81–90 of 201 posts
"The medikit was actually really comprehensive ... that contained ... even morphine." I am surprised that it contained morphine. Pain killers would not help much in resolving whatever medical issue is occurring. Besides, is it not dangerous to report the fact that morphine is available on a flight? Some medkits are easily accessible and can be taken when the flight attendants are not looking.
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.
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...
Everything in that bag is likely able to be used autonomously by a paramedic - it deals with acute care, not chronic, which unsurprisingly is what paramedics are used to dealing with:
* childbirth * airway management / ventilation, up to emergency cricothyroidotomy * ET / NG intubation, including RSI (rapid sequence induction, essentially sedation, anesthetization in preparation) * bleeding control / fluid resuscitation * pain management * seizure / neurological * cardiac events, drug administration, manual and automated defibrillation, pacing * diabetic * overdose / poisoning * less common on an aircraft, but trauma, including burns * medication administration via IV/IM/IO routes
Most paramedics work almost entirely autonomously via protocols and training, and do not require direct physician approval for drug administration (as opposed to nurses). This range of drugs is quite extensive (my county allows approximately 40, including adenosine, amiodarone, atropine, dopamine, etomidate, fentanyl, morphine, midazolam, lidocaine, furosemide, promethazine, succinylcholine, vasopressin).
Earlier quoted context omitted.
I'm assuming the patient wasn't a racehorse? If I had a dollar for every time a dermatologist or podiatrist tried to be 'helpful' on an emergency scene... I could probably buy a coffee at Starbucks... The same goes for 'nurses.' If an ER nurse wants to help out, that's great. Invariably though, it's a nurse at a nursing home or dialysis center... I don't mean to imply these folks aren't skilled professionals, but pre…
Unlike a podiatrist, a dermatologist went to medical school. If they're young, there's actually a good chance that they were among the very best medical students -- in the past few years, dermatology has become one of the more competitive fields in medicine because of the lifestyle (short predictable hours, high pay, minimal insurance hassles). There are daft people in every field, but I would be delighted to have mo…
Like I said, I'm not try to discredit these folks as skilled (and in many cases, extremely smart) individuals.
However, a couple weeks of a rotation through an ER during med school isn't really going to prepare you well for prehospital emergencies (SAR, on the other hand, can be great training for that). Making an assessment and clinical decisions based on fairly limited information isn't something I've found most physicians to be comfortable with, especially in an emergency setting.
My list of 'glad to see you' docs is pretty much: ER, OB, and Anesthesia.
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 wa…
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…
Earlier quoted context omitted.
There is an ICAO recomended kit list, but usually is more extensive than that, I have our company list (I'll search it and post it later) but trying to find if there is a more general one. Now a days there are also automatic defribilators (spelling?) in transoceanic planes. There should be some kind of general briefing for physicians, from airlines and medical asociations.
I believe this document has the current ICAO med kit. Interestingly, I work with the guys who draw up these supply lists for naval ships, and we're chopping one now. Will definitely include this in the discussion. I really hope you can send me your company list. http://www.asma.org/asma/media/asma/pdf-policy/2007/airline-...
My dad, an electrical engineer, was once on his way back from a conference with a Concorde flight full of other EEs. In the air, the stewardess asked, "Is there an engineer on board?" Everyone responded enthusiastically. She was forced to clarify, "Is there an aeronautical engineer on board," to disappointment all around. I must admit, some secret part of me always hopes I'll be in a situation on an airplane where th…
One of the top 5 questions you don't want to hear over the loudspeaker while flying on a supersonic jet.
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 wa…
How did you get the water into someone who was semi-concious?
In retrospect I should have given her honey or the like just in case she was having her first ever diabetic shock.
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…