I have been an emergency medicine physician for many years. Trauma, cardiac arrests, strokes, lacerations. I’ve seen them all. But sometimes I wonder how I would do in an actual emergency. I mean, I can run a trauma or cardiac arrest code without much problem on my own turf. Get them into the resuscitation room where I have a full team and multiple resources at my disposal. Everyone knows their job in an emergency department. But how would I handle an emergency situation, say at 36,000 feet, with limited supplies and bystanders with unknown skills?
I travel a lot, and I’ve started to think about what could potentially be in my aircraft’s safety kit as I sit watching the other passengers start to board the airplane: the hurried, red-faced person who was wiping sweat off their face as they rushed aboard, the obviously pregnant woman who was pacing around the waiting area, the barrel-chested passenger who looked as if they couldn’t wait to land to be able to pull out a cigarette from the pack in their pocket and take their next drag, the laughing out loud been-at-the-airport-bar-during-their-layover pair, and the other hundred or so ticking time bombs of potentially unknown medical problems.
I’ve also started to look around the plane wondering who would be most helpful in an emergency. The exit row group. Yes! They’ve already consented to helping out in an emergency, so I could probably count on them. Anyone in uniform, sure, they’ll help out. It’s a kind of Plane Survivor; you, yes, join my tribe, you, no, voting you off the island, um, aircraft.
Obviously, most of us won’t be faced with a situation like Dr. Wallace, who in 1995 relieved a tension pneumothorax (collapsed lung putting pressure on the heart) with a wire hanger, a catheter, and a bottle of brandy. However, I would like to think I could handle something reasonably simple. A bump on the head from a piece of falling luggage? A panic attack. A slip and fall.
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In the 2000s, the British Medical Journal ran an article listing the top ten in-flight medical emergencies as chest pain, collapse, asthma, head injury, psychiatric problems, abdominal problems, diabetes, allergic reactions, and OB/GYN emergencies. Since 1986, most airlines carry an automated external defibrillator (AED), and most also carry oxygen and some basic medical supplies. Airlines are required to carry an emergency medical kit, which has medications such as epinephrine, lidocaine, nitroglycerin, pain relievers, inhaled bronchodilators, and dextrose. They will also contain basic first aid supplies as well as some medical equipment like oxygen, stethoscopes, blood pressure monitors, gloves, and masks.
You want the best, fly on an Emirates aircraft that has the ability to get vitals, EKGs, and blood sugar levels and send them in real time to a ground medical team. Delta has upgraded equipment on its aircraft. Several other companies have trained specialized crew members for in-flight emergencies.
Armed with my medical knowledge and remembering a presentation I went to at a national conference, 101 Uses for a Safety Pin and Duct Tape, I board, looking around at my fellow passengers and thinking in my head, “Surely you can’t be serious?” “I am serious, and don’t call me Shirley.”
Veronica Bonales is an emergency physician.
