Common ailments that occur in flight

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If you're a health professional, chances are you could be pulled into action if a passenger on a commercial airline experiences a medical problem.

It does get busy up in the skies. There are about 44,000 in-flight medical emergencies on commercial airliners worldwide each year, estimate researchers in the departments of emergency medicine at the University of Pittsburgh and East Carolina University.

That's an average of one medical emergency for every 604 flights, 16 medical emergencies per each million passengers, the researchers concluded after studying data from a Pittsburgh-based medical command center, for five major airlines, between Jan. 1, 2008 and Oct. 31, 2010.

Fainting and light-headedness account for the most common in-flight emergencies -- at a combined 37.4 percent of medical emergencies during the study period. People can get light-headed when experiencing a sudden drop in blood pressure when standing up or stretching.

The next most common medical problems were respiratory symptoms (12.1 percent) and nausea and vomiting (9.5 percent). In only 7.3 percent of the incidents was the medical emergency serious enough to cause diversion of the flight.

In nearly a third of incidents (31.2 percent), by the time the aircraft landed at its scheduled destination, the afflicted passenger had recovered sufficiently so that emergency medical service personnel were not requested.

When EMS personnel did meet a flight, the patient was taken to a hospital in 37.3 percent of the incidents studied.

The more serious medical emergencies were cardiac symptoms (7.7 percent) and cardiac arrest (0.3 percent), seizures (5.8 percent), abdominal pain (4.1 percent) and possible stroke (2.0 percent).

Diversions needed

Cardiac symptoms were responsible for 18.4 percent of all aircraft diversions, possible stroke for 16.4 percent, seizures for 12 percent. Only 0.5 percent of all in-flight emergencies involved obstetrical or gynecological symptoms, but these accounted for 18 percent of aircraft diversions.

Cardiac symptoms (21.5 percent) and cardiac arrest (16.7 percent) were responsible for the most hospital admissions, followed by possible stroke (23.5 percent) and obstetrical or gynecological symptoms (23.4 percent).

Cardiac arrest was responsible for 31 of 36 in-flight deaths during the study period. Fainting accounted for four, respiratory symptoms for one. The passengers who died ranged in age from 1 month to 92 years. The mean age was 59.

The emergency medical kit the FAA requires each airliner to carry is sufficient to treat all the lesser medical emergencies and to initiate treatment for the more serious ones, and flight attendants have been adequately trained in its use, the researchers concluded.

Onboard assistance for afflicted passengers was provided most often by other passengers who were physicians (48.1 percent), nurses (20.1 percent), EMS personnel (4.4 percent) or other health care professionals (3.7 percent).

"Airline passengers who are health care professionals should be aware of their potential role as volunteer responders to in-flight medical emergencies," the researchers concluded.

The study was led by Christian Martin-Gill, Pitt assistant professor of emergency medicine, department of emergency medicine. It was based on calls from five domestic and international airlines to UPMC's STAT-MD Communications Center, a 24-hour physician-directed medical command center.

The study, which was funded by the National Institutes of Health, was published in the New England Journal of Medicine May 30.

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Jack Kelly: or 412-263-1476.


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