# emt equipment and commercial flights



## DV_EMT (May 24, 2009)

so, im headed to italy this fine morning. I decided to bring few glove my bp cuff, stethoscope, and a few dressings. now note this is a transatlantic flight. anyone else travel with gear on commercial flights on the outside chance something might happen?


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## Scout (May 24, 2009)

No the plains are very good in that they have their own stuff on board. Short of a pair of gloves and a 4x4 i could see no need for anything else. Maybe a sticky plaster.

I'd be worried if you were going transpacific


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## akflightmedic (May 24, 2009)

Planes are very well stocked as stated, especially international flights.

I believe there is a thread about this sort of thing. Most airlines carry a full complement of ALS equipment to include intubation, IV therapy, ALS drugs, AED and a bunch of other things.

I fly international all the time and occasionally there are incidents on board. You better be prepared to effectively manage the patient and all the quacks who raise their hands and insist they are a doctor in Timbuktu.

The flight attendants are very well trained in "triaging" the volunteers if you will and have asked people to return to their seats many times, thanking them for their willingness to help. You had better be prepared to make sound clinical judgment in regards to the patients health and quite honestly, short of an extreme respiratory or cardiac arrest, you are in no position to do so as an EMT. The pilot will want to know if they need to divert or continue on. In some instances, you may be connected to the airlines medical officer and must be able to provide your case to him so he can make or assist in the decision.

There are many times where patients have had syncopal episodes on flights I have been on and it is a HUGE decision to decide if we divert or continue on. If you divert, you better have darn good justification, plenty of reasons why and it will never be simply because you say so.

By the way, do yourself a favor and leave the whackerism at home...especially if going to Italy. That would of been one of the last things I considered to pack, if at all.


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## silver (May 24, 2009)

yes its a very interesting thing what they have on board. In fact I was going to ask on one of my flights last week where the plane was half full, but it turns out there was awful turbulence, and we diverted two landings. But they are stocked very well, and I feel like they let people with online medical direction go above a normal scope (ie. a flight attendant, or EMT-B )...not really sure though.

On a transatlantic flight don't really except you to be the only one on board though and to be some superman hero. For instance when I last flew to Amsterdam, there were 3 doctors (1 was emergency medicine), a paramedic, and the flight attendant was in her fourth year of a BSN. We were about two hour away from Iceland when someone was showing signs and symptoms and dehydration and some anxiety, so if anything serious happened its just us.


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## Melclin (May 24, 2009)

akflightmedic said:


> all the quacks who raise their hands and insist they are a doctor in Timbuktu.



Lol, people are idiots. You got any specific examples that I can LOL at?


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## akflightmedic (May 24, 2009)

Sure why not.

My most recent one was a few weeks ago, Dubai to Atlanta. Older Indian male had syncopal episode. Lead stewardess said I have 10 minutes to make a decision on whether or not to divert as we will be too far over the water at that point.

While kneeling over the now conscious patient, I have a man try to insert himself between me and the patient. I do not care who you are, once someone has already established rapport and appears to be competent, you do not interrupt. You may add on in a bit if you like, because any provider can clearly see there is no dire emergency.

Anyways, he asks what I am and when I inform him I am a paramedic, he made a face like he really did not know what it was and then countered with "Well, I am a doctor". Whatever dude, I am not going to argue or fight in front of anyone, I much rather be sleeping still but this occurred 3 seats in front of me.

I quickly briefed him on what I had ascertained and he then asked for the patient medication list. I asked for a glucometer and BP cuff which they attendants promptly brought. I handed the cuff and stethoscope to the doc and I went about getting a BGL.

After finishing the finger stick, I noticed the doc looking rather puzzled over the highly complicated BP cuff, so I took it from him and did it quickly. He seemed very nervous with everyone watching, but hey man, you wanted the show.

