted.

Pretty much a collision of unfortunate events. We were at a work function until 2am in London and returned to our room to find it had been robbed. The thieves took his bag which contained his insulin kit. So now it's 3am GMT and he can't reach his doctor in the States. We're supposed to leave at 8am for the flight home. No pharmacy is open and even if they were, they wouldn't help him. Nurses at Heathrow couldn't hel…

Ouch. Were I ever to become diabetic (and manage to figure out my fear of needles), I'm pretty sure I'd carry around spare insulin, like an epi-pen. (Is it something that can be carried around trivially? Or does it need to be refridgerated? You know what, maybe I'll just eat healthier.)

Insulin will last around 30 days unrefrigerated. Refrigerated, it lasts until the expiration date, which is years for the insulin I have.

That said, insulin is used to treat hyperglycemia, which is usually not an acute incident. "Diabetic shock" refers to hypoglycemia, in which the individual needs sugar to raise their blood sugar to normal levels.

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

#72

Post by jQueryIsAwesome »

maaku wrote: post #60
niels_olson wrote: post #24

Earlier quoted context omitted.

Beyond a certain capacity the bladder is no longer contractile and must be catheterized to urinate. Happens every day in the OR or PACU.

Really? What happened before modern medicine? I'm not being snarky: I believe you.. but a burst bladder would be lethal without access to modern medical knowledge. That seems like a epic fail by evolution.

There are lots of epic fails by evolution, is more about quantity than quality so to speak.

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

#73

Post by Dove »

lotharbot wrote: post #69
JshWright wrote: post #53

Earlier quoted context omitted.

That story seems _really_ fishy to me... Why would electrical engineers fly to a conference on a Concorde? What good would an aeronautical engineer be _in flight_?

(Disclaimer: I'm Dove's husband. The man in question is my father in law, and I've heard the story from him firsthand, apparently much more recently than my wife did.) > "Why would electrical engineers fly to a conference on a Concorde?" The airline was moving a Concorde to a different facility (ie, it wasn't part of regular scheduled service). They decided to "upgrade" a bunch of passengers who were scheduled to be…

Ah. I guess it has been some years since I heard the story. Thanks for the correction. :)

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

#74

Post by logjam »

I was half-dozing on a Southwestern flight when a stewardess came on the PA system calling for any physician to identify themselves.

I spoke up, and the crew directed me toward the back. They already had this incredible medical kit opened in the aisle. I mean they had everything....ACLS drugs, defibrillator, suction, a complete mini-pharmacy, and what looked like a few plastic-7 wound and/or trauma kits at the least. I mean, I was practically drooling over this high-tech kit.

Of course, it was also at that moment that I started frantically running through cardiac code algorithms in my head, and pondering exactly how long it had been since I'd actually dealt with a code in a hospital, with plenty of trained staff, lab support, etc.

Of course, it wasn't any kind of life-and-death situation at all - a young person very stressed and anxious about relocating and the actual conditions of the flight, who'd been hyperventilating, hadn't eaten or had anything to drink for many hours, near-syncopal, etc etc.

I tried my hardest, but couldn't think of a single thing to use out of the medi-kit. I wanted to use it.

I just sat down next to her and listened, which is 90% of medicine anyway.

Southwest was great - gave me two round-trip tickets to anywhere for taking a few minutes to talk.

A colleague at University of Hawaii wrote a paper about dealing with psychiatric emergencies in the air. One thing that stuck out in the paper was the interesting phenomenon of what he called "honeymoon psychosis", with one of a young newly married couple away from home for the first time, possibly on their first flight, all leading to some interesting disturbances on those long pan-Pacific flights.

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

#75

Post by cockerham »

cynwoody wrote: post #49
aleyan wrote: post #26

Earlier quoted context omitted.

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 ... In the current case, there is a timestamp of sorts at the bottom of the page: "Updated December 27, 2012 Copyright 2012 Cockeyed.com". Here is blog owner's About page, last updated January 27, 2012: http://www…

Is there some form of timestamp which is better than the full date at the bottom of the page?

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

#76

Post by JshWright »

omegant wrote: post #66
JshWright wrote: post #47

Earlier quoted context omitted.

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...

We don't have inmediate access to a physician via frequency(lime AA seems to have which is great), but surely the ground team would find the airport team if necessary. Mind you that even if you have access to the medical kit, you are not going to use it properly, I have some general knowledge but I can not distinguish an heart atack from a simple pass out. You could easily complicate a simple issue. I carry on my Iph…

I'm trained as a paramedic. I routinely make those sorts of assessments (much more frequently than most physicians, in fact). It's unlikely you carry anything in your medkit that I don't carry in my ambulance.

My question is mostly if the 'physcian' requirement could be circumvented if someone with medical training (other than a physician) were in contact with a physician on the ground. If, for example, I were to explain to a remote physician that there's someone on board who is experiencing A, B, and C, and I would like to do X, Y, and Z. If the doc concurs with the decision, would that be enough, or is there some set in stone policy that couldn't possibly be overridden?

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

#77

Post by loceng »

omegant wrote: post #68
maaku wrote: post #54

Earlier quoted context omitted.

I know I'm going to get down-voted for an information-free post, but I think it's awesome that you're a commercial pilot and participating in HN. It can sometimes get too insular with valley-type techies here. Thanks for participating.

Well I am also founding my own startup..;) so maybe it doesn't count!

I wish there was a better way on HN to know someone's other disciplines. They're usually hidden out of context.

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

#78

Post by omegant »

JshWright wrote: post #76
omegant wrote: post #66

Earlier quoted context omitted.

We don't have inmediate access to a physician via frequency(lime AA seems to have which is great), but surely the ground team would find the airport team if necessary. Mind you that even if you have access to the medical kit, you are not going to use it properly, I have some general knowledge but I can not distinguish an heart atack from a simple pass out. You could easily complicate a simple issue. I carry on my Iph…

I'm trained as a paramedic. I routinely make those sorts of assessments (much more frequently than most physicians, in fact). It's unlikely you carry anything in your medkit that I don't carry in my ambulance. My question is mostly if the 'physcian' requirement could be circumvented if someone with medical training (other than a physician) were in contact with a physician on the ground. If, for example, I were to exp…

Let me check the rules, but I certainly would give you access to the emergency kit, and control over the issue. Your experence and formation is much more related to an onboard sudden problem, than for example a dentist or any other physician who has forgoten basic ER knowledge.

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

#79

Post by larrys »

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…

(Always wanted to be a commercial pilot. My wife also is a physician).

Curious, what is type procedure to verify that someone really is a physician? The OP doesn't mention if a license was checked or otherwise. He relates having to speak to a someone on the ground before he could use the kit but doesn't indicate if any check of credentials was made.

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

#80

Post by herdrick »

I'm a former ski patroller, which is a kind of outdoors EMT / paramedic. Once, on a flight from Seattle to Boston (for a YC interview!) I walked to the aft bathroom only to find a young woman who had collapsed there, still prone and lethargic, with a stewardess standing over her with a look of annoyed disgust. An evaluation indicated she was probably just dehydrated, so I had the still-annoyed stewardess bring her water, which revived her. (Of course I recommended that she see a doc when we landed just in case, but I doubt she did.) After an hour or so we were able to get her back to her seat. The rest of the flight was uneventful. The only thing that never added up was the bizzare attitude of the stewardess.

(edited: semi-conscious -> lethargic)

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