As a registered nurse, I have many times been asked questions that were out of my trained specialty. Any ailment that arose when I was present amongst family or friends, was immediately turned over to the “the nurse” in the room.
However, just as a brain surgeon would feel uncomfortable delivering a baby and a delivery room nurse cringes when asked to clean out a tracheostomy- the fact that medical training was in your past means that people may rely on you during a crisis.
Since I have personally assisted in two medical emergencies on board flights (2 years apart and very ironically both on flights to St. Louis!), I can relate to the
feeling of insecurity when the dreaded announcement (“if there are any medical personnel on board please make your way to the back of the plane”) is made.
It is unnerving knowing that:
1. medical supplies are limited
2. the cheap stethoscope is going to be useless next to the sound of the engines
3. the entire plane will be silent and observing
(some will look at their watches annoyed at the possibility of a flight diversion, while others are fascinated and expect the drama like that on an episode of Grey’s Anatomy)
So I recently decided that I would find a way to help others (medical or non-medical personnel) who may have anxiety about assisting during an in-flight emergency.
<b>It is important that you remember to “do no harm” and only practice within the limits of your training and knowledge.</b> You probably will not be able to fix the problem, however, if you are able to collect valuable information from the patient and their traveling companion as well as report medically what you have observed, you will help the crew and patient. The goal is to communicate the situation to crew and any medical team involved on ground, to alleviate symptoms and stabilize a patient until the plane is able to land. If the patient is not stable, request an emergency landing. Do not make an assumption that this will be done. Either way, make sure to communicate the need for an ambulance to meet the plane on the runway and for the passengers to wait until the paramedics reach the patient before deplaning.
Most airline crew will be happy to assist. Ask for a piece of paper and pen as well as for someone to keep track of the time and to document vitals as you take them.
Here is basic information that is valuable to collect.
1. Age, sex, and weight of patient
2. Complaint or problem
3. Is the patient conscious? Note appearance of patient.
4. Obtain Medical History from patient or traveling companion
-Medic Alert Tag?
-Events leading up to incident?
-Has this incident happened in past?
-Any known food/drug allergies?
-Medications (both prescription and non-prescription)
-When the last dose was taken/last meal was eaten/alcohol consumed?
5. Take frequent vital signs (heart rate, blood pressure, respirations)
6. Request the airline crew contact the airline’s emergency medical response team on the ground to communicate directly the patient’s status
7. Monitor and document patient’s progress
If uncomfortable with the role you find yourself in, communicate your limits and act accordingly. Do not feel it is your responsibility to save the day. However, sometimes just holding a patient’s hand, taking vital signs, communicating with the airline medical service, or assisting a fellow caregiver can make all the difference.
Remember to breathe! Take care of yourself as well… The last thing the flight needs is another patient.
I was reminded of this because when the last emergency occurred I was 12 weeks pregnant and very nauseous. I had confirmed that a diversion was unnecessary since the patient remained stable. Forty five minutes later, as I kneeled above the patient in the galley, I miserably looked over at the firefighter who was also assisting. I realized if I didn’t remove myself immediately from the patient’s horrible breath, that I would be throwing up all over him! I handed the duties over to the firefighter and asked for some ginger ale. A few minutes away did wonders.
I was happy to see the paramedics board the plane after our very quick landing into St. Louis. My role was done as soon as I reported off to them.
I was happy at least until the following Tuesday after the long weekend, when I boarded the plane only to hear, “My nurse is on this flight!” I stopped, turned, and stared – what were the chances that my “patient” was on this very same flight back home? My nausea returned.
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