Medical emergencies at 30,000 feet: What really goes on up there?

Medical emergencies occur on commercial flights about 50 times per day in the U.S. (2). An increase in air travelers combined with an aging population has heightened the risk of such scenarios (1).

Innumerable variables affect the gravity of in-air emergencies, including differences in: airlines’ procedures, airline training and experience, passenger populations on board, available equipment, potential language barriers, and more (1).  

Common in-flight emergencies require quick responses from the trained crew members. A passenger may contract an illness, requiring both attentive care but also isolation from other passengers to limit a contagion’s spread (2). A passenger might also experience the effects of a pre-existing condition, such as a cardiovascular episode in response to the reduced cabin pressure (1).

The three most common medical situations in the air are:

  • fainting or dizziness from a dip in blood pressure (37%),
  • gastrointestinal problems (10%), and
  • respiratory symptoms (12%) (3).

Common symptoms brought on by the stress and conditions of flying include dizziness, shortness of breath, nausea and vomiting, chest pains, and headaches (2). In most cases, the plane’s first-aid kit contains sufficient remedies for these ailments.

Medical situations can quickly become emergencies if a passenger suffers a heart attack, seizure, stroke, asthma attack, or goes into premature labor (1). These emergencies may cause the flight to be diverted to the nearest airport to expedite the passenger’s transfer to a hospital (2).  The first challenge, however, is determining whether a passenger is suffering from a non-serious illness or a life-threatening event, as symptoms often overlap.

Crew members typically bear the responsibility for diagnosing and assessing the severity of a passenger’s illness (1). And since 1985, they’ve been helped through that process by Med-Link, a phone service by which in-flight crew members can connect with trained emergency physicians (1). Of course, any medically-trained passengers will also be called upon to assist with triaging the ill passenger’s symptoms (2).

The frequency of in-flight emergencies – which only afflict about one in six hundred flights – recently made headlines when actress Carrie Fisher suffered an ultimately fatal medical event in the air.  In late 2016, Ms. Fisher was aboard an 11-hour flight from London to Los Angeles when she went into cardiac arrest (4). The crew gave her emergency CPR until paramedics took over when they arrived in Los Angeles.  Some news sources reported that she stopped breathing for up to 10 minutes in-flight, however, before being taken to the hospital where she died just four days later, on December 27 (5).

Ms. Fisher’s heart attack was not provoked by any malfeasance by the airline and thus does not qualify as an “accident” that might trigger potential legal consequences (1). The distinctions between many medical events and accidents may seem blurry, but the terms have been defined by the U.S. Supreme Court to lend clarity. In this context, an “accident” is “an unexpected or unusual event or happening that is external to the passenger” (1). In contrast, medical crises like those suffered by Ms. Fisher are “internal” events unique to the passenger (1).

Sources cited:

(1)   Clyde & Co LLP, Is There a Lawyer On Board? Lexology (Mar 3, 2017).

(2)   Patrick Skerrett, Is There a Doctor On Board? STAT (Nov 24, 2015).

(3)   Ben Tinker, Sick and Dying at 30,000 feet, CNN (Mar 3, 2016).

(4)   Sierra Marquina, Carrie Fisher, Debbie Reynolds Causes of Death Revealed, Us Magazine (Jan 9, 2017).

(5)   Char Adams, Carrie Fisher Texted About Her Mom Before Boarding Fatal Flight to LA, People (Jan 3, 2017).

 

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