Working beneath my licensure, again.

[mycrofft]

Trivia: originally "stewardesses" as they were called had to be "trained nurses".

 

[AtlasFlyer]

Anyone have additional reading/sources on these flight EMK kits? Seems interesting. Would like to hear if there's any med control involved back on the ground.

Do you want to know specifically what is in the kit?

 

[rwik123]

Do you want to know specifically what is in the kit?

Yeah. I wasn't aware that they existed.

 

[PotatoMedic]

AtlasFlyer

Did they allow ND's to open it? (Naturopathic Doctor)

 

[AtlasFlyer]

FAA Required Medical Kit Contains (this is info dated 15 APR 2000)

-Three sizes of airways
-Stethoscope
-Blood pressure cuff
-Tourniquet
-Iodine wipes
-Gloves (2 pair)
-Green and red lock seals
-Two packages of medicine, each containing
*Syringes and needles
*Dextrose
*Epinephrine
*Diphenhydramine
*Nitroglycerine tablets
*Instructions for use of drugs


The EMK (which in re-reading my materials the E is for Enhanced, as in Enhanced Medical Kit) is a separate kit to be used 1st, before the FAA required kit (as the FAA required kit is a no-go item and if it's been opened and used the airplane is grounded until it is replaced). The EMK contains the same items as the FAA required medical kit, and also has an ambu bag and other medicines in it, my materials do not list the specific medicines. I suppose they figure we (F/As) can't use it anyway, so why bother telling us.

 

[AtlasFlyer]

AtlasFlyer

Did they allow ND's to open it? (Naturopathic Doctor)

When I was working, probably not.

Nowdays, they'd probably be more lenient on access.

And in re-reading my manuals I read that the blood pressure cuff and ambo bag can be given to an EMT, nurse or other credentialed health care provider, and that access to the EMK's contents can be granted to providers with other credentials (RN, EMT, EMT-P, etc) with discussion and specific approval gained from the pilots calling the company medlink. So the F/As couldn't just hand over the EMK to anyone other than an MD or DO, specific approval could be granted with company permission. It's nice to know that provision is there.

 

[AtlasFlyer]

In 7 years of flying I never had an onboard medical emergency of any kind, even requiring so much as a first aid kit. A few band-aids needed now and then but nothing serious. From the stories I've heard from others though, it is VERY common that there is at least some sort of medical assistance found on the plane when needed, a pax who is a nurse, doctor or emergency responder. My favorite story is a guy who had a heart attack on a plane, the FAs asked for medical personnel and 3/4 of the pax rang their call buttons. The flight was FULL of cardiac surgeons enroute to a medical convention. So, that pax picked a REALLY great flight to have a heart attack on...

 

[OfficerEvenEMT]

Nope [not at the time]. MD or DO only, SPECIFICALLY.

I'm glad Mr. BaldGuy ) ) has said that the rules have relaxed a bit on that. It seemed to me to be a bit hyper-militant to refuse access to the kit to someone like you say, with solid experience who could really help someone who needed it. Perhaps it was an insurance/liability issue on the part of the carrier, but I'm glad the rules have relaxed.

Not only were we told that we were under NO circumstance to give the EMK to anyone other than an MD or DO we would be fired, NO EXCUSES, if we violated this. The EMK was locked, so the kit was inaccessible without a F/A accessing it.

We were also told in new-hire school that if we (as F/As) were also EMTs or nurses or whatnot that we WERE NOT allowed to operate outside of the scope of what we were taught in new-hire medical training. The company could not protect us legality-wise if we did something outside the scope of the company's training. We had an RN in my new-hire class in 1995 and she was shocked to hear she was specifically forbidden from acting in anyway further than basic CPR/first aid.

I'm VERY GLAD to hear these militant policies are changing! It was particularly ironic as the very first stewardesses in America were required to be RNs... the RN requirement wasn't dropped til WWII as nurses were direly needed for the war effort.

Cool that the rules have relaxed. I know a guy who is a "Trauma Nurse Practitioner" and has the Masters Degree in Nursing and some specialty board certification as such. He runs an ER solo very often and runs codes on a daily basis. It would be just weird for him to not be allowed access to the kit.

