IN-FLIGHT MEDICAL CARE:
AVAILABILITY OF EQUIPMENT DOES NOT CORRELATE TO OUTCOME
The title of this column (Airplanes are Not Flying Hospitals) was derived from a comment (“No matter how well-equipped airlines become, they are still transportation vehicles—not in-air ER s.”) made by the medical director of one of the nation’s leading air carriers. It came during an interview I initiated around the time when airlines were first planning to place portable defibrillators aboard aircraft.

His point: The availability of new medical equipment could lead to greater, perhaps even unrealistic, expectations of the type of medical care that can be delivered in flight. Passengers, he observed, can get lulled into a false sense of security by whatever airlines were doing in terms of enhancing their medical kits or adding automatic external defibrillator (AED) units to their cabins.

The consumer press heralded the decision to include defibrillators, and there were even a few incidents of lives being saved on aircraft that already had them on board. But what was also happening, and getting far less press, were incidents with less-favorable outcomes. Some travelers with iffy health histories and serious heart conditions, for example—people who should not have been traveling—were perhaps getting a little too comfortable. That feeling of security engendered by the presence of AEDs was sadly misguided.

When I wrote the original article several years ago, I included a piece of information that often got bypassed by readers who were too thrilled about the “good” news to read on to the punchline. Every doctor I interviewed for the story made the point that even with a defibrillator onboard, even if you were revived quickly enough (and these are big ifs), you had to get someone on the ground—and into a cardiac care unit, not a plain-vanilla hospital—within a small window of time, something like 20 minutes, tops.

THE ODDS ARE NOT IN YOUR FAVOR
Think about that. How many planes can land that fast, let alone deplane you and get you into an ambulance and into a specially equipped hospital? Do the math. The odds are not in your favor.

Let me say here that I’ve got a simple take on the airline’s responsibility in health emergencies: Airlines should do what they can do—upgrade the contents of medical kits to meet what non-airline medical professionals consider standard equipment, provide ground contact with medical professionals for in-flight treatment advice, and get the plane down as quickly and safely as possible if a medical crisis occurs during a flight. And to err on the side of caution, not cost.

Flight attendants are trained in CPR and the use of the defibrillators but I don’t expect them to render the same care and services provided by hospital staffers. Even attendants with EMS or paramedic experience shouldn’t be expected to act as cardiac specialists or emergency room physicians. And while it may be reassuring to know that the likelihood of having some kind of medical professional on your flight is high (around 70%), it’s not reassuring enough to entrust your life to a stranger no matter how helpful—especially one who is not likely to have the equipment he/she needs to help you.

Safeguarding our personal health is our sole responsibility. Let the airlines focus on protecting the equipment and the process. Given today’s travel landscape, that’s a demanding enough agenda without us passengers adding to it.