akflightmedic
Forum Deputy Chief
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Interesting thread here.
Due to the amount of travel I do annually, I have had my fair share of experience with these scenarios. Some of you against working outside the box just do not seem to grasp the nature of air travel.
You can not just plop down anywhere as soon as an emergency on board arises. Even if flying over the US at a normal altitude of 30-35K feet, it will take 30 minutes or more to do an emergency landing. There are runway considerations, fuel issues, etc. Now with that time frame in mind and knowing the proven statistics of viability of a cardiac arrest patient outside of a hospital, what would you do?
I do a lot of international travel, meaning there are times where it could be HOURS before a landing is even possible. So go back through this scenario and ask yourself, would you provide ACLS medications without knowing what is on the screen? What if it were a family member? Would you still try?
The few times I have assisted on an IFE (In Flight Emergency), the attendants were extremely calm and quite selective in whom they allowed to assist the patient. My certs are always in my pocket and validating them (best as you can at 35K feet) is required before they even told me who the patient was. Basically they looked at them for appearance sake and checked the expiration date, which is fine because I do not imagine too many whackers travel with false credentials. I am sure it occurs but not that often.
I have worked one cardiac arrest, several syncopal episodes, abdominal pain, two chest pains and administered a patient's pain medication IM.
Except for the cardiac arrest as it was quite a few years ago, I had to show documentation of who I was and then after the flight attendant was comfortable with me, I was then allowed to assess the patient and determine if they needed any intervention and if the plane needed to divert. After my assessment, I was then placed on a phone with medical control whom I briefed on patient status and gave my opinion of whether or not we should land.
This is the tricky part!! It would be very easy for some overzealous, inexperienced or undereducated rescuer to say "we need to land now", when in all reality the patient will probably be fine. They do not want to hear those words unless it is absolutely necessary. Be prepared for medical control to question you quite extensively. If they are the attendant are dissatisfied with your answers, treatment or conduct, they will very quickly have you take a seat and make you sit on your hands.
(Seeing who read this far)
As far as legalities, we have covered that already with links to documentation supporting us so that we may render care, however I had indeed asked the same question when I offered my services. One of the airlines had me sign a document prior to rendering care that made me a temporary employee of the airline and thereby falling under the auspices of the airline's medical control physician. Since I was an employee, they have to compensate me, so I did receive an upgrade for a future flight and some Dom Perignon.
Not sure where I was going with all this, but I think I just want to stress that there are and will be times when you have to work outside your comfort zone. Some times within reason. extreme situation may call for an extreme action. Pushing medications on a cardiac arrest while in flight with no chance for landing instantly would be one of those times.
Due to the amount of travel I do annually, I have had my fair share of experience with these scenarios. Some of you against working outside the box just do not seem to grasp the nature of air travel.
You can not just plop down anywhere as soon as an emergency on board arises. Even if flying over the US at a normal altitude of 30-35K feet, it will take 30 minutes or more to do an emergency landing. There are runway considerations, fuel issues, etc. Now with that time frame in mind and knowing the proven statistics of viability of a cardiac arrest patient outside of a hospital, what would you do?
I do a lot of international travel, meaning there are times where it could be HOURS before a landing is even possible. So go back through this scenario and ask yourself, would you provide ACLS medications without knowing what is on the screen? What if it were a family member? Would you still try?
The few times I have assisted on an IFE (In Flight Emergency), the attendants were extremely calm and quite selective in whom they allowed to assist the patient. My certs are always in my pocket and validating them (best as you can at 35K feet) is required before they even told me who the patient was. Basically they looked at them for appearance sake and checked the expiration date, which is fine because I do not imagine too many whackers travel with false credentials. I am sure it occurs but not that often.
I have worked one cardiac arrest, several syncopal episodes, abdominal pain, two chest pains and administered a patient's pain medication IM.
Except for the cardiac arrest as it was quite a few years ago, I had to show documentation of who I was and then after the flight attendant was comfortable with me, I was then allowed to assess the patient and determine if they needed any intervention and if the plane needed to divert. After my assessment, I was then placed on a phone with medical control whom I briefed on patient status and gave my opinion of whether or not we should land.
This is the tricky part!! It would be very easy for some overzealous, inexperienced or undereducated rescuer to say "we need to land now", when in all reality the patient will probably be fine. They do not want to hear those words unless it is absolutely necessary. Be prepared for medical control to question you quite extensively. If they are the attendant are dissatisfied with your answers, treatment or conduct, they will very quickly have you take a seat and make you sit on your hands.
(Seeing who read this far)As far as legalities, we have covered that already with links to documentation supporting us so that we may render care, however I had indeed asked the same question when I offered my services. One of the airlines had me sign a document prior to rendering care that made me a temporary employee of the airline and thereby falling under the auspices of the airline's medical control physician. Since I was an employee, they have to compensate me, so I did receive an upgrade for a future flight and some Dom Perignon.
Not sure where I was going with all this, but I think I just want to stress that there are and will be times when you have to work outside your comfort zone. Some times within reason. extreme situation may call for an extreme action. Pushing medications on a cardiac arrest while in flight with no chance for landing instantly would be one of those times.
