Airlines rethink in-flight medical care

March 19, 2008|Michelle Higgins, New York Times News Service

When a New York woman died aboard an American Airlines flight returning from Haiti last month, her death raised concerns among passengers about the level of medical treatment available at 30,000 feet.

An inquiry is still underway in the death of Carine Desir, 44, aboard American's Flight 896 on Feb. 22, but it has already prompted airlines and passengers to review the current protocol.

What happens if a passenger has a heart attack onboard? How well-equipped is the plane? What kind of training does the flight crew have?

Medical emergencies happen on planes more often than you might think. MedAire, a Phoenix company that provides cabin crews with medical advice, received 17,084 in-flight calls last year. Most were minor in nature, involving fainting or an upset stomach.

But 649 planes were diverted for medical reasons, and 97 people died onboard, says the company, which advises 74 commercial carriers, including Continental, JetBlue, and Virgin America.

"We fly more than a quarter-million people a day on average, which would easily fit a medium-size city," said Tim Smith, a spokesman for American. "Just about anything that can happen on the ground can, and will, happen on an aircraft."

So how prepared are the airlines for medical emergencies? It depends on the carrier. The Federal Aviation Administration's rules are pretty thin: Planes are required to be equipped with a first-aid kit, a defibrillator and, for all but the smallest planes, an emergency medical kit that includes a stethoscope, needles, epinephrine, and an intravenous set.

But beyond being trained in basic CPR, and being drilled every 24 months on how to use a defibrillator, flight crews aren't required to know much more than where the medical equipment is kept. A 2006 FAA advisory states, "Flight attendants should not be expected to administer medications or to start IVs."

Candace Kolander, a flight attendant and the health coordinator at the Association of Flight Attendants, said: "Although we have the equipment onboard, the reality is we aren't trained as medical hospital personnel. In reality, it's minimal first aid."

Attendants can open a first-aid kit to dole out bandages, and they can administer oxygen, and use the defibrillator. But they are not supposed to use the stethoscope and syringes, or even administer aspirin without the direction of a medical professional. Rather, they are typically instructed to call upon medically trained volunteers from the cabin.

So, in the event that a medical crisis strikes miles up in the sky, passengers are generally at the mercy of who happens to be onboard.