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The Haile T. Debas Academy of Medical Educators
Is there a physician on th=
is
flight? - Airplane Medicine 2009
Molly
Cooke, MD
The Haile T. Debas Academy of Medical Educators
The Haile T. Debas Academy of Medical Educators
Airplane Medicine 2009
<=
span
class=3DHBB style=3D'position:absolute;left:-3.78%'>•Epidemio=
logy and
management of in-flight emergencies
![](3D"slide0020_image008.jpg")
The Haile T. Debas Academy of Medical Educators
The Haile T. Debas Academy of Medical Educators
Airplane Medicine 2009
<=
span
style=3D'color:#FFDC15'>•Epidemiology and management of in-flight emergenci=
es
![](3D"slide0042_image009.jpg")
The Haile T. Debas Academy of Medical Educators
The Haile T. Debas Academy of Medical Educators
Incidence of in-flight emergencies
![](3D"slide0041_image011.jpg")
•Serious events 1 per 333-1900
flights
•Serious events 1 pe=
r 10,000
- 40,000 passengers
•Deaths 1 per 1 - 5 x 106<=
/span> passengers; 21-72 <=
span
style=3D'position:absolute;top:49.41%;left:8.13%;width:84.55%;height:24.7%=
'>deaths
per year in the US (est.)
The Haile T. Debas Academy of Medical Educators
The Haile T. Debas Academy of Medical Educators
![](3D"slide0008_image012.gif")
Common Medical Events In-Flight
10
Trauma=
tic
10
Respir=
atory
25
GI
42
Neurol=
ogic
10
Cardia=
c
Vasova=
gal
≈22,000 (est.)
N=3D910
N=3D1132
MedLink
2007
Dowdall
2000
DeJohn=
2000
DeJohn and Dowdall as quoted in Gendreau NEJM 2002
MedLink as quoted in Tonks BMJ 2008
as percent of all
The Haile T. Debas Academy of Medical Educators
The Haile T. Debas Academy of Medical Educators
![](3D"slide0017_image013.gif")
In-Flight Medical
Emergencies
June to December 2002 (N=3D507)=
June to December 2002 (N=3D507)=
9
Falling luggage
9
Scalds
7%
37
Trauma
8
Abdominal pain=
128
Syncope
28%
140
New
medical conditions
33
Abdominal pain, diarr=
hea,
vomiting
46
Cardiovascular proble=
ms
69
Respiratory problems<=
/span>
65%
330
Exacerbation
of pre-existing condition
Qureshi Emerg Med J 2005
The Haile T. Debas Academy of Medical Educators
The Haile T. Debas Academy of Medical Educators
Ground-to-air emergency
medical advice
N=3D 273 calls between Jan. 20= 01 and Dec. 2006
N=3D 273 calls between Jan. 20= 01 and Dec. 2006
![](3D"slide0045_image015.gif")
![](3D"slide0045_image017.gif")
Urwin J. Telemedicine and Telecare 2=
008
The Haile T. Debas Academy of Medical Educators
The Haile T. Debas Academy of Medical Educators
Inflight pediatric emergencies
<=
span
style=3D'font-size:83%'>•9.2% of all inflight consultations (222 of 2425)
<=
span
style=3D'font-size:83%'>•53 pre-flight (24%) Þ chickenpox
<=
span
style=3D'font-size:83%'>•169 inflight consultations (76%)
<=
span
style=3D'font-size:83%'>–45 (27%) ID Þ
fever, otitis
<=
span
style=3D'font-size:83%'>–25 (15%) neurologic
<=
span
style=3D'font-size:83%'>–22 (13%) respiratory
<=
span
style=3D'font-size:83%'>–17 (10%) GI
<=
span
style=3D'font-size:83%'>–15 (9%) allergic
![](3D"slide0030_image019.jpg")
Mayo data base of consultations between 1/95 and 1=
2/2002
=
=
Moore Pediatric Emergency Care 2005<=
/span>
The Haile T. Debas Academy of Medical Educators
The Haile T. Debas Academy of Medical Educators
![](3D"slide0043_image022.gif")
The Haile T. Debas Academy of Medical Educators
The Haile T. Debas Academy of Medical Educators
The physician
volunteer’s role:
consultant to the captain
consultant to the captain
<=
span
class=3DHBB style=3D'position:absolute;left:-10.36%'>•Decrease
altitude
<=
span
class=3DHBB style=3D'position:absolute;left:-10.36%'>•Diversi=
on
<=
span
class=3DHB1B style=3D'position:absolute;left:-8.08%'>–Minimum=
40
minutes
![](3D"slide0044_image024.jpg")