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Another in flight emergency...

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  • #91
    “I wonder how non physicians who insist upon the title of doctor feel in these situations?”
    Helpless of course!
    No offense, Doctor in of itself is an achievement. A PhD in Finance is useless in medical situations.

    Off the cuff , the Orthopedic guy is probably the best of the worst choices for a delivery. Ten to one, he/she would step up.

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    • #92




      As a pathologist, I absolutely dread these announcements.  But when I hear the request a second time, and my kids are looking up at me wondering why their doctor parent is ignoring a call for help, I will absolutely respond.  I am a long way off from basic medical training, but I do feel it is my ethical responsibility.  I have treated an allergic reaction, and have been turned down for help when someone more qualified eventually responds.  If there were a medical emergency, and I were the one treating the patient, and I found out there were other physicians on the plane who couldn’t be bothered to help, you can bet I’d be judging you harshly.  I am rather appalled by the number of physicians on this thread who say they would ignore a call for help.
      Click to expand...


      As a radiologist I always wait for the second call ...

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      • #93
        Just offer what you can do , go with your best instincts, declare yourself as uncomfortable if you have to ,  and document.

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        • #94




          Just offer what you can do , go with your best instincts, declare yourself as uncomfortable if you have to ,  and document.
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          My rationale for waiting is more to not keep a "real doctor" from answering the call if he or she sees me responding. Until they install CT scanners in planes anyway ...

          Scary how fast 3 years of surgery training are erased from your brain - I could probably still do a chest tube but that's about it.

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          • #95







            Just offer what you can do , go with your best instincts, declare yourself as uncomfortable if you have to ,  and document.
            Click to expand…


            My rationale for waiting is more to not keep a “real doctor” from answering the call if he or she sees me responding. Until they install CT scanners in planes anyway …

            Scary how fast 3 years of