What happened when they announced: “Is there a doctor on board?!”

Hollywood fiction or reality? What should one consider before making a choice between keeping quiet and stepping up in the (un)likely event of an in-flight medical emergency? How can Health Informatics be of help in such emergencies? What happened when they announced: “Is there a doctor on board?!”

Hollywood fiction or reality?

I’m sure we’ve all seen a movie or two that had this cliché plot twist, rolled our eyes and instantly labeled the whole thing as a product of Hollywood fiction.

Truth is, these situations happen more often than we think. There are around 600.000 people in the air at any given moment, equalling the population of a larger city. Therefore, it comes as no surprise that the frequency of occurrence of in-flight medical emergencies is the same as in any larger city on land.

What I am trying to say is, some of us will eventually end up in this movie-like scenario and have to choose between keeping quiet (and hoping someone else steps up) and stepping up.

What should you consider before making a decision?

People often say that being a doctor is a calling and not a profession. As a doctor, you are morally and often times legally obliged to hit pause on whatever is going on in your life and tend to a person in a restaurant, movie theater, on a bus or a plane.

When choosing whether to step up or not, it is important to consider:

  1. Your current condition. Feeling tired or inebriated might cloud your judgement and reflect on your ability to help the person in need of medical attention.
  2. Whether you have received the right skills during your training.
  3. That you might be the only person with medical training on board.
  4. That conditions on board are different than those in a hospital, in the sense that you only have access to a few diagnostic and therapeutic tools. However, having some mobile phone apps installed might help in such situations.
  5. The ethical, professional and legal obligations in case of off-duty emergencies.

 

How can Health Informatics be of use in this type of situations?

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The mobile health app market has seen an enormous growth in the last couple of years. Examples include apps that allow the retrieval of patient data through lock screen, help establish diagnosis based on the symptoms, check for drug-drug interactions, act as offline medical translators etc.

Some mobile health apps even come preinstalled like the Apple’s “Health” app which holds a Medical ID that can be accessed through the lock screen.

Although there is no denying that using the Medical ID app provides us with valuable patient data, we should bare in mind that it only comes preinstalled on Apple products. Since not everyone is an iPhone user, we can’t expect every doctor to be aware of this possibility or know how to use it, nor every patient to have it.

 

 

 

 

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What happened when they announced: “Is there a doctor on board?!”

After a two hour delay I was finally on board a half empty Ryanair evening flight bound for Berlin, on my way to have a fun weekend before heading back to Stockholm.

I sat in an empty row, put my headphones on and played some music on iTunes. I was going to spend the next two and a half hours working on that week’s assignment. The creative juices were pouring in until an hour into the flight I noticed people started turning heads. I took my headphones off and heard a woman in the back of the plane screaming for help. A few moments later a flight attendant announced that a passenger is in need of medical attention and asked if there was a doctor on board.

I waited to see if a more experienced doctor would step up, but nobody did. Although I had never been in a situation like this before, I volunteered to help the passenger that had lost consciousness. As I made my way to the back of the plane I felt the pressure since everything I had learned during my training was about to be put to the test.

When I reached the back of the plane I saw a man struggling to remain conscious. His face was really pale and his forehead covered in sweat. There was a big group of people around him causing a lot of commotion. I asked the other passengers to return to their seats and clear the row so that we can lay him across the seats. His wife loosened his belt and unbuttoned his shirt while I checked his pulse. I suspected it might be a case of syncope so we lifted his legs in the air and put a cold cloth on his forehead. I asked his wife about his health status, existing chronic illnesses and current medication. I used an app to learn more about the medication he is currently taking and check for his symptoms. The app confirmed that his symptoms matched those of a syncope, which I later found out accounts for around 30% of all in-flight medical emergencies. I explained to his wife what he was experiencing and asked the flight attendant to bring him some water and a candy bar. After around 20 minutes, the man’s face had fully restored its normal color and he claimed he felt much better. I told his wife to make sure he’s well hydrated and to call me in case he needs further assistance. As I walked back to my seat, my hand started to shake… I will never forget that flight.

 

I hope that those of you belonging to the medical profession who still haven’t experienced a similar situation, find this text useful and that it encourages you to brush up on your first aid skills and install some mobile health apps that could potentially help you establish a correct diagnosis and avoid complications.

What this experience had taught me is that it’s very important to be aware of your limits, try to remain calm, make the most of the available tools and act according to the ethical, professional and legal obligations. The majority of in-flight emergencies are fairly simple and can be alleviated by following a series of easy steps.

Check out this video to learn more about the epidemiology of in-flight medical emergencies.

 

Feel free to share your own experiences, questions / comments in the comment section bellow and I will get back to you as soon as I can.

 

Nikola

 

Contact me via:

Instagram: nomad_dentist

LinkedIn: Nikola Mastilovic

e-mail: nikola.mastilovic@stud.ki.se

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