Medical emergency protocols should be upgraded and optimised on all major airlines

Medical emergency protocols should be upgraded and optimised on all major airlines, argues a doctor in this week's BMJ.

Osman Dar, a clinical fellow at Addenbrooke's Hospital in Cambridge shares his experience of treating an elderly man with crushing chest pain on a flight to Africa.

He describes how the medical equipment was limited and how, on landing, the crew did not announce that an ill patient was on board who needed priority evacuation from the plane.

And, although the pilot radioed ahead for an ambulance to transfer the passenger to a hospital , the ground staff did not have the means or the facility to arrange one, so when they landed there wasn't one present.

“What I experienced can only be described as a catalogue of failures by a reputable airline,” he says.

With the advent of telemedicine and the availability of automated external defibrillators (AEDs), no reason exists now why a suitably trained doctor on the ground cannot at least communicate basic life support management to aircraft crew or even advise the captain to request an emergency landing, he writes.

Although cost implications are an issue for airlines around the world, a proactive policy rather than a reactive one seems sensible, he says. The United States, for example, has mandated AEDs on all airlines since 2004. He also suggests basic minimal standards for medical kits on all planes on all routes and regular audits to improve and individualise them.

A feature article also published in this week's BMJ looks at how common in-flight medical emergencies are and what doctors are expected to do in such circumstances.