Have you ever treated or assisted a sick person in the air?

[jfoxcpacfp]

Just read this story on Quora:

Do airlines compensate doctors for assisting during an emergency?

Answered by: Harris Wild, BS Chemistry, Tufts University. MBS Biomedical Sciences, Rowan University (2016)

25.7k Views • Upvoted by Tom Farrier, Retired USAF command pilot; Chair, ISASI Unmanned Aircraft Systems Working Group

I actually know a doctor who told me a similar story to this. During his flight, a man fell very ill and someone called for a doctor. He was hoping someone else would answer the call, but no one came, so he stood up. He examined the man and found that while ill, the flight did not have to be diverted, and told the crew that as long as the man got proper medical attention on the ground, they should be okay.

After the plane landed, a representative from the airline asked to speak to the doctor privately. She wanted to sincerely thank him for his help, and wanted him to know that the airline wanted to compensate him for his service. She handed him a slip of paper, smiled politely, and walked off. The doctor was very excited. Perhaps a free flight? Miles? A first class upgrade?

Heading to the baggage claim, he excitedly unfolded the paper.

"This coupon good for one (1) drink order."

[Raj]

I havent personally treated anyone in air but my dad did once. A middle aged guy was having an asthmatic attack and my dad injected theophylline (first aid kit in the flight). He felt better. I was a kid then. We got some gifts/toys in the plane. We kids were really excited. Not sure if miles existed then. My dad was non-chalant about the whole episode.

[VagabondMD]

When I was a resident, some buddies and I were headed to Greece and assisted a man who experienced a vagal reaction over the Atlantic. I remember the airlines staff being uncooperative but the family being very grateful for our assistance. We received nothing from the airlines, and the family took us out for dinner in Athens.

One other time, I heard the overhead page on a domestic flight, and I waited about 30 seconds before responding. Fortunately, when I arrived, there was an internist already on the scene, and the ophthalmologist and the radiologist (me) could sheepishly slink back to our seats.

[7Rays]

I'm a radiologist and told myself that if I was ever on a plane I'd make great effort not to be 'the doctor on board' if someone was in need, just because of unknown liability and the fact that I don't do that stuff anymore.

I was on a 2-3 hour flight from somewhere in the midwest to Phoenix and sure enough an hour into the flight there was an overhead call for medical assistance, specifically asking for a doctor on board. I was snoozing at the time but woke up after my pregnant wife nudged me. Like everyone on board, I started looking around but nobody got up. They asked again on the speaker and nothing. I saw something happening in the back of the plane with the flight attendants and people were scrambling and looked clueless. Even though I wanted to stay in my seat... I couldn't. So I got up and went to the back and started to assess the person. Shortness of breath, history of anxiety, on new meds, 55 female, non-english speaking (which was fun let me tell you), etc etc. It was a cluster. Non-functioning worthless 5 dollar stethoscope from the plane. Had a BP cuff though. Tried to get rough BP by palpation with the cuff and fingers. Had a nurse on board help me who had some experience with this from military work. That's it. Have fun Mr. radiologist!

Long story short, she seemed to not be dying, so we didn't do an emergency plane landing (they asked my opinion, of course). I stayed with the patient for the last 1.5 hours in the back of plane doing intermittent vitals and she did fine. We landed and EMTs were waiting and took her. Airline DID ask me to fill out a progress sheet with rough vitals, etc, what happened, and sign it.

I ended up finding out later an anesthesiologist, internist, and an EMT were on board the plane and watched me doing things in the back of plane, walked back to check things out like 5-10 mins after I got back there, never said a word to me (I didn't see them either, lots of people), and went back to their seats for the rest of the trip. Thanks for the help guys. My pregnant wife told them I was a radiologist too.

 

Learned a couple things from this event.

1. I couldn't not help someone in need.

2. Next time I need to stay in my seat longer when they call for a doctor.  

3. Airlines are happy to use you for your doctor skills. They are not interested in compensating you for it. They did offer a few drink coupons. I still can't believe they made me sign my name on an assessment form.

4. If you treat a patient on a plane, you are the second person off of the aircraft!

[AlexxT]

My experience, similar to the above.  No compensation.  No help.  No useful equipment at the time,although now they may have automatic defibrillators.

If they offer compensation, it's probably best to decline it, because if you get compensated you lose the protection of the good samaritan laws.

There was a story in the news a few years ago about  an orthopedic  surgeon on an airplane who diagnosed a woman with shortness of breath as having a tension pneumothorax. (She had been in a minor accident earlier and had a tender and bruised rib).  He rigged up a fluid valve, used oxygen mask tubing and a pen knife, and treated the pneumothorax.

https://en.wikipedia.org/wiki/Angus_Wallace

 

[jfoxcpacfp]

AlexxT wrote:

If they offer compensation, it’s probably best to decline it, because if you get compensated you lose the protection of the good samaritan laws.

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Good point and, of course, I hadn't thought of that. Maybe the airline personnel in the original story had already been trained not to offer anything substantial such as a free ticket (but the story is much funnier the way it's written).

