# Interesting experience at 30,000 feet



## SafetyPro2 (Dec 31, 2004)

So, was flying back home from the in-laws today, on a flight from Indianapolis to Dallas, then onto LA. I'm thoroughly engrossed in "The Complete Adventures of Sherlock Holmes" when I hear, over the PA:

"If there is a doctor aboard the aircraft, please ring your call button."

Not hearing any rings, as the flight attendant comes down the aisle, I say "I'm an EMT if that's any help." He says that they think they've got him [the patient] under control now, but will call on me if they need.

So, we cruise along, and then over the PA comes the announcement that we've been cleared for a priority landing because they "kinda declared a medical emergency" (I swear he said "kinda") and would we all kindly stay in our seats when we land so that the EMS crew can come in. We land, taxi straight to the gate (quickest taxi I've ever had) and in come two DFD paramedics and an airport cop. At first they were gonna deplane us one row at a time to keep the aisle relatively clear, but the medics decided we could all deplane before they took the patient off.

Never did get to see the patient or find out exactly what was going on, but I overheard the flight attendant talking with the co-pilot and saying something along the lines of "Yeah, apparently, if he yawns wrong, he sometimes stops breathing." 

I was sorely tempted to go back and see, but I figured offering my services to the crew was as far as I could go, and if they didn't ask for it, it wasn't really my place to intrude (I know there's things they can do that I'm not even allowed to anyway) and I don't think there was really anything I could do that they hadn't already done (saw them returning a BP cuff, steth and O2 kit to the front shortly after the first announcement). Besides, at 30,000 feet and over Texas, I'm really just a well-trained layperson anyway. Anyone else ever had an experience like this on a flight?


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## Phridae (Dec 31, 2004)

Sounds like quite the experience.  I've never flown anywhere, so I really dont know what its like to be there and not be able to do anything. I've never been in that sort of situation anywhere yet.


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## rescuecpt (Dec 31, 2004)

It depends who the crew is.  A friend from my critical care class was on his honeymoon - his wife is a P, and someone was having chest pain.  The attendants called for help and the couple pressed the call button.  They went to the front of the plane where the flight staff had their own (airline) medical control on the phone.  The flight attendants looked at their c-cards, gave the info to medical control, and medical control gave the flight attendant permission to open the drug box (drug box!!!) and then spoke to the medic.  They started a line, gave some nitro, made an emergency landing, and off the patient went.  I wish I knew which airline that was, because it sounds like medically the best place to be if something is going to happen!  I always carry my card with me now, just in case.


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## PArescueEMT (Dec 31, 2004)

Here, we aren't truly "official" unless we carry our c-card and CPR card. If the state wanted to, they could take your truck out of service for "improper personnel"

Happens quite often in NJ.


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## SafetyPro2 (Dec 31, 2004)

I always carry my EMT license and current CPR card in my wallet. Of course, my department also issues wallet badges, so that's in there too.

Its amazing to me what the FAA allows/requires flight crews to do, but it makes sense. Even if you're over an airport when something happens, its probably gonna take 20 minutes at least to get clearance and be able to come around for a landing.


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## rescuecpt (Jan 1, 2005)

> _Originally posted by PArescueEMT_@Dec 31 2004, 11:07 PM
> * Here, we aren't truly "official" unless we carry our c-card and CPR card. If the state wanted to, they could take your truck out of service for "improper personnel"
> 
> Happens quite often in NJ. *


 Copies of my card and license are kept in all of the ambulances I ride in.  What I meant was that I didn't usually carry my card when I travel by plane, but now I do.


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## ffemt8978 (Jan 1, 2005)

I always carry my cards (EMT, CPR, Instructor) with me because I've had a couple of incidents where I responded to a call and had to prove my credentials to a self identified "nurse" on scene before they would let me assume pt. care.  The funny part is they did not have their credentials with them, so I got to treat them like any other bystander and tell them to step back away from MY patient.


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## Jon (Jan 2, 2005)

> _Originally posted by ffemt8978_@Jan 1 2005, 12:31 PM
> * I always carry my cards (EMT, CPR, Instructor) with me because I've had a couple of incidents where I responded to a call and had to prove my credentials to a self identified "nurse" on scene before they would let me assume pt. care.  The funny part is they did not have their credentials with them, so I got to treat them like any other bystander and tell them to step back away from MY patient.    *


 AMEN.

I know some people who don't carry wallets, and work for only one squad. they actually have laminated their CPR and EMT cards and keep them on the squad ID tag.

Wouldn't work for me - I'd need a bunch of copies, wouldn't be covered to play whacker off duty, and I can never remember my ID badge anyway    :lol: 

Jon


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## MMiz (Jan 2, 2005)

Interesting story!

I used to fly 3-4 times a year but now only fly one or two round trip flights.  I've never had a medical emergency, and question if I'd offer myself in all situations.  I guess I'd have to be there to decide, but this is the same "Do you stop or keep driving" question I've posted before.  If I was the only one I'd gladly volunteer, but otherwise I'd let others step forward.

