- Air travel
By Michael Gebicki
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“If there’s a doctor on board would he or she make themselves known to the cabin crew?”
That’s one inflight announcement that gets everyone’s attention. Cases of inflight medical emergencies are rare, between 25 and 100 cases per million passengers, according to German airline Lufthansa. Babies get born, defibrillators get switched on and discharged, fights break out and noses are broken – but these are rare exceptions.
According to a study of almost 12,000 inflight medical emergencies by the University of Pittsburgh Medical Centre, in almost 40 per cent of cases the problem was temporary loss of consciousness due to low blood pressure. Respiratory symptoms accounted for 12 per cent, nausea or vomiting 10 per cent and cardiac symptoms eight per cent.
In roughly three quarters of cases when flight crews requested assistance from passengers with medical training, the response was positive.
Feeling crook?
While the most common medical problems that happen onboard are nausea or dizziness, if it’s something more serious, tell the cabin crew. If you’re travelling with a partner or friend, ask them to do it. Cabin crew have access to a medical kit and they’re trained to deal with medical emergencies, but only up to a point. They might be first responders but they’re not paramedics and if it’s a situation they’re not trained to deal with they may make an announcement asking if there’s a doctor on board.
Medical professionals are sometimes reluctant to step forward in answer to the call, and there’s no obligation for them to do so. Some will wait in hope that another qualified medico will respond, some lack the relevant qualifications, others might be put off by the cramped surroundings and lack of resources.
There is also a fear of possible legal consequences, yet according to a report on Medical Guidelines for Airline Travel by the Aerospace Medical Association there are no known cases of legal proceedings against a medical professional who has volunteered in an inflight medical emergency.
Australian law provides protection for Good Samaritans and in the USA the Aviation Medical Assistance Act of 1998 also provides legal protection for medically qualified professionals. Many other major carriers also indemnify medical professionals against legal liability.
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Should you fly if you’re feeling unwell?
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We push it, don’t we? We want to get to where we’re going and – it’s only a head cold, a mild fever, I haven’t sneezed today so I’m probably not infectious. Or maybe there was just one pre-flight drink too many in the terminal.
Flying impacts your circulation system, since you’re likely to be inactive for long periods, and respiration, due to less oxygen in a pressurised cabin than at ground level. That can tip you over the edge if you’re suffering from some health conditions that make it imperative to have a medical check-up before flying. The list includes angina or chest pain, any infectious disease including COVID-19, an ear or sinus infection, a recent heart attack or stroke, if you experience breathlessness at rest or difficulty breathing or a recent operation. Even something as simple as a toothache can turn a flight into head-pounding torment.
Flying too soon after scuba diving can cause decompression sickness, and the only cure for that is a fast return to low altitude and a hyperbaric chamber. According to the Professional Association of Diving Instructors and the Divers Alert Network, divers need a minimum surface time of 12 hours following a single dive and 18 hours after repetitive dives or multiple dive days. The US-based National Association of Underwater Instructors recommends 24 hours after any dive before flying at altitude.
Airlines can refuse to board you if you’re sick
Your airline doesn’t want you onboard if you’re not healthy.
“Medical conditions can be exacerbated by the on-board environment,” writes former Qantas Captain Bill Austen in his memoir Cloud Surfing.
“Reduced oxygen, dry air, stress, fatigue, separation from medicines and a lot of minor complications. In an attempt to thwart such problems, the only thing to do, in obvious cases, is not to take the problem on board in the first place. I could give numerous examples of passengers being refused boarding. People are never happy with this, but sometimes it has to be done.”
Staff at the check-in desk and at the boarding gate are on the lookout for passengers who present as unwell, and that require further investigation, with the possibility of offloading that passenger. A sick or incapacitated passenger is trouble they don’t need. In an extreme case, an aircraft might have to make an unscheduled stop to offload a passenger suffering a medical emergency. If that can be anticipated, that passenger won’t be flying today.
Can you get off at a transit stop?
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If you have a transit stop coming up and you’re unwell, you might consider ditching your connecting flight in favour of medical attention. If so, you need to let your cabin crew know. They’ll probably refer you to the transfer desk in the terminal, where you can make whatever arrangements might be necessary. If you’re too unwell for that, again your cabin crew can advise. If you don’t show up for your connecting flight without telling the airline, not only do you risk delaying the flight but your booking will be cancelled.
Medical assistance at airports
Major airports will usually have a health clinic. They vary in the services they offer but at the very least they can provide a diagnosis and medical treatment similar to what you could expect from a GP. In some cases such as Melbourne Airport’s Health Clinic, these medical centres can perform minor operations. For anything beyond the services and expertise they offer, the clinic staff should be able to arrange any further treatment that may be necessary. The health clinic should be your first port of call if you arrive feeling unwell.
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