Air care

Is there a doctor on board? 5 tips to provide care at 30,000 feet

Beth Longenecker, DO, shares how she used her emergency medicine skills to help ill passengers on flights.

Beth Longenecker, DO, never imagined that her journey home from a blissful trip to Hawaii would include these seven words: “Is there a medical doctor on board?”

She immediately sprang into action, abandoning her book to help a passenger who had been found unconscious in the bathroom with dangerously low blood sugar levels. Quickly, Dr. Longenecker, who is board-certified in emergency medicine, obtained an IV and administered glucose to the patient on the plane. Eventually, the patient came to, though she was confused.

“Since the passenger couldn’t be moved back to her seat, I braced myself on the ground and held her while we landed,” Dr. Longenecker says.

As the holiday travel season approaches, Dr. Longenecker shares what you need to know if a medical emergency occurs on your next flight. A frequent traveler, Dr. Longenecker has answered the call for a physician on an airplane several times, including instances when she treated dehydration and an asthma attack.

Care in the air: 5 tips

1. Don’t be afraid to help

Although flight crews typically receive basic medical training and have access to an on-the-ground physician via telemedicine, in-person medical expertise from a physician on board can be critically important during an emergency.

“This is a patient who truly needs help. You don’t need to be trained in emergency medicine; any physician has a broad enough knowledge base to provide initial care,” Dr. Longenecker says.

2. Show some ID

To put the flight attendants and patient at ease, show your medical license, state license card, business card or another document that identifies you as a physician. You may also want to show your Advanced Trauma Life Support or Advanced Cardiac Life Support cards.

3. Understand that supplies will be limited

Typically airlines will have basic supplies such as oxygen and aspirin, but the supplies in the flight kit can be limited. Here’s a list of what the Federal Aviation Administration requires in flight kits.

“It’s a little more frightening treating someone on an airplane than in your office where you know what supplies you’ll have,” Dr. Longenecker says. “It’s hard to be prepared.”

In this situation, physicians might need to think outside of the box if the necessary supplies are not available in the kit. For instance, when Dr. Longenecker treated a patient who had an in-air asthma attack, another passenger had an inhaler he was able to use.

Beth Longenecker, DO (right), provided care to an ill passenger on the flight home from an anniversary trip to Hawaii with her husband, Bill Kortier. (Photo provided by Dr. Longenecker)

4. Prioritize care

Assess the situation to determine the most crucial issue that needs to be taken care of on the airplane. For instance, on Dr. Longenecker’s journey from Hawaii, that meant providing the passenger with glucose to help elevate her blood sugar levels until they landed.

“You will get frustrated if you think comprehensively like you would in your office rather than addressing what is immediately correctable,” she adds.

5. Don’t accept payment

Good-faith treatment provided by a physician during an in-air emergency is protected from liability by the federal Aviation Medical Assistance Act of 1998, a Good Samaritan law. However, the law doesn’t apply if you accept payment for your services. But gifts of appreciation, such as a voucher for a free flight from the airline, are fine.

9 comments

  1. I am Dr Christina KoLade ,had an experience with a patient who had thrown an embolus on a trip Dom Lagos ,Nigeria to JFK New-York .The patient 68 yr Old African male with known history of DVT but has no clue of his diagnoses but in my 2-3minutes interaction with him found out he was taking a blood thinner before he lapse into coma .Fortunately the group got me right away we had to improvise ,used glucometer from other passenger.Most importantly we gave Lactated Ringer s with Lots of Oxygen via nasal cannula . Stablize the patient and turn over to EMT in New York.

  2. I had what amounts to a series of on flight patients with grand mal seizures – extremely frightening for the flight crew and other passengers but pretty easy to deal with. I had two such patients, both on international flights over the middle of the Atlantic Ocean. Of course, all I could do was administer O2 and keep the patient’s airway open. There was no Accu check available. They soon emerged from their post-ictal states. Both patients did well and I gladly turned them over to EMS upon landing. Very dramatic but as a calming, leadership presence, the flight attendants and other passengers were extremely grateful. Interestingly, no one ever asked me for any credentials.

  3. I have been drafted into service several times. Sadly the on board kits do not have Ativan, it would have been useful when dealing with a seizure. I have also had intractable vomiting with the benefit that I had my own kit with an antiemetic. The last even I recall was painful disc disease. The take home is that the kits are very limited and there is no way to restock, so the supplies there must be judiciously used.

  4. While enroute to the ACOFP convention in LV a few years ago, I answered the call –only one on the flight(?) to come foreword. As I was attending to the passenger, a very nice Littman stethoscope was passed up from the rear of the plan for me to use—hummmm. Passenger had an acute abdomen and we experienced “Medical Priority” landing–all ended well. Thank you to the Stethoscope owner–much appreciated!! :)

  5. Coming back from my honeymoon from Hawaii, being a your DO just finishing medical school, found myself in the same situation, while on the flight back from the honeymoon. I was in the planes bathroom and the announcement went over head is there a nurse or doctor on board. Naturally my wife Grozda volunteered my services to an elderly woman whose father died state side, who left her medicine (beta blocker) in her luggage, and whose dogs were in the lower portion of the plane, who experienced fainting. The supplies on the plane were minimal at best-even the oxygen was in PSI. Also a military trained nurse who wanted to out show the young medical student, assisted me. And a sales man for oxygen who did not know the conversion of PSI to L/min helped us. The patient’s vitals were stable, and the crew helped as best they could. We wound up strapping the patient on our laps until the plane landed in San Francisco. On came the EMS team and rescued the day. Upon exiting the plane my wife noticed the flight crew stashed a bottle of champaign in our carry on luggage. This was when phone cameras were unavailable–bummer.

  6. Thank you to the Physicians who came forward to help. The tips the gave for in flight emergencies are invaluable!

  7. I had a patient with classic chest pain on the way home from Orlando ACOFP a few years back. Luckily it didn’t happen until shortly before landing in Denver, so we didn’t end up needing to divert. I was happy that they did have NTG in the kit.

  8. I would be cautious in accepting any form of payment or favors, which can be deemed as payment. Obviously cash is not acceptable, but accepting a $200 airline voucher can be seen as payment in some cases.

    Just be careful in acceptance of gifts.

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