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Fainting Most Common Medical Crisis on Planes
Date:2/27/2009

But researchers note that exact in-flight medical emergency numbers hard to find

FRIDAY, Feb. 27 (HealthDay News) -- More than half of the medical emergencies that occur on airplane flights involve fainting, a new study shows, but the researchers note that a lack of good data on such cases makes it hard to know how to best protect passengers in the future.

Researchers requested in-flight emergency data from 32 European airlines, although only four of the airlines had the data, and only two of those participated in the study. What they discovered: 53.5 percent of incidents involved fainting; 9 percent dealt with gastrointestinal problems; and about 5 percent experienced cardiac events. Of the flights studied, 52 people died while on a plane, and two babies were born.

However, these numbers were hardly comprehensive, they added.

"There were very big differences between the airlines," said study author Dr. Michael Sand, of the department of general and visceral surgery at the Augusta Krankenanstalt, Academic Teaching Hospital at Ruhr-University Bochum, in Germany. "Some were documenting very precisely, some very bad or not at all."

The report was published in a recent issue of Critical Care.

"The problem with most of these studies is largely that the data is not recorded in any consistent form, and there's no common definition of any of these medical conditions," said Katherine Andrus, assistant general counsel of the Air Transport Association. "It makes it difficult to compare data across different airlines and across different countries."

"I think airlines should think about documenting in-flight emergencies in a standardized manner to have better data in the future," said Sand. "Based on this data, one could facilitate the design of in-flight emergency kits and give advice to chronically ill patients who are more likely to have an emergency while in the air."

Meanwhile, the researchers and industry experts suggest that people, especially ones with preexisting medical conditions, take responsibility for themselves before boarding a plane.

"A chronically ill patient who already had some myocardial infarction should consult his doctor before a long distance flight," Sand said. "Somebody who's diabetic should be traveling with insulin."

The good news is that when medical emergencies do happen mid-flight, the researchers found that medical professionals were often on board and willing to help.

"In 86 percent of the cases, we had a nurse, paramedic or a doctor on board who could assist in treating the patient," said Sand. "Another possibility would be a bonus program for physicians who voluntarily register as a physician on board in case there will be an emergency."

"This study, like the others that have been done, is actually pretty reassuring," said Andrus. "If there is an emergency, they are probably better off than they would be in a lot of other public spaces."

But more work remains to ensure consistency of emergency care among airplanes, the study authors noted.

"In fact, all flights have first-aid boxes. However, there are big differences regarding the contents. It would be favorable that every airline would carry emergency medical equipment so that a physician would have everything necessary for a reanimation or securing the airway or IV medication," said Sand. "Currently, this is not the situation in every airplane."

"The other limitation in terms of reporting anything is that we often don't know the outcome or final diagnosis, particularly in the United States, where we have strict privacy laws," said Sand. "The airlines appropriately do not have access to your medical records."

"This study, like the others that have been done, is actually pretty reassuring," said Andrus. "If there is an emergency, they are probably better off than they would be in a lot of other public spaces."

Another report, published in the Feb. 19 issue of The Lancet, pointed to an increase in the number of medical emergencies on planes, a consequence of an aging population.

In-flight medical events are increasingly frequent, because a growing number of individuals with preexisting medical conditions travel by air, wrote the researchers from the Lahey Clinic Medical Center in Burlington, Mass. Fortunately, most of these emergencies were minor.

Passengers over age 70 had the highest rates of in-flight medical events, but the mean age of passengers with an in-flight medical event was 44 for men and 49 for women. Commercial aircraft have medical kits, including one enhanced medical kit, as required by aviation regulatory agencies. Emergency medical kits do vary from carrier to carrier and can be extensively complex. Most commercial flights also carry an automated external defibrillator.

More information

For more on airline safety, go to U.S. Food and Drug Administration.

Fly Safely

To increase your already strong odds of making it through the flight safely, Dr. Michael Sand, of the department of general and visceral surgery at the Augusta Krankenanstalt, Academic Teaching Hospital at Ruhr-University Bochum, in Germany, offered these tips on preparing for the flight:

  • Be sure to drink enough fluids. The dry air in the cabin requires patients to steadily drink a sufficient amount of water. Sand also recommended avoiding excess caffeine and alcohol consumption.
  • Move around. Sitting in the same position for hours at time increases your chances to develop sometimes life-threatening blood clots, which can be avoided by making sure you get up and move around. "Move your feet and lower legs from time to time," said Sand.
  • Visit your doctor. Passengers with preexisting medical conditions should see their physician before their trip and be sure to bring along any required medications.
  • Take time zone changes into consideration when taking medication. "Patients taking medication should consider the time lag, especially for time-dependent medications such as insulin in diabetics or anti-convulsive medications in epileptics," said Sand.



SOURCES: Katherine Andrus, assistant general counsel, Air Transport Association, Washington, D.C.; Michael Sand, M.D., department of general and visceral surgery, Augusta Krankenanstalt, Academic Teaching Hospital, Ruhr-University Bochum, Germany; Jan. 20, 2009, Critical Care


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