After telling him the BP (the pt did not speak English very well), and his medications were all gibberish to me, the "doctor" started insisting that the pt needs a NTG tablet. I asked why and he said he just needs one. At this point, the stewardess has seen the difference between me and the doctor and the faces I was making. I quickly gave them a look like WTF, this guy is not a doctor. The doctor then asked for Atropine. It was at this time, that I said to the stewardess that this guy needs to take a seat, it is crowded here and I need room to work. I wanted to sit the pt up and do some orthostatics.

The attendant asked the man to take his seat, thanked him for his help and he seemed very confused as to why but they insisted several times. I think he finally got the hint and went back to wherever he came from. The pt's BP was fine, pulse strong, regular and with basic English and gestures I made a judgment call that the pt was fine; I then told the attendant to relay to the pilot to continue on. They asked if they could tap me on the shoulder during the remaining of the flight (8 more hours) should anything arise, instead of asking for help over the intercom. I agreed, went back to sleep and nothing else came of it.

This is just one incident, there have been a few others. However, there has also been times where there were some pretty kick *** docs on board and jazzy nurses as well and everything was fantastic. The joys of international flying on a frequent basis...whoo hoo!


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## Flight-LP (May 24, 2009)

To echo what AK stated, honestly, outside of a mechanical performer of CPR, you will be of little use. Being a pilot and swapping stories with many an airline captain about medical issues during flight, I can attest that most pilots see EMT's for exactly what they are, minimally trained technicians that lack the critical thought process to effectively make high dollar decisions. 

Think about it for a moment, you see a "sick" person on the flight. As you are not trained, equipped, nor prepared to handle a medical emergency for several hours, you tell the captain to divert. Do you realize the cost associated with this decision? It is tens of thousands of dollars. It sucks sometimes, but honestly it is usually better to continue the flight than divert. Plus for your transatlantic flights, there is an approximate 4 hour window that you have nowhere to divert to. Its either Iceland, Ireland, or far east Canada. So your stuck with them. Ask yourself, can you honestly maintain effective care of this pt during that time? If not, I guarantee the airline will have no hesitation in hanging your arse out to dry should anything go wrong. It takes any and all blame off of them!

I had a similar experience happen on one of my recent returns back to the U.S. The flight attendant came and woke me up (she has known me for a while and knew I was a medic) and asked for my assistance. I inquired what was wrong and how I could help. She told me the pt. was vomiting and felt "ill". I asked if she had any anti-emetics on board and if their medical control would release the use of them. She said no and stated the pt. is has a long history of air sickness and failed to pack her Meclizine (said with a sarcastic smile). I told her there was nothing I could do for the lady, just keep giving her vomit bags. I reclined my bed and went back to sleep. About 15 minutes later I hear commotion up front at the flight deck door. I hear some yahoo telling the captain to "immediately land due to this ladies illness". He laughed at the guy and told him to get a life (I LOVE IT!!!!!). 

This idiots next words were priceless............"I am an EMT and you are required to listen to my medical orders!" 

Captain: Sorry son, this is my plane and I am not diverting to some god forsaken remote airport because you believe this to be an emergency. We will keep her comfortable and land as manifested unless her condition deteriorates.

Moron EMT: So you are willing to take full blame for anything wrong happening to this woman (yes he was a redneck!).

Captain: I take full responsibility for this lady, just as I do for all 200 passengers on this flight. Now go sit down.

Needless to say, the lady wasn't feeling the greatest, but she made it just fine (another passenger slipped her some Zofran).

Prime example of why I usually just dont get involved. To add to the humor, a PA that I worked with was sitting a few seats away and hid quite well during all of the drama. We had breakfast together when we got to D.C. and he told me he wanted nothing to do with that and as such is the reason why he hit the bottle early in the flight. I probably should have done the same!

I should write a book..........."Stupidity at 38,000 feet".


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## daedalus (May 24, 2009)

Concentrate on your vacation. Do not bring a BP cuff or anything else.

Flight_LP, I actually got embarrassed for that EMT. What a shame on my profession. I guess there are yahoos everywhere, but because of the low training requirements of EMTs, it is easier for them to get into EMS.

