[Is there a doctor on board?]

Abstract

Medical problems during flight have become an important issue as the number of passengers and of miles flown continue to rise. Cabin pressurization causes hypoxia, hypobaria and decreased humidity, which are responsible for most medical incidents occurring during flight. Worldwide daily medical incidents are estimated at 350, i.e., one per 14,000 to 39,600 passengers. Medical advice is obtained in 69% of cases, from physicians (40%), nurses (25%), or paramedics (4%) on board the plane. The leading causes of medical incidents are gastrointestinal (25%), cardiac (10%), and neurological (10%) diseases. The incidence of cardiac arrest in flight is 1000 cases a year, worldwide. Since 1992, airlines have progressively equipped their planes with automated external defibrillators, and crew members are trained to use them. Passenger flights carry medical equipment and drugs, determined according to number of passengers and the flight distance. The conditions of intervention are codified: "good Samaritan" laws protect professionals from liability when they choose to aid others who are injured or ill. Current recommendations call for physicians to identify themselves, request an interpreter when necessary, obtain the patient's consent, conduct out examination, inform the patient, family members and crew members of the situation, contact ground medical staff, use well-known procedures, consider flight diversion, and write up a case report.