Is There A Nurse Onboard? The Reality Of In-Flight Medicine



Several weeks ago I found myself onboard a KLM aircraft flying from Amsterdam to Hartford, anticipating the usual sequence of pleasantly dull activities that occupy a six hour confinement inside coach.  You know the drill - the procession of back-to-back censored films, trashy magazines, maybe a session of small-talk with a seatmate.  These unexceptional activities did indeed transpire as usual, but then something altogether unexpected happened - the sound in my headphones abruptly switched from Juno's soundtrack to the tense voice of our head flight attendant. "If there is a medical professional onboard, please inform the flight crew." I'm a non-practicing nurse-midwife.  This is the sort of real life situation I dread.

I conferred with the man seated to my right, a dentist, about the proper course of action.  Both of us felt ill-equipped to manage a medical emergency, but we also agreed that we were ethically bound to announce ourselves.  So we turned our heads to the rear of the plane where a scuffle of activity had commenced.  Then we discreetly flagged down an attendant and told her that we were available just in case.  The attendant told us, "A boy in the back had a seizure, but he's okay now.  There's a doctor attending to him."  The dentist and I exhaled in unison with relief. 

This story brings me to an interesting piece of trivia.  Did you know that once upon a time all flight attendants were qualified nurses?  It's true.  According to Wikipedia, the first nurse-stewardess was an RN named Ellen Church, hired by United Airlines in 1930. In fact, during the early days of commercial flights, all flight attendants were required to be registered nurses.  But this stipulation only lasted until the beginning of World War II when the skills of American nurses were obviously needed elsewhere. 

These days, airlines rely on a combination of strategies to attend to passengers' unexpected mid-flight medical needs.  MedAire, a company which handles about a third of all airline carriers, is staffed by doctors who advise flight staff from the ground.  MedAire doctors communicate with flight crews, assess the gravity of given situations, and dispense instructions.  But doctor-issued directives can be problematic for non-trained crews.  Although most flight attendants possess certain skills, such as CPR, they are often unable to administer the intravenous fluids or injections supplied in aircrafts' emergency medical kits.  For these critical and sometimes life-saving tasks, sick passengers rely on strangers.

Chances are good that if you have a nut allergy and accidentally ingest peanut oil during an in-flight meal, you will be in the company of someone who knows how to handle it.  Northwest Airlines estimates that 96 percent of their flights have a physician, nurse, or paramedic onboard.  MedAire concurs, reporting that in 48 percent of their calls, passengers with medical qualifications voluntarily stepped forward to help. 

It's unlikely that I'll ever find myself delivering a baby on the floor of a 747, what with current recommendations against women flying during their third trimesters and all, but you never know.  If necessary, of course I'd do it.  Similarly, I surely hope that some nurse innocently reading People magazine would step forward to assist me just in case



Gross, S. (2008, Feb 29). Deaths on planes are rare, difficult. The Boston Globe



Copyright 2008- American Society of Registered Nurses (ASRN.ORG)-All Rights Reserved


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