#VinitasPune: Rise In Mid-Air Medical Emergencies Need Introspection And Action

CPR - Doctor on Flight
Image used for representation only.

Last week, a city doctor on board a Nagpur-Pune flight, saved a patient who suffered a cardiac arrest, mid-air…

With such medical emergencies on the rise, is it time for the airlines to getting better equipped to handle these situations?

For the record, a passenger on board the Nagpur-Pune flight- Ashok Jadhav lost consciousness 20 minutes after take off. The cabin was alerted and the pilot announced to check if there was a doctor on board… Dr Uday Rajput, Director of the Cardiopulmonary Resuscitation (CPR) Centre of B J Medical College was on board and immediately performed CPR on Jadhav. He had not only fallen unconscious but there was no breathing or pulse, which indicated cardiac arrest. When Jadhav did not respond to CPR, Dr Rajput called for the on board automated external defibrillator – with the help of a replacement battery for cardiac science g3 -which restored his heart beat and the passenger was saved, thanks to the immediate professional intervention of the doctor.

All such cases are however not as fortunate…

On November 13, 2018, 78 year old Vijay Kulkarni was on Go Air flight from Port Blair to Mumbai. He complained of uneasiness and pain in the chest, which led to the pilot doing emergency landing in Chennai. However, he collapsed and died as soon as the plane landed. On October 5, 2018, a Thai passenger aboard a Spice Jet flight from Bangkok to Delhi, suffered a heart attack. The pilot did an emergency landing in Varanasi but the patient was declared dead on arrival at the hospital. On September 1, 2018, a 60 year old passenger, Charanjit Singh Anand died of heart attack aboard the Lufthansa Airways flight from Frankfurt to Delhi. On January 24, 2018, a 53 year old man died of heart attack on board the Jet Airways Delhi-Mumbai flight. Again in the same month of 2017, Air India had to make an emergency landing at Jaipur Airport when a woman on the Delhi-Rajkot flight suffered a heart attack. Despite her being rushed to the hospital on landing, she passed away. In a freak case, a 70year old passenger died because the denture of his lower jaw got dislodged and got stuck to his throat on a Mumbai-Amritsar Spice Jet flight. Despite an emergency landing on Delhi Airport, he did not survive.

Are such mid-air medical emergencies on the increase? I certainly think so!

I have been travelling by air for more than two decades, yet, it was this year that I witnessed two medical emergencies on each of the two flights that I took this October. One of them was on the flight from Mumbai to Istanbul on Turkish Airways flight. The pilot suddenly announced a medical emergency on flight and the cabin crew did well to rush to the elderly gentleman who suffered chest pain. Fortunately, he responded to the first aid treatment. On the next flight, on the continuing journey aboard Turkish Airlines from Istanbul to Miami, an elderly woman suffered chest pain and looked very uncomfortable. Again the pilot announced on the Public Address system and again the crew did a commendable job. The destination was a good four hours more and everyone was on tenterhooks, to see the lady visibly uncomfortable.

Though there was no emergency landing and both the patients looked better, the fact is, it did make me worried and nervous. It was the first time that I witnessed such medical emergencies on two consecutive flights, which seemed just a bit too often!

According to research data though, on–board emergencies are approximately 1 per 10 – 40,000 passengers and that is about 30 such events per day on a global basis

The DGCA makes it mandatory for all cabin crew to complete a safety training course which includes a week’s practical training for First Aid performed on a dummy. Incidentally, the defibrillator is a mandatory equipment to be kept by the airline. The airlines and its crew are required to follow the protocols for onboard medical situations. The automated defibrillators are essential on a flight just in case there are any medical emergencies whilst being in the air. Aircraft can get their defibrillators from sites like Seton.co.uk to ensure that each passenger can receive the right onboard medical treatment if needed.

Did you know that the first ever flight attendants or air hostesses as they are known now were all registered nurses who had served patients in World War I?

Probably, it is time to have a Doctor on board provided by the airline considering the increasing number of cases. Also, airlines could have a designated space on the flight where the patient can be attended to better and conveniently by the crew staff/doctor on board.

Studies suggest that due to the increased longevity thanks to modern medicine, there are an increasing number of senior citizens travelling and maybe prone to face minor and serious health conditions on the flight. As per a research paper written in 2017, titled ` Onboard Medical emergencies in Commercial Air travel’ by Dr’s Ajithkumar S, Rajasekharan C of Medical College, Trivandrum, ‘the operation factors affecting on-board medical emergencies include: `the environmental conditions of aircraft which constitute a physiological and psychological stress. The operational factors affecting ideal medical care are as follows :- a) Physiological issues and operating altitude of aircraft. Physiological stresses include hypoxia, barometric pressure changes, orthostasis, temperature changes, dehydration, noise, circadian disorders and fatigue. b) restricted space, availability of appropriate and necessary equipment for handling a given emergency. c) Unless they are traveling on board as passengers, qualified medical personnel are not generally available in the air craft. Difficulties were encountered by the passengers with certain medical emergencies such as respiratory or cardiac arrest as the cabin environment is also pressurized to an altitude in the range of 6,000 to 8,000 feet (91). d) Psychological stress is also there in the circumstances of travel. e) The range of medical problems onboard aircraft varies widely – from trivial to life threatening.”

Puneites are enthusiastic air travellers with age not being any restriction and this is amply demonstrated by the large population at the Pune Airport, at any point of time.

Perhaps, it’s time now for air passengers to come together and impress upon on the airlines to ensure proper medical attention is available on board at all times. Akin to Delhi based entrepreneur and activist, Veeresh Malik taking up the cause of quality of air inside the cabin and flying sickness, this reality also needs activism considering the possible dangers. And yes, it is a good idea for all of us to learn to conduct CPR in case of an emergency. This may just be what can save a good life on this earth. ~~ #All views expressed in this column are the authors and Pune365 does not necessarily subscribe to them.

Vinita Deshmukh