Airlines have a strategy to deal with sick passengers

A gray-faced woman grasps a friend’s hand and shuffles toward the airplane’s bathroom. A few minutes later, she wobbles back to her seat and a voice comes over the PA: “Is there a medical professional on the plane? A passenger needs assistance.”

“I’m a doctor,” answers a woman seated behind me. Another woman also rushes up the aisle to help. Flight attendants scramble back and forth with glasses of orange juice. Passengers gossip: The woman has diabetes; she didn’t eat before the flight; she has nausea and can’t communicate.

A call goes out to the passengers for glucose and a glucometer. Five people volunteer theirs. Two more doctors join the medical group. One is an ER doctor on her honeymoon, the passenger grapevine buzzes.

A flight attendant brings a medical kit, and soon an IV is hanging from the overhead luggage compartment.

The captain emerges from the cockpit, his face long with concern. He confers with the medical personnel, then announces that the plane is about an hour from its destination, and, since the patient is in good hands, the plane will be continuing on. You can practically feel the change in cabin pressure from the passengers’ collective sigh of relief.

When I get home, I start inquiring about how often this happens, and how passengers and flight crews respond. It turns out it’s more common than you might think.

Doctors, apparently, fly a lot

U.S. airlines contract with services that give them access to medical professionals on the ground. Had there been no doctors or nurses on my flight — and, in some cases, even when there are — the flight attendants would have called one of them.

In the United States, there are two main services that airlines call. One is MedAire, which runs the MedLink Global Response Center, where physicians from the emergency department of Banner-University Medical Center Phoenix handle calls, and the other is the UPMC Communication Center, where physicians from University of Pittsburgh Emergency Medicine deliver advice.

Dr. Christian Martin-Gill, a physician at UPMC Communication Center and assistant professor of emergency medicine at Pittsburgh, co-authored the study “Outcomes of Medical Emergencies on Commercial Airline Flights,” which the New England Journal of Medicine published in 2013. He says his research addressed whether flying is, indeed, safe.

The researchers reviewed 11,920 calls made by five domestic and international airlines to the center between Jan. 1, 2008, and Oct. 31, 2010. Based on that data, they estimated that the 2.75 billion total passengers who fly each year experience 44,000 in-flight medical emergencies. That boils down to one in every 604 flights, or nearly 50 every day.

In those cases, the most common symptoms were fainting or lightheadedness (37.4 percent), respiratory issues (12.1 percent), and nausea or vomiting (9.5 percent). Just over 7 percent of affected flights landed because of the illness.

The surprising finding for Martin-Gill was this: In 75 percent of those medical emergencies, a medical professional was on board to volunteer, and 50 percent of the time, that medical professional was a physician.

In other words, having medical professionals step up is more common than not, and that’s a good thing for sick passengers. Because while flight attendants must be trained in CPR and using an automated external defibrillator, they are not medical professionals.

Flight attendants are familiar with the contents of the onboard emergency kits (which include, in part, syringes, needles, a blood pressure meter, devices to open airways, an IV set with tubing and tourniquet, and a variety of medications) but they’re not trained to use those items. That’s when you hope that the person sitting next to you is either a nurse or doctor.

“This is kind of a wilderness environment, because you’re up 30,000 feet in the air, and it’s nice to see people come together and help each other out,” says Martin-Gill.

Attendant helps with a sandwich

Lauren Nehmer, a pediatric oncology nurse at Children’s Healthcare of Atlanta, has been on three flights that involved medical emergencies. She helped with two; the third already had enough volunteers.

On a flight from Milan to Atlanta, a teenage girl was having a seeming allergic reaction that made her throat itch. Fearful of the reaction worsening and impacting her breathing, Nehmer and another nurse gave her Benadryl through an IV, and, four hours later, a shot of epinephrine. When the plane landed, an ambulance whisked the girl to a hospital, where she recovered.

On a flight to Asia, Nehmer and another nurse helped a man who complained of severe abdominal pain. He hadn’t been able to urinate for at least 12 hours before their flight (she says she thinks he had some larger medical issue causing the problem). The solution was to insert a catheter to give him some relief, which they did, right there on the plane.

She adds that in the air, you have to be creative. While the emergency kit was equipped with catheter tubes, she needed a container to hold the urine. The plane’s hot tea pitcher came in handy. “I was like, oh, God, that seems wrong or weird.”

Sara Nelson, the international president of the Association of Flight Attendants, has seen her share of medical incidents since she began working as a flight attendant with United Airlines in 1996. “When I was flying a full schedule, I would say that I encountered it at least once a month,” she says.

She says diabetic issues — low blood sugar, in particular — are a frequent occurrence, and she has sacrificed her snack to help out. “I have given up my peanut butter and jelly sandwich many times,” she says.

While the medical emergency is stressful enough, Nelson says that since Sept. 11, 2001, there are also security issues to consider. Flight attendants know that any unexpected incident could be intended to divert the crew’s attention as part of a terrorist attack. “When there is a medical emergency, we take that seriously and we respond to the health emergency, but every member of the crew also goes on high alert for a potential security threat,” says Nelson.

Despite those risks, Nelson says that in almost 20 years as a flight attendant, she’s seen, time and again, the goodness of people who are willing to help a stranger in need.

“You’re up there in this metal tube at 35,000 feet, and you’re all in this together,” she says.