Emergency at 21,000 Feet
In 2011 I was travelling back from South Africa having spent 9+ weeks studying both physically and mentally, taking exams in close protection and remote medicine A few hours into the flight, an announcement came over the tannoy: “can any drs, nurses or medical personnel make themselves known to the cabin stewards”
It was 2am, the lights were dimmed and I was half asleep, but I got up and made my way down to the stewardess to make myself known.
As I got there, there was a lady there who said she was a Dr, a Gynaecologist. I asked her when the last time she did emergency medicine to which she replied, not since her training years ago.
I explained who I am, what I do for a living and how I’d just been on an extensive training course in remote medicine.
The Patient was displaying stroke like symptoms, slurred speech and was very weak. The Dr offered her assistance kindly but said to be quite honest that I was more trained to deal with this.
The stewards and stewardesses took me to the patient were I introduced myself and she didn’t look very well at all. I did a quick check of her in her seat and while she was slurring her speech, she had no side weakness and appeared to be no different to someone who’s extremely exhausted and tired, like someone who’s done a marathon for instance. I Proceeded to take the lady to first class because I wanted her to lay flat down – we laid her down by the bar in first class and gave her blankets to make her comfortable and curtained it off from the other passengers.
I took my medic bag, sat on the floor and assessed the patient, taking a full set of observations: blood pressure, spo2, temperature, blood sugars, lung sounds, pupil reaction and a neurological exam.
I always carry my observation kit with me on the plane because I’m legally allowed to, there’s no sharps in it or anything of that nature and its always important to be prepared for anything.
I knew they had at least oxygen, a defibrillator an AED – Automated External Defibrillator and a First Aid Kit. Unbeknownst to me at that time they had a full and advanced life support medical pack, as seen in the picture. That carries everything from observation equipment to drugs, from basic level to advanced level to assist a Dr, paramedic or nurse to give remote medicine help to the patient in the sky at that point in time which is a fantastic thing to have.
They also had medical direction on the floor which is what we call telemetric advice which is where we can talk to the ground where there’s a Dr on standby 24/7 who can give advice and guidance to whoever on the plane treating.
The co-pilot introduced himself to me and said please don’t do anything until we’ve spoken to the ground. He took my details and then spoke to the Dr on the ground. The Dr. on the ground upon hearing who I was, and my qualifications, gave me the all clear to just carry on and do exactly what I saw fit and use whatever equipment was provided.
There was a machine that takes an ECG – a picture fo their heart, the electrical impulse of their heart and sends it back down to the ground. Along with blood pressure, temp, oxygen saturation and pulse and that means the Dr on the ground can see if there’s any cardiac conditions or blood pressure things of that nature.
I did that and there was nothing out of the ordinary that I could see on the ECG machine or wrong with the lady’s pulse. It was a good pulse, however she did have quite low blood pressure.
So I placed a cannula in her hand to give her fluids to rehydrate as she was quite dehydrated and to raise the blood pressure. Whilst we were doing this she felt quite nauseous so we gave her an antiemetic – an anti-sickness drug – which took effect quite quickly. Every 15-20 mins we did a full set of observations.
All this I documented and got ready to hand over to the ground crew on our arrival at Gatwick. As we were now coming into morning they were now serving breakfast and although I was sitting on the bar floor, it was very nice to have breakfast in first class and the stewardesses were very accommodating plying me with bacon rolls as a thankyou for stepping in to help.
On landing an ambulance was brought to the plane and the lady was loaded into the ambulance and taken away and there I was thanked by the crew, the pilot and the co pilot and that was the end of my trip!
It turned out in South Africa she had picked up a virus at a wedding party she was at, and pretty much everybody at the wedding party had this particular virus making them ill with a variety of different symptoms, some were hospitalised, some were not and a few weeks later I received a lovely letter in the post from the lady thanking me for all my help
So it just goes to show no matter where you are or what your doing, its always good to be prepared for the unexpected because things don’t go to plan, things happen unexpectedly, and having the knowledge and training in medicine and being able to implement them when needed is of the upmost importance.