Live data from Hacker News

What happens when you are the doctor on the airplane?

cockeyed.com

21–30 of 201 posts

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

#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.

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

#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 necessary action (Is not going to be easy with such limited capabilities, sometimes is just impossible, but is better an overreaction), is important because commercial planes fly at 8 NM/minute, and depending where are you flying ( flying over the ocean or africa) 10 minute delays could mean another 30 extra min to land or even several hours if you have passed a no return point in the middle of the ocean.

Don´t hesitate to take control of the situation regarding the patient, stewardesses and other passengers:

- Ask for the medikit (only physicians are allowed to use it). I have seen some chief stewardess resisting to bring it, just to avoid having to write the compulsory report. - If it is necessary to lay the passenger on the ground or other seats, bring him water or any other thing, just give the needed orders and ask for help. - Ask the stewardesses to keep other passengers away if they are interfering too much. - As soon as practicable give a report to the captain and if necessary ask him to land the plane. He will be waiting for it. - 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 emergency team can take care of the patient. We apply this in Europe although it is not a written rule, I don´t know how it works in USA. -Remember when in doubt it is better to ask the captain to land. Everybody will lose an hour or two but a live will probably be saved.

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

#23
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…

As a physician, thank you for this. Is there a standard medkit load out?

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

#24
post #14

Earlier quoted context omitted.

intense bladder pains mid-flight which turned out to be the result of downing a huge quantity of beer before the flight and being unable to urinate was that due to the altitude or something else?

The stricken passenger had the option of using the restroom, but for unknown reasons could not urinate. They stretched him out on a row of seats which seemed to help the pain, but from what I recall was unable to go until they reached the destination airport. The total trip time was about three hours.

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

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

#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.

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

#26
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.

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

#27
This happened once to my father on a flight. He's an orthopedic surgeon (the woman in this story really hit the jackpot with an a anesthesiologist--the only thing better would be an ER doc, I think), and someone was having chest pains. He determined very quickly that it was not a heart attack or other critical condition, but through the whole ordeal, the passenger next to the patient (who did not know the patient and had no medical training) kept second guessing my dad's requests and diagnosis. The flight attendants ended up "asking" this other guy to move several rows back to an empty seat.

Everyone's a critic.

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

#28

"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.

When you have a myocardial infarction or acute pulmonary edema inflight, you'll be glad there's morphine available.

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

#29

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.

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

#30

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?
Post reply on HN