We need to write in a new section in EMT books. A humble pie section, filled with an overtly complicated medical case study with many complicating disease processes, medications, etc, to make the student realize they actually know nothing.


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## DV_EMT (May 24, 2009)

Well... as I know what I am and what my scope is, im sure that im not going to act as something more than I am. heroism isn't my thing, patient care is. I know that there will probably be higher qualified people (doctors, rns, and emt-p) aboard. 

as for the whacker ness. i had no idea that there was so much equipment on board. I brought the minimum just in case, but apparently its not needed. thanks for the input everyone,  im glad I can get great feedback from people who know these things.


furthermore, that emt that states that his medical direction was imperative to a patients life... what a bafoon.  anytime I show up to a code to help, I sit and watch until called upon to help (whether its helping with compressions or just grabbing floor stock IV's). but trying to run in and run the code with lower qualifications.... what an idiot.


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## WolfmanHarris (May 24, 2009)

Don't bring anything with you, the most use you'll get is as a conversation starter with airport security.


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## Jac [ITA] (May 24, 2009)

DV_EMT said:


> so, im headed to italy this fine morning. I decided to bring few glove my bp cuff, stethoscope, and a few dressings. now note this is a transatlantic flight. anyone else travel with gear on commercial flights on the outside chance something might happen?



[OT]
Italy! Nice...  

Where exactly? If I may ask... 
[/OT]


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## DV_EMT (May 24, 2009)

to roma! then down the coast t a few towns. then a boat to croatia for a few days. should be fun.


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## Hockey (May 24, 2009)

Leave work at work.  


You're going to be one of those burn outs if you keep doing what you're doing IMO.


Don't ever bring work home.  Forget about work.


Heck, I forget about work when I'm at work.  In fact, I'm sitting here in bed at work about to forget about forgetting work.


Long story short, leave the junk, stuff, whatever at home/work.  Airport security is going to harass you and most likely, will refuse to let you take it through Customs.  

Not trying to be mean, but you're not going to save the world.  You don't need anything.


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## DV_EMT (May 24, 2009)

Hockey9019 said:


> Leave work at work.
> 
> 
> You're going to be one of those burn outs if you keep doing what you're doing IMO.
> ...



I understand wherefore coming from. I usually leave work at work. te only reason I brought work with me was because I figured that it was a long flight overseas. had it been domestic... then whatever, the pilot can land wherever. but now, I know that there is apt equipment available on planes and I font have to bring anything in the future.

but like I said... thanks for being honest. id rather be informed and get feedback for the future


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## Scout (May 24, 2009)

god forsaken remote airport????



Ireland and Iceland have nice hospitals no fair....


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## mikie (May 24, 2009)

*Not to interrupt ...*



akflightmedic said:


> After telling him the BP (the pt did not speak English very well), and his medications were all gibberish to me, the "doctor" started insisting that the pt needs a NTG tablet. I asked why and he said he just needs one. At this point, the stewardess has seen the difference between me and the doctor and the faces I was making. I quickly gave them a look like WTF, this guy is not a doctor. The doctor then asked for *Atropine*...



Did the 'doc' say why he wanted to give Atropine?!  Or the NTG?


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## MMiz (May 24, 2009)

I'm sure you can find it if you search, but I reluctantly offered my assistance  one time  to a man having a suspected MI on a cross country flight.

The airplane had a full ALS drug kit and jump bag with everything that would be on an ambulance.  They had an AED, oxygen, and I was able to speak to medical control via the captain.

I got a voucher for 5,000 frequent flyer miles and a little certificate out of it.


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## medicdan (May 24, 2009)

Per MMiz's suggestion, check out 
http://emtlife.com/showthread.php?t=10208


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## mikie (May 24, 2009)

From another thread, here is a company that supplies the airplane's 'jump bags.' 

Here!


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## Flight-LP (May 24, 2009)

Scout said:


> god forsaken remote airport????
> 
> 
> 
> Ireland and Iceland have nice hospitals no fair....