[AlexxT]

I doubt that they have doctors' best interests at heart.  I think that they're just stingy.  But I'm a cynic, and you seem to want to think the best of others.  

[jfoxcpacfp]

AlexxT wrote:

But I’m a cynic, and you seem to want to think the best of others.

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Well, that was kind of you. At least I think it was. Now I'm feeling cynical. :?

[The White Coat Investor]

Yes a couple of times. Best not to accept compensation as you will lose the ability to claim good samaritan status.

My claim to "hero" fame was bringing a guy back from the dead at the baggage claim though. Woke up and wanted to get his bags and go home. I talked him into going to the hospital and getting a CABG instead. His ICU nurse wife, waiting outside in the car, was grateful.

[Gas_Doc]

7Rays wrote:

 

I ended up finding out later an anesthesiologist, internist, and an EMT were on board the plane and watched me doing things in the back of plane, walked back to check things out like 5-10 mins after I got back there, never said a word to me (I didn’t see them either, lots of people), and went back to their seats for the rest of the trip. Thanks for the help guys. My pregnant wife told them I was a radiologist too.

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That's unfortunate. I had the exact opposite situation on a plane. I was a 4th year med student, heard the "we need a doctor" call overhead, waited the usual 1-2 minutes hoping someone else would get up. After all, I wasn't a doctor yet. Didn't see anyone, so I finally decided to do something.

 

By the time I got to the back part of the plane, there were two people "assisting" (ie, looking at the patient like a deer in headlights). Turns out the guy was an epileptic who missed a dose of his meds and was having a seizure in his seat. The two people "assisting" were a psychiatrist and radiologist. They asked what my training was, I told them I was a MS4 that had just finished his Neurology rotation, and they proceeded to defer all decision-making to me.

 

The guy ended up doing fine, no status epilepticus or aspiration or anything, but in hindsight it was a total "but I did stay at a Holiday Inn Express last night" moment.

[Josh0731]

During general surgery residency a friend of mine was on a plane to Hawaii when an older man had a sudden cardiac arrest and died. He answered the call for help, said the flight attendants gave him a medical bag, but he said when he opened it the contents were a disorganized random assortment of EMT-type supplies that he said wound up not being helpful at all. Worst part of the story was that the guy had a lot of family on the plane watching the whole thing.

I will answer a call if they ask me to, but the last time I did it was just a woman who had an anxiety attack and locked herself in the bathroom...

Good point WCI about remaining a Good Samaritan for medicolegal reasons - I hadn't thought about that.

[uptoolate]

Three times that I can recall. None of them major disasters.  SOB in a CHF patient who was on the second leg of a trip across 12 time zones and since she wasn't sure what to do with all her meds she just stopped them!  Syncope in a 80-something man which was probably vasovagal.  Abdominal pain and faint in a 30-something woman which was probably a ruptured ovarian cyst.  The first one was almost 30 years ago and my recollection was that I got a nice little plaque and a voucher from the airline.  Second one was maybe twenty years ago and got very many thanks from the crew for saying that I didn't think that they needed to land the plane and a letter I think.  Last one maybe ten years ago (maybe I'm due!) and the crew took all my information but I don't think I ever heard anything from the airline.  I think in the second case an RN was helping by the time I got there.

It can be a pain. I love to just relax when flying. Back in the old days before flights were booked to the max it was a good way to get an upgrade. These patients need lots of room to recline and stretch out after all!

[shantster]

NJEM publishes a good article that goes over the equipment available on the plane, medicolegal protections, and common scenarios. They do an update relatively often.

http://www.nejm.org/doi/full/10.1056/NEJMra1409213

[G]

Yes, several times.  Although as I think about it, I haven't done it in several years...and I usually fly 30K+ miles each year.  Maybe the flying public is getting healthier?

I have received a voucher for 5000 miles, drink/headset coupons, but most often just a sincere thank you from the flight staff.

Unless it's a morning flight, I take full advantage of the free cocktails, so it'd probably be best to let the radiologist or psychiatrist sort things out. 

My best baggage claim story is when an attractive young woman approached me pushing a baby stroller and said "You don't remember us, do you?"  She broke up my stammering by reminding me that I had delivered her infant several months prior.

[NJDoc]

G wrote:

My best baggage claim story is when an attractive young woman approached me pushing a baby stroller and said “You don’t remember us, do you?”  She broke up my stammering by reminding me that I had delivered her infant several months prior.

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That is too funny!

 

Just last week , while traveling abroad this happened where a request was made for a physician. We were in a non English speaking country and on a local  airline. A woman was having an allergic reaction to a small dog in the row behind her. My friend , an anesthesiologist, and I attended to her, and to my astonishment my friend pulls out his good stethoscope and listens to her lungs. Ultimately, we ended up getting her an antihistamine and moving her to another row. I found out later, through one of the English speaking crew members that the dog in the row behind her was hers and was being held by her husband. Not one person said thank you, patient, airline personnel or the husband...