General medical emergency advice

Theres a reason we use the outside resources like dispatch and StatMD to help us make the best decisions and we don’t just make assumptions.

What if you’ve got two nurses onboard treating a passenger and one wants to break into the medical kit and administer medicine and the other does not advise that (true story happened to me).

What if you are at the gate at a hub and you have a pregnant lady throwing up in the bathroom and a retired medical doctor onboard who says that in his medical opinion the woman should be removed from the flight, but the woman doesn’t want to go because ‘it’s just morning sickness and that man isn’t my doctor/he don’t know me, and also I just had too much to drink on my last night in Montego Bay last night. (True story, happened to me.)

What if you have an incapacitated passenger and multiple doctors onboard giving different opinions and then the passenger dies and one of the doctors who turns out to be an OBGYN goes to the media and screams she was discriminated against because she was black (happened to my airline).

What if you make that command decision to divert to Long Runway, USA because you need to save this guy in the back’s life and when you land you get ‘awesome to have you here Capt, we actually have a cardiac treatment center right across the street... but we are an RJ only airport and you are a 737 so we actually dont have airstairs that fit your aircraft so we are going to have to load some on a truck from that other airport 70 miles to the south that you could have landed at and drive them up... probably not possible to redispatch during a medical emergency huh?’

Don’t be macho... use all your tools and have people im your corner.
 
mastermags said:
Theres a reason we use the outside resources like dispatch and StatMD to help us make the best decisions and we don’t just make assumptions.

What if you’ve got two nurses onboard treating a passenger and one wants to break into the medical kit and administer medicine and the other does not advise that (true story happened to me).

What if you are at the gate at a hub and you have a pregnant lady throwing up in the bathroom and a retired medical doctor onboard who says that in his medical opinion the woman should be removed from the flight, but the woman doesn’t want to go because ‘it’s just morning sickness and that man isn’t my doctor/he don’t know me, and also I just had too much to drink on my last night in Montego Bay last night. (True story, happened to me.)

What if you have an incapacitated passenger and multiple doctors onboard giving different opinions and then the passenger dies and one of the doctors who turns out to be an OBGYN goes to the media and screams she was discriminated against because she was black (happened to my airline).

What if you make that command decision to divert to Long Runway, USA because you need to save this guy in the back’s life and when you land you get ‘awesome to have you here Capt, we actually have a cardiac treatment center right across the street... but we are an RJ only airport and you are a 737 so we actually dont have airstairs that fit your aircraft so we are going to have to load some on a truck from that other airport 70 miles to the south that you could have landed at and drive them up... probably not possible to redispatch during a medical emergency huh?’

Don’t be macho... use all your tools and have people im your corner.
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Thank you for the examples.

Talking to a nurse it seems like an ambulance will generally be capable of stabilizing cardiac emergencies. A stroke would be better to get to somewhere with a nearby hospital since they have a maximum of 90mins to get the appropriate drug an ambulance wouldn't have. So it seems most D airports will do the job if paramedics can get there and stroke patients are better off being brought closer to a hospital.

Obviously you want to utilize all available resources in the given time, but I think it's worthwhile to consider standard strategies from likely available info and make adjustments from there if you get extra information. I'd rather go into the situation having an idea of what I will do until I have a reason to do something else.
 
Gundam said:
A stroke would be better to get to somewhere with a nearby hospital since they have a maximum of 90mins to get the appropriate drug an ambulance wouldn't have. So it seems most D airports will do the job if paramedics can get there and stroke patients are better off being brought closer to a hospital.
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Most 121 aircraft have a tPA drug onboard in the drug kit. If you talk to your resources, they'll know that, and if you have a passenger who is authorized by license to give drugs (and willing to do so), StatMD or MedLink will prescribe over the phone patch. In that case, what a surface ambulance has or doesn't have becomes less important.

Again... your job is to tap into all the resources you have, manage the flying part of the situation, make sure the destination advice you are given by your resources is safe and possible to do and then do it.
 
I'm wondering if your decision could be opened up to legal scrutiny? Are you protected by the airline? I wonder what liability a pilot could be exposed to by making a decision, assuming no help from a med service.
Reminds me of a story about guys who were at 470 and decided to take a sick plane back to home base because it would of taken same time as spiraling down to nearest airport. I believe the story goes, they got violated.
 
bucksmith said:
I'm wondering if your decision could be opened up to legal scrutiny? Are you protected by the airline? I wonder what liability a pilot could be exposed to by making a decision, assuming no help from a med service.
Reminds me of a story about guys who were at 470 and decided to take a sick plane back to home base because it would of taken same time as spiraling down to nearest airport. I believe the story goes, they got violated.
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Anything can be open to legal scrutiny, but if-under scrutiny- it is found that you followed all your company’s established procedures, then you personally should be off the hook.
 
bucksmith said:
I'm wondering if your decision could be opened up to legal scrutiny? Are you protected by the airline? I wonder what liability a pilot could be exposed to by making a decision, assuming no help from a med service.
Reminds me of a story about guys who were at 470 and decided to take a sick plane back to home base because it would of taken same time as spiraling down to nearest airport. I believe the story goes, they got violated.
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If someone dies or suffers an illness, there will be a lawsuit... so better have your company and your ops procedures in your back pocket.
 
mastermags said:
If someone dies or suffers an illness, there will be a lawsuit... so better have your company and your ops procedures in your back pocket.
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What about from the dispatch point of view?
If there is an emergency I (or "we" technically with the PIC) can take any actions deemed necessary.

When that happens the "rule book" gets thrown out does it not?
 
DogwoodLynx said:
What about from the dispatch point of view?
If there is an emergency I (or "we" technically with the PIC) can take any actions deemed necessary.

When that happens the "rule book" gets thrown out does it not?
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The PIC can take any action he deems necessary, but its not a get out of jail free card... you are still going to have to explain yourself later.
 
mastermags said:
DogwoodLynx said:
What about from the dispatch point of view?
If there is an emergency I (or "we" technically with the PIC) can take any actions deemed necessary.

When that happens the "rule book" gets thrown out does it not?
Click to expand...

The PIC can take any action he deems necessary, but its not a get out of jail free card... you are still going to have to explain yourself later.
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If your SOPs have a section dealing with what to do if a pax has a medical emergency and you don’t follow that, you’re boned if something goes south.
 
Jordan93 said:
We use StatMD. I’ve never actually used it. Someone who has, correct me if I’m wrong but you have to communicate through your dispatcher who then relays the information over to StatMD. So your dispatcher becomes the middle man and it just becomes a game of telephone which can be frustrating and inefficient. It’s not a direct line between pilots and StatMD. This is how I understand it. Again, someone who has used it, please correct me if I’m wrong.
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Yes and no. You call in through the appropriate radio (company, ARINC, etc.) and they will alert dispatch you need StadMD. Dispatch will advise the doctor of the situation, position, destination, and anything else pertinent. The radio operator will then have you all patched in together on basically a three-way call.
 
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