The flight was well past your side of the pond....................

Besides, if we would have stopped, everyone would be too drunk to leave!


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## Jon (May 25, 2009)

DV,

Here's an even better challenge for you. What good is a B/P cuff and scope? Look at your patient? Do they look like they are poorly perfused? Gee... lets lie them down. Do they have good cap refil and good strong radial pulses?

I can't argue with the idea of a few dressings. In fact, for any traveling, a small first aid kit is a great idea. I still often carry one I made up for Scouts, years ago. Bandaids and moleskin are great things to have on any long trip - and it is SO much cheaper than having to buy them on the trip. That, and some 4x4s, gauze rolls, neosporin, tweezers... about covers it.


So yeah... the airlines have advanced kits and usually have on-line medical direction that will at the very least participate in the decision to divert the aircraft.


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## Melclin (May 25, 2009)

*akflightmedic* and *Flight_LP* : HAHAHAHAa. Ah, flight if you write that book I'll read it.

What the hell did he want GTN or atropine for? Did he ever actually give a reason or was he just a nut?

And scout...sorry man, Dublin International terminal is rubbish


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## Jon (May 25, 2009)

Melclin said:


> *akflightmedic* and *Flight_LP* : HAHAHAHAa. Ah, flight if you write that book I'll read it.
> 
> What the hell did he want GTN or atropine for? Did he ever actually give a reason or was he just a nut?
> 
> And scout...sorry man, Dublin International terminal is rubbish


GTN? Are you cixelsyd?


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## Melclin (May 25, 2009)

Glyceryl Trinitrate --- nitroglycerine. 

Haha, you yanks and your different names for things. Honestly, one day I'm ganna fly over there and pop whoever decided to use the name epinephrine instead of adrenaline. Bloody epi infests all of our textbooks and I have to switch things around in my head. Never had poor Aussie paramedic students in mind did you 

for good measure : http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1127537


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## akflightmedic (May 25, 2009)

Jon said:


> GTN? Are you cixelsyd?



You think GTN is odd, you ought to hear how they pronounce phenergan and aluminum.


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## AJ Hidell (May 26, 2009)

Flight-LP said:


> Prime example of why I usually just dont get involved. To add to the humor, a PA that I worked with was sitting a few seats away and hid quite well during all of the drama. We had breakfast together when we got to D.C. and he told me he wanted nothing to do with that and as such is the reason why he hit the bottle early in the flight. I probably should have done the same!


Reminds me of the last in-flight medical emergency I helped with.  I had just taken a couple sleeping pills so I could sleep through the 9 hour flight and be fresh when I got back to the states.  Just as the drugs began to kick in on me, the flight attendants made a PA announcement asking for any doctor on board to please notify a flight attendant.  I tried to inconspicuously look around the plane to see if anyone was stepping up.  After a couple of minutes, I had seen nobody volunteer, and the flight attendants repeated the announcement.  So reluctantly, I undid my seat belt and got out of my seat to approach the flight attendant.  As I did, the guy sitting next to me said, _"Well, if you'll go, I'll go."_  Turned out he was a Sports Medicine physician from New York.  We were taken to the galley where two other physicians had also gathered.  The sick lady was well cared for!

The point of the story being, I doubt there are any transatlantic flights without at least two physicians on board.  If there's a full arrest, well then you as an EMT are probably the best qualified compressor on board!  But otherwise, don't expect anything you bring to the table to be of any use.

Regarding equipment, it can be hit and miss.  While the flights are _supposed_ to be well equipped with medical supplies, sometimes someone drops the ball.  On the flight above, we ended up with all three medical kits being brought to us, all of them sealed and certified to be complete, and not a one of them had a stethoscope in them.  Other items were missing too.  The people that inspect and restock those things are apparently non-medical, minimum-wage idiots, so don't ever be surprised to find them incomplete.  But still, if all you are is an EMT, I wouldn't be cramming anything in my carry-on in preparation of that possibility.


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