 

[AtlasFlyer]

Cool that the rules have relaxed. I know a guy who is a "Trauma Nurse Practitioner" and has the Masters Degree in Nursing and some specialty board certification as such. He runs an ER solo very often and runs codes on a daily basis. It would be just weird for him to not be allowed access to the kit.

It would make no sense at all for someone like that not to be able to access the kit and help someone. As a F/A, if I had a pax who had a medical emergency, and a guy with those credentials was onboard to help, I'd be all "Oh, cool, here ya go!" and hand him pretty much everything I could find. Then I'd stay out of his way.

 

[mycrofft]

Well, the first gig went ok as far as licensure concerns.

Everyone there was basically up to speed, there was a lot of cooperation, while we were working under adverse conditions yielding numerous hypothermic-only patients, with the help of local fire dept and the third party private transport crew, things worked out ok. I started to tick off my cohorts but they seemed to appreciate me more later, when I dialed back and let them do their thing as well. If we had a do-over on that, I'd want the same folks.

 

[Akulahawk]

Everyone there was basically up to speed, there was a lot of cooperation, while we were working under adverse conditions yielding numerous hypothermic-only patients, with the help of local fire dept and the third party private transport crew, things worked out ok. I started to tick off my cohorts but they seemed to appreciate me more later, when I dialed back and let them do their thing as well. If we had a do-over on that, I'd want the same folks.

I was not that far away, from the event, but I was not working it. Chances are I know a few of the people that did respond to it, just because I do work in the area. From what I understand of the event, and the response, the first aid team had their hands full. It also sounds like there was a more than adequate response to the incident, which was largely driven by inclement weather that was less than expected. While the weather situation was probably less than expected, I would very much suspect that they will be more prepared for such a turn of events in the future.

I say "first aid team" because that's exactly what they were, because, they were not set up as an organized EMS type response team. For that kind of event, 99.9% of the time, that type of team is all you need. Being able to provide basic first aid is, by and large, the skill set that is needed. I have worked other events where they had physicians and nurses on site, working in their capacity as such. It is a wonderful thing when that happens, simply because occasionally something goes sideways and you need that skill set.

At least, they did not need air transport, however, there is an airport nearby that would easily support some significant air ambulance traffic without difficulty.

 

[mycrofft]

Dustoff?

Heck, 30 mph gusts, deep mud/running water, air trans would have been a bust. Although we were near an airport.

What we needed was a big dry tent with a heater, chairs, and hot drinks/chow. And of course another for the patients.

The three catering trucks did a good job staying open and running through the event, and even gave out their last bananas free at the end.

I wonder if any of my co-wowrkers there are on EMTLIFE? I keep plugging it...

 

[Veneficus]

I often feel I am working far below my capacity and it is utterly maddening.

 

[mycrofft]

Feeling that way is either just having some reserve capacity, or grandiosity

I get to feeling that way and something will rise up and bite my glutes every time. I repeatedly wonder how the teeth get past my cape, my tights, and where they got Kryptonite dentures!

 

[mycrofft]

Further reflections

I have been googling and emailing and can find no standards for such events. The low percentage of the total participants being actually injured is encouraging, but looking at participants' stories elsewhere/when, I read stories about delayed dermatologic infections and staph, mud hazards smelling like manure, and other events where rain raised the level of water hazards and concealed track hazards under mud.

I think I can be OK philosophically with them if I continue to see low injury numbers and good spirits, but I would be more comfortable if there were rules to setting up and running such events.

 

[bigbaldguy]

I often feel I am working far below my capacity and it is utterly maddening.

Says the guy who's avatar is God.

 

[Akulahawk]

Says the guy who's avatar is God.

Minor Correction: "Says the guy whose avatar is Morgan Freeman, playing God..."

I must say that he did a very good job of it though. Jim Carrey did a pretty darned good job playing a guy who got God's power (and only abused it a little) in that same movie...

 

[bigbaldguy]

Emergency medical kit

Yeah. I wasn't aware that they existed.

First aid kit

AED

Fancy mask

O2 (flows at max of 4 liters per minute with non rebreather)

 

[mycrofft]

I so hate those unitized supplies.
Uh, anyone have a gig available servicing them? :blush: