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3
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An evaluation of in-flight medical care in the U.S.
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DeJohn CA; Wolbrink AM; Veronneau SJ; Larcher JG; Smith DW; Garrett JS
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Aviat Space Environ Med 2002 Jun;73(6):580-6.
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BACKGROUND: In-flight medical care has been studied for many years. In an effort to evaluate in-flight medical care delivery on U.S. airlines, this study includes a detailed correlation between in-flight medical care, patient response, and postflight follow-up. METHODS: A survey of five U.S. domestic air carriers from October 1, 1996 to September 30, 1997 showed 1132 in-flight medical incidents. These airlines accounted for approximately 22% of scheduled U.S. domestic enplanements during the period. RESULTS: Results indicate that there was good overall agreement between in-flight and postflight diagnoses (79% of cases), and passenger condition improved in a majority of cases (60%). CONCLUSIONS: The results suggest that in-flight diagnoses were generally accurate and treatment appropriate.
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FAA Civil Aerospace Medical Institute, Oklahoma City, OK 73125-5066, USA. charles.dejohn@faa.gov
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| PMID |
12056675
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4
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In-flight medical events and aircraft diversions: one airline's experience.
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Delaune EF 3rd; Lucas RH; Illig P
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Aviat Space Environ Med 2003 Jan;74(1):62-8.
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BACKGROUND: An aging population combined with the increasing mobility of people with acute and chronic illnesses could make an increase in the frequency of in-flight medical events aboard commercial aircraft likely. OBJECTIVE: To determine the incidence of each type of in-flight medical complaint, the appropriateness of medical kit contents, which factors lead to aircraft diversion, and which factors effect the appropriateness of the decision to divert. METHOD: Medical complaints reported aboard a sample airline from July 1, 1999 through June 30, 2000 were studied. The frequency of aircraft diversion was related to complaint and medical assistance provided. The appropriateness of the decision to divert was determined as a function of hospital admission rates. RESULTS: There was an incidence of 22.6 medical complaints per million passengers and 0.1 deaths per million passengers. There were 210 diversions per million flights with one of every 12.6 incidents resulting in a diversion. When a passenger volunteer was used, they opened the medical kit 62% of the time. When a physician participated in the decision to divert the hospital admission rate was 49% versus 15% with no physician input. CONCLUSION: Variations in incidence of medical complaints cited in previous studies demonstrate the need for an industry-wide standardized reporting method of in-flight medical events. All in-flight medical complaints could likely have been adequately treated with the contents of the FM's newly mandated medical kits. Physician participation in decisions to divert aircraft should be sought as it is associated with more appropriate divert decisions.
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Department of Emergency Medicine, the George Washington University, Washington, DC, USA. efdelaune@aol.com
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12546300
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5
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Frequency and types of medical emergencies among commercial air travelers.
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Cummins RO; Schubach JA
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JAMA 1989 Mar 3;261(9):1295-9.
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We performed a one-year prospective survey of emergency medical responses to travelers at an international airport to observe the frequency and type of emergencies experienced in flight and before and after travel. Emergency personnel evaluated a total of 1107 people; 754 (68%) were travelers, 232 (21%) were employees of the airport or airlines, and 118 (11%) were area residents. Of the 754 travelers, 190 (25%) experienced their problem during flight; the aircraft made an unscheduled landing for seven of these travelers. The frequency of in-flight emergencies was 1 per 753 inbound flights, or 1 per 39,600 inbound passengers. The most common emergency problems among all travelers were abdominal pain, chest pain, shortness of breath, syncope, and seizures; 25% of the emergencies were caused by minor trauma. The majority of emergencies among air travelers (75% [564/754]) happened on the ground within the air terminal. Most problems (84% [633/754]) were effectively handled by personnel trained as emergency medical technicians. The types of problems encountered suggest that the "doctors only" medical kit now required aboard US air carriers contains clinically useful items and should continue to be required on board.
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Department of Medicine, University of Washington, Seattle.
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2915456
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6
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Inflight medical emergencies.
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Lyznicki JM; Williams MA; Deitchman SD; Howe JP 3rd
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Aviat Space Environ Med 2000 Aug;71(8):832-8.
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This report responds to resolutions asking the American Medical Association (AMA) to develop recommendations for the use of medical equipment and technology onboard commercial airlines. Information for the report was derived from a search of the MEDLINE database and references listed in pertinent articles, as well as through communications with experts in aerospace and emergency medicine. Based on this information, the AMA Council on Scientific Affairs determined that, while inflight morbidity and mortality are uncommon, serious events do occur, which require immediate emergency care. Management of serious problems requires an integrated emergency response system that ensures rapid notification of medical personnel on the ground, assistance from appropriately trained flight crews and passenger volunteers (if available), and adequate medical supplies and equipment to stabilize the victim. Physicians have an important role in the preflight evaluation and counseling of potential passengers who are at risk of inflight medical complications, and in providing inflight medical assistance. Some U.S. and foreign air carriers are upgrading inflight emergency medical kits and placing automated external defibrillators aboard aircraft. Few data are available regarding the effectiveness of such improvements in improving health or survival outcomes. Recent federal legislation requires assessment of the extent of inflight medical emergencies, including the adequacy of emergency medical supplies and equipment carried onboard commercial airliners. This legislation also should alleviate liability concerns by providing immunity for physicians and others who render inflight medical assistance.
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American Medical Association, Chicago, IL 60610, USA.
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| PMID |
10954361
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