The Boon and Bane of a Flying Doctor

Recently we read in Daijiworld an incident where an Air India express flight made an unscheduled return to Bajpe airport to offload a sick passenger bound to the Gulf. This must have raised the questions in many a people’s minds as to what happens if one falls suddenly ill while flying on an aircraft.

If you are lucky the aircraft may be carrying some basic life support equipment and medicines. Though the cabin crew are trained to offer basic life support they are not allowed to administer any medicines to patients.  You are very fortunate if a doctor who is properly trained in life support is on board.

Some years ago I was on a flight from London to Mumbai when the captain announced if there is a doctor on board to come to the front cabin as someone needed medical help. I learnt that a female passenger in her mid fifties  had suffered a heart attack. Luckily for her I was carrying some life saving medicines in my hand bag as I was traveling to India after hearing the news that a close relative of mine had suddenly fallen ill .

Those days medical equipment on board aircrafts was insufficient to treat medical emergencies. I could successfully treat this lady and advise the captain not to land at Teheran for an emergency as Iran was in turmoil those days and the patient was stable enough to fly another 2 hours to Mumbai. While thanking me profusely for the help rendered the captain told me that a couple of weeks earlier under similar circumstances a passenger died of a heart attack as there was no doctor on board to render timely help.

Two things stood fresh in my mind when I returned to England where I was employed those days after this episode. My close relative had died before I could reach Mangalore and offer any medical help for his sudden illness. There was a letter for me from the patient I had treated onboard thanking me for saving her life which forwarded by the airline . Ironically , I could save a patient flying 30,000 feet above while I did not even get a chance to save someone on ground!

During the course of the years while flying I had many more opportunities to attend to medical emergencies on board of aircrafts. Hence when a private institute in Germany offered a diploma called Flying Medical Doctor, I was one of the first to register and obtain this qualification . The course included intensive training in Aviation medicine and life supporting techniques under the difficult and space limiting circumstances in the sky on board an aircraft, which included training with flight simulators of Lufthansa, the national carrier of Germany.

Presently this training is also offered by Airbus Industrie at Toulouse ,France and soon one such course will also take place in Abu Dhabi with the help of Ethiad and the UAE Air force

Although these courses are quite expensive and time consuming, some Doctors opt to do them mainly to act as a “GOOD SAMARITAN “ and not so much for a monetary benefit.

Most of the renowned airlines compensate for the services in anticipation. While checking in if a Doctor identifies himself as a specially trained  flying doctor, an upgrade to a higher class is considered. This will not only make the doctor comfortable but is close at hand when a medical emergency occurs.

Although most of the Intercontinental flights carry sufficient equipment for basic life support, medicines to be used by a Doctor who may be present, oxygen cylinders and even Automated Electric Defibrillators ( AED ) to treat life threatening heart rhythm disturbances  are not available. Our airlines from India flying to the Gulf lack some of this equipment.


HOW  CAN ONE AVOID OR DEAL WITH  A MEDICAL EMERGENCY ON AN AIRCRAFT?

First and foremost , find out from your house physician if you are fit to travel if suffering from acute or chronic illness and carry your medicines to be given in an emergency. This applies to heart ailments like Angina pectoris, after recent heart attacks, blood pressure problems, diabetes, asthma, epilepsy, allergy etc.

If travel is inevitable, it is better to carry a medical note from your house physician indicating the nature of your illness and the appropriate treatment in an emergency because the Doctor you might get on board may not be trained to handle acute medical emergencies at all.

This also applies to pregnancy though it is not an illness. Most airlines demand a medical clearance in the third trimester of pregnancy to fly.
 

DILEMMA FACING DOCTORS WHO MAY WANT TO HELP.

On a flight from U.S.A. to Europe a person suffered a heart attack. (Acute myocardial infarction) Two Doctors on board both gynecologists who were on the way to Italy to attend a medical conference responded to the pilots request over the Atlantic rendered medical help to the patient.

But unfortunately the Patient did not respond to treatment and being over the Atlantic no airport was within reach for an emergency landing , the patient died. The relatives of the patient came to know that the doctors were gynecologists and sued the Airline and both the doctors. So the Doctors were in trouble for trying to help the patient.

For doctors who may not be well versed in treating acute medical emergencies there could always be expert help available.  Most of the airlines subscribe to a service rendered by medical experts located in the Far East who are available round the clock to give advice over radio contact if the pilot of the aircraft requests for it at the request of the Doctor on board.

Though the journey on an aircraft may be pleasant for most passengers who may not even think that someone can fall ill on the flight, it is better to be aware of the problem in case of an unexpected emergency.

by Dr. Ben Rebello, Abu Dhabi
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Comment on this article

  • Ben, Mangalore/Abu dhabi

    Mon, Aug 31 2009

    Dear relatives, friends, colleagues, classmates ( cyril ) & well wishers, I am pleased to learn about your interest & comments on my article. It encourages me to write more such articlesin the future. For Drs Praveen and Desmonds enquiry the cource on aeromedicine in Abu dhabi takes place from 8th till 12th november fulltime. fee is UAE dhs 5600! if you need further information kindly email me on and i will send you the details. for the course in Germany and france contact info@medifan.com regards, Ben

  • Praveen Bangera, Kaup/Dubai

    Sun, Aug 30 2009

    A fantastic article. Thank you Daiji and offcourse thanks Dr. Mr. Ben.

  • DESMOND D''CRUZ, Kinnigoly/Abu-dhabi

    Sun, Aug 30 2009

    Hi Ben, your article is very useful to all of us .I want to know how to apply for this.Similar opinion from Sonia.

  • CYRIL MASCARENHAS, DAMARSAKATTE/MIRA ROAD

    Sun, Aug 30 2009

    CONGRATES,AND WELL DONE DR.BENEDICT REBELLO.ALL THE BEST.

  • Dr Praveen, mangalore

    Sun, Aug 30 2009

    Dear dr Ben, congrats on your article. I was called in recently to help on a short flight from Bangalore to Mumbai. a young man had hemetemesis.  I got the captain to authorise me to open the emergency kit .   I found his BP was high. I was ready with medicines from the kit.but he was fine with just reassurance.yes the kit in the aircraft is pretty basic. No defibrillator, but they do have some oxygen tanks which is a must in jets anyway. The staff on board were not even aware what is inside it. How expensive is this flying doctors course was just curious.  Thanks anyway

  • Brian A. D''souza, Bandra, Mumbai

    Sun, Aug 30 2009

    Congrats! wish you all the very best Dr. Ben

  • Celine C. Pinto, Mangalore

    Sun, Aug 30 2009

    Congrats! Good job you did to save one life. I appreciate your self less service to the needy patient. All the best to you in your future days.

  • A.S.Mathew, U.S.A.

    Sat, Aug 29 2009

    It is a very interesting and informative article. I do remember an event while flying from NY to Frankfurt on a TWA plane. one lady from Iran, after her medical treatment in the U.S. was returning to Iran. She did''t speak English. She got sick over the Atlantic ocean, three Doctors went to help her, but the language problem made the matter very confusing. However, the flight was diverted to Gander (Newfoundland) and she was shifted to the hospital. Dr. Rebello''s ariticle will shed light on a serious problem of medical emergencies while flying, especially in long haul flights.

  • Jossie Mascarenhas, Bajpe, Dubai

    Sun, Aug 30 2009

    Nice article. Dr. Ben, as I know you personally you have served in Dubai as well as Abu Dhabi besides being in Germany, you sure are a boon for Mangalorean people in the UAE. We need more such thought-provoking articles in common man’s language, specially on medical issues. What about the swine flu which is currently sweeping the world ? Keep writing sir. Thanks

  • olivia, bendore/bangalore

    Sat, Aug 29 2009

    Very interesting & illuminating .

  • William Sequeira, Suratkal / Dubai

    Sat, Aug 29 2009

    Very informative article Dr Ben .Looking forward to more contributions from you on Daiji World.

  • Loveina Noronha, Mangalore/Bangalore

    Sat, Aug 29 2009

    Congratulations!!!! A well written article.

  • Mariet Castelino, Mangalore

    Sat, Aug 29 2009

    I sincerely appreciate your effort in taking various courses to get trained on Aviation Emergency Medicines. I feel young doctors should take your advice and example and go in for this , so that they too can be a boon to fellow air passengers..Not that you are saved or become worse is the matter of concern, but the very fact that the patient is in safe hands of a doctor itself ,may help the patient feel better. Thank you for making the air passengers aware of their responsibilities too, especially of carrying sufficient information along with them to get help. congratulations and keep up your self less service.


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