I know doctors who have not volunteered because of liability reasons, and wonder if I could be held liable too.  Without med control, and as a relatively inexperienced EMT I'm not sure what I could do.  I've only seen meds pushed through an IV once or so, and that was years ago.  I've never seen an injection directly into a person's flesh (beyond our EPI pens).  I still have lots to see.


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## ffemt8978 (Jan 2, 2005)

The liability issue you raise has some interesting possibilitiies.  First of all, you would be protected under the Good Samaritan Law of what ever state you happen to be over at the moment, provided you meet all of their criteria (not negligent or reckless, don't accept payment of any kind, act as reasponable person would, and don't act beyond your training).  Also, your malpractice insurance (if you have it), should cover you in situations like these.

The issue of not going beyond your training is what could get you into the most trouble.  You might be able to do needle decomp's where you live as part of your job, but you would get into serious trouble if you did it on your own outside of your response area.  The same applies to being in an aircraft.  You would have to follow all laws of the state you are over at the time, so you're better off sticking to just the first aid level of care.

I do know that all 50 states have their own version of the Good Samaritan Law, but I can't find the page that has links to all of them at this time.


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## rescuecpt (Jan 3, 2005)

You would have the airline's medical control, and as long as you do what they say and stay within your level of training (don't push drugs if you're not trained to do so!) you should be covered by Good Sam and/or the airline's insurance policies.


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## SafetyPro2 (Jan 3, 2005)

> _Originally posted by rescuecpt_@Jan 3 2005, 09:32 AM
> * You would have the airline's medical control, and as long as you do what they say and stay within your level of training (don't push drugs if you're not trained to do so!) you should be covered by Good Sam and/or the airline's insurance policies. *


 Bingo. As soon as they make that "Is there a physician on-board?" announcement and they accept your assistance, it should be on the airline from a liability standpoint (so long as you stay within scope).


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## Summit (Jan 3, 2005)

I spoke with a medic about this. I was told that lawyers often will go through the passenger manifest after an incident and research everyone. If they find out you had training and didn't assist they will try to get a party to sue you. Sounds insane!

As far as following the laws of the state you are over, I don't think that state laws apply to airplanes. If you start treating over your own state do you stop treating the moment the plane flies into another state? Or what if you are headed towards your state? "Sorry Ma'am I know your husband is dying but I can't execute lifesaving procedure X until the plane flies another 50 miles." I'm pretty sure different rules apply to planes. What those are I have no clue.

Mapractice insurance? For EMTs? More info please.


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## ffemt8978 (Jan 3, 2005)

> _Originally posted by Summit_@Jan 3 2005, 11:50 AM
> * Mapractice insurance? For EMTs? More info please. *


 HPSO


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## Summit (Jan 3, 2005)

But but but that coverage seems way to good to be true... malpractice PLUS a $1M general liability umbrella policy PLUS they are gonna reimburse me for bandages I use to fix some guy outside my job?

Are they for real? Are they reliable? Will they actually do what they say?


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## rescuecpt (Jan 3, 2005)

Sounds really inexpensive to me - my scuba instructor liability insurance is $700 per year... but that assumes I'm teaching everyday as my job.  I would think this insurance only covers you when you're not working or volunteering with an organization - basically when Good Sam should be covering you - so it is less expensive because the amount of incidents it actually covers is less.


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## Summit (Jan 3, 2005)

"HPSO provides coverage 24 hours a day whether you're on the job, off-duty, and even if you change jobs. Whether you are employed, self-employed or a student."
Basic intermediate fulltime employed yearly premium $148. That just seems way too cheap.

Rescuecpt: who is your dive instructor insurance through and who do you instruct for?


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## rescuecpt (Jan 3, 2005)

> _Originally posted by Summit_@Jan 3 2005, 08:16 PM
> * "HPSO provides coverage 24 hours a day whether you're on the job, off-duty, and even if you change jobs. Whether you are employed, self-employed or a student."
> Basic intermediate fulltime employed yearly premium $148. That just seems way too cheap.
> 
> Rescuecpt: who is your dive instructor insurance through and who do you instruct for? *


Since I don't get paid to be in EMS I was speaking from a volunteer perspective about only being covered for a few things.  I think it's a bout $75 for vollies. 

I'm a PADI Master Scuba Diver Trainer.  The insurance is Vicenzia and Buckley (the rate PADI negotiates, and they accept few others).


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## ffemt8978 (Jan 3, 2005)

It does sound to good to be true, but consider a couple of things.  First of all, if you get sued for malpractice, it will probably be for more than your policy coverage.  Secondly, the number of EMT's being sued for malpractice is relatively small compared to doctors (probably because of the deep pockets theory and our scope of practice is so limited).

I've not heard anything bad about HPSO, and actually carry my insurance through them.   My guess is that they make their money elsewhere, and provide this as a service to EMS personnel.


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## Summit (Jan 3, 2005)

> _Originally posted by rescuecpt+Jan 3 2005, 08:27 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (rescuecpt @ Jan 3 2005, 08:27 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-Summit_@Jan 3 2005, 08:16 PM
> * "HPSO provides coverage 24 hours a day whether you're on the job, off-duty, and even if you change jobs. Whether you are employed, self-employed or a student."
> Basic intermediate fulltime employed yearly premium $148. That just seems way too cheap.
> 
> Rescuecpt: who is your dive instructor insurance through and who do you instruct for? *


Since I don't get paid to be in EMS I was speaking from a volunteer perspective about only being covered for a few things.  I think it's a bout $75 for vollies. 

I'm a PADI Master Scuba Diver Trainer.  The insurance is Vicenzia and Buckley (the rate PADI negotiates, and they accept few others). [/b][/quote]
 Rescuecpt: You are surprised you have to pay buckets of cash for something PADI related? PADI Put Another Dollar In!   (My sport certs are PADI (AOW+ RD))  I miss warm water diving. It's ice diving season here (vs frigid diving season) and the vis is probably 0-10!

ffemt: Have you heard anything good about them or ever made a claim on their peripheral coverage stuff?

I'm just trying to get over the "If it seems to good to be true..." mindset.


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## rescuecpt (Jan 3, 2005)

> _Originally posted by Summit_@Jan 3 2005, 09:15 PM
> * Rescuecpt: You are surprised you have to pay buckets of cash for something PADI related? PADI Put Another Dollar In!   (My sport certs are PADI (AOW+ RD))  I miss warm water diving. It's ice diving season here (vs frigid diving season) and the vis is probably 0-10! *


 I never said I was surprised - doesn't seem too crazy to me if you're teaching full time.  It's a lot less expensive if you're "non-teaching" status but since it covers me whether I'm teaching, diving for fun, or doing anything water related (like with the FD), it's a good investment in my mind.  Plus, until the statute of limitations runs out on my instruction-heavy days (1998-2000) it's a good thing to stay covered.

PADI is the way the world learns to dive.    

Before I went to divemaster I did some classes with other groups (NAUI, SSI) and I thought PADI was the most thorough and best represented in the world, that's why I stuck with them.  Also, in the circles in which I worked, it was most respected.


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## Summit (Jan 4, 2005)

> _Originally posted by rescuecpt_@Jan 3 2005, 09:26 PM
> * Plus, until the statute of limitations runs out on my instruction-heavy days (1998-2000) it's a good thing to stay covered.
> 
> PADI is the way the world learns to dive.
> ...


In my dealings I found PADI less thorough vs the other organizations I've worked with. Things may have changed between your time and my time I don't know. However my full opinion is you can get the fullest out of any o those agencies if YOU put your full effort and time into learning the subject and practicing regardless of how thorough the curriculum is. But then I'm not an instructor 

In the circles I'm in (PSD mostly former commercial divers, DRI instructors, SSI instructors, IANTD lovers) PADI is probably the  least respected organization apart from maybe the DIR/GUE fanatics. (I've taken plenty of humorous jabs for having PADI certs, there used to be a PADI instructor on the team too, it was funny). I think PADI lost respect when they started doing some their learn to dive in a day business models.

I do think PADI has some of the best tables. Of course we are using SSI/NAVY/NOAA tables here (mostly diving the 10,000ft table).

That HPSO malpractice insurance claims that you care covered for the entirety of that statute of limitations as long you were insured at the time of the treatment (ie you don't have to keep the insurance after you stop working). Too good to be true?


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## rescuecpt (Jan 4, 2005)

Summit - I don't do any commercial diving - I am strictly a rec diving kinda girl and in those circles, from what I've encountered, it's the best.    But I can't speak for commercial diving stuff since I have nothing to do with it.  PADI is also the largest - because it IS a business.  I'm not a happy feely huggy type - business is business and their business model is pretty good.  I've also seen differences of opinion between the non-pro and pro populations of PADI... once you hit DM they brainwash you.  It gets worse when you become an instructor - and then when they tell you that you've achieved MSDT, well... I'm basically just a PADI robot.


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## Firechic (Jan 9, 2005)

SafetyPro - I'm curious - did you land at Love Field?

>Once the aircraft doors are closed, you are under federal jurisdiction - not any state.


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## ffemt8978 (Jan 10, 2005)

> _Originally posted by Firechic_@Jan 9 2005, 12:37 PM
> * SafetyPro - I'm curious - did you land at Love Field?
> 
> >Once the aircraft doors are closed, you are under federal jurisdiction - not any state. *


True, but I'm not aware of any federal guidelines for practicing medicine as an EMT (other than the obvious).  I think this is an issue where the feds would defer to the state having jurisdiction, but it is definately a complicated matter.


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## rescuecpt (Jan 10, 2005)

Once the aircraft doors are closed, under federal jurisdiction, you follow the airline's med control.


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