Download Airplane Medicine Questions

Airplane Medicine
The objectives of this Friday School Session are:
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Know the top 3 medical issues that can arise while on an airplane
Know the medical equipment most likely to be available on an airplane
Know the procedure and indications for diverting a plane
Know the approach for treating a pt with syncope on an aircraft
Be able to start an IV on a patient
Background:
You were asked to read NEJM: Outcomes of Medical Emergencies on Commercial Airline Flights, and In-flight Medical
Emergencies from the Western Journal of Emergency Medicine which were emailed to you. The following questions are
based on those readings.
While you do not need to provide answers to the following questions, your answers will be discussed with your Friday
School Faculty member.
1. What is the approximate incidence of in-flight emergencies?
2. What are the top 3 medical emergencies on an aircraft?
3. About what percent of medical emergencies was a physician present for in the study cited by NEJM?
4. About what percentage of pts ultimately went to the hospital via EMS?
5. Does the airplane crew consult with a medical service on the ground?
6. What are the most common medications used on an airplane?
7. Not a question, but be sure you know how to operate an AED:
8. Is there an emergency medical kit on airplanes?
9. Be familiar with what is available in the Basic Medical Kit.
10. Can a physician be sued for helping on a plane?
11. Approach to syncope on a plane?
12. Know the algorithms presented in Table 3 of the NEJM article on approach to a medical emergency on a plane and in
the Table 5 of the Western Journal of Emergency Medicine.
13. Understand the pulmonary stresses of airtravel. The partial pressure of oxygen at 8000ft (which is what the cabin is
pressurized to) is 118mmHg (it is 160mmHg at sea level). That is about the same as is found in Aspen, CO.
Patients with COPD, ILD, or pulmonary HTN are at risk of developing hypoxia.
14. List some sx of hypoxia:
15. Don’t forget to screen your pulmonary patients prior to going on a flight. Those with relative hypoxia should either
not travel, or travel with O2. There is a special tank required on an airplane, and the pt needs to contact the airline for
procedures ahead of time. Often requires physician documentation.
16. Appreciate the cost of diversion of an aircraft: can be up to $100,000.
17. Recognize that treatment with an antiemetic has been shown to decrease the diversion percentage from 5.4% to 0.9%
in one retrospective analysis.