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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?

#151

Post by jeffdavis »

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.

Before modern life, we had plenty of opportunity to urinate well before it became a serious problem.

If we were intelligently designed, after all, I think God would call holding it for hours a "user error" and mark it "won't fix".

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

#152

Post by SeanA208 »

An uncle of mine was in a situation like this once. He was sitting in first class and had to tend to someone in economy class. He decided that it would be best that he stayed by the man he was tending to so my uncle swapped seats with the man's wife. They gave him a bottle of wine for his help but I would have expected something more.

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

#153

Post by lambda »

ilamont wrote: post #4

If you are interested in medical "hacks" on long-distance flights, the award has to go to two doctors who were on a 1995 British Airways flight from Hong Kong to London when a patient had trouble breathing. They determined that the patient suffered a collapsed lung, so they made an incision in her chest, and used a coat hanger, brandy, and a tube from a medical kit to drain the lung. As I recall the story, there was…

This article has a bit more detail about the procedure itself; it mentions the flight attendants assisting, but no nurse:

http://community.seattletimes.nwsource.com/archive/?date=199...

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

#154

Post by miles_matthias »

felideon wrote: post #133
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…

> Also, is it legal to just put a blanket on the guy, pretend he's sleeping, and then deal with it when you get to your destination? Not to sound insensitive, but I wonder what the alternative would be? Declare him deceased and then do what? See this comment elsewhere: "If possible never declare a decease onboard , first you could be wrong!, and it is a bureaucratic mess. Is better to keep trying CPR till the emergen…

Well like my friends experienced, apparently they divert your flight to land and get the person to a hospital (to officially declare him I bet - or maybe just a mortuary?) as soon as possible.

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

#155

Post by bosch »

niels_olson wrote: post #67
maaku wrote: post #60

Earlier quoted context omitted.

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.

http://en.wikipedia.org/wiki/Tycho_Brahe#Death

Now I have something to be paranoid about and will be going the bathroom as much as possible.

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

#156

Post by ig1 »

joezydeco wrote: post #35
pavel_lishin wrote: post #30

Earlier quoted context omitted.

Why would a diabetic person not travel with insulin?

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…

FYI. There's a 24-hour pharmacy in Earl's Court in London (called Zaffash I think)

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

#157

Post by jeltz »

FireBeyond wrote: post #102
JshWright wrote: post #91

Earlier quoted context omitted.

Opioids are rarely in RSI. RSI uses a sedative and a paralytic. The sedative is almost always a benzodiazapine, and occasionally a dissociative or hypnotic sedative like ketamine or etomidate. Morphine would be a _very_ poor choice for a sedative in an RSI protocol.

Actually, no idea why I grabbed onto morphine in that discussion. Our protocols call for vecuronium, atropine, etomidate, succinylcholine. However, we do also use fentanyl if indicated to deal with tachycardia and ICP. One other thing I noted in the original article was bemoaning the lack of pulse oximetry, "to assess if patient was exchanging oxygen". Treat the patient, not the number. If your patient is in respirat…

If I was the patient I would love to hear that my oxygen levels were normal and that I am not at any risk of dying any time soon. I would say treating the patient should include first measuring how urgent it is.

Additionally if you panic you can easily imagine having trouble breathing, or that your trouble breathing is worse than it actually is. I have experienced this first hand when just relaxing removed most of my problems.

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

#158

Post by [deleted] »

cperciva wrote: post #129
Dove wrote: post #51

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…

I must admit, some secret part of me always hopes I'll be in a situation on an airplane where they need an emergency perl script written On a flight from Sydney to Vancouver earlier this year, the in-flight entertainment system on my plane was broken. I spoke up: "Hi, I have a doctorate in computer science and I know a bit about these systems... want me to take a look?" I was surprised when they agreed, brought me up…

[deleted]

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

#159

Post by lotharbot »

TillE wrote: post #136
mkuhn wrote: post #130

Earlier quoted context omitted.

Now I am intrigued and want to hear the other four.

#1 would probably be asking for a pilot. There have been a number of tests on simulators, and pilots licensed for smaller aircraft have a surprisingly low chance of being able to land a commercial jet.

That said, pilots -- or even non-pilots -- can actually do fairly well landing a large aircraft as long as they're being talked through the process by someone experienced.

See http://mythbustersresults.com/episode94

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

#160

Post by nnethercote »

donretag wrote: post #25

"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.

If major turbulence occurs -- enough that passengers are thrown around -- I can see all kinds of uses for morphine.
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