Summary: <br> <a href="https://i2.wp.com/littlebigmed.com/wp-content/uploads/2017/08/cropped-Little-Big-Med-Logo-2.png"></a><br> <br> <br> <br> On this episode, host Jason Woods speaks with Dr. TJ Doyle, medical director of the communicaton center at the University of Pittsburgh Medical Center (UPMC) and medical director for <a href="http://www.stat-md.org">STAT-MD</a>, a ground based consulting group for airlines. The discussions encompasses that frequency and types of in-flight medical emergencies (IME), what is in the medical kit on airplanes, what resources are available in-flight, and the legal ramifications for medical vounteers. <br> <br> <br> <br> The highlights:<br> <br> <br> <br> * Worldwide ~ 2.75 billion persons fly annually.* IME occur in roughly 1 per 604 US flights, or 24-130 IME per 1 million passengers. * 69% had EMS requested, 25% transported to hospital, 8.6% admitted, 0.3% died. * Aircrafts divert in about 4$ of IME* Airplane cabins are pressurized to between 5000 and 8000 ft altitude* Minimum equipment in the US (see graphic) <br> <br> <br> <br> <br> <br> <br> <br> * AED* Hemorrhage control* IV line* Gloves* Medications to treat “basic conditions”* Pain* Allergic reactions* Bronchoconstriction* Hypoglycemia* Dehydration* “Some” cardiac conditions* Equipment for initial assessment* Most common IME* Syncope or near 32.7%* GI 14.8%* Resp 10.1%* CV 7.0 %* Medical volunteer role* Individual airline policies may have different guidance* Not generally required to carry proof of medical license* Primary role is to gather info, provide assessment, and communicate with ground support. May need to admin medicines or perform procedures but direction of care is by ground medical. * Legal and ethical issues* US Aviation Medical Assistance Act* Protects passengers who provide medical assistance from liability except in cases of negligence or willful misconduct. * Medical volunteers who seek compensation for this service may jeopardize their protections under this law, though now lawsuit of such has been filed* Duty to respond * In US, Canada, England, Singapore, no legal duty* In Australia, many European countries, physicians are required to render assistance. * Other countries may have different protections or no protections at all<br> <br> <br> <br> Guests<br> <br> <br> <br> Thomas J. Doyle, Clinical Assistant Professor of Emergency Medicine, University of Pittsburgh Medical Center; Associate Medical Director, STAT MedEvac; Medical Director, Command Center, STAT-MD.<br> <br> <br> <br> References<br><br> <br> <br> <br> * <a href="https://www.ncbi.nlm.nih.gov/pubmed/30575886">Christian Martin-Gill, MD, MPH; Thomas J. Doyle, MD, MPH; Donald M. Yealy, MD. In-Flight Medical Emergencies: A Review. JAMA. 2018;320(24):2580-2590. doi:10.1001/jama.2018.19842</a>* <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1212052">Peterson DC, Martin-Gill C, Guyette FX, et all. Outcomes of Medical Emergencies on Commercial Airline Flights. NEJM. 2013:368(22):2075-2083. doi:10.1056/NEJMoa1212052</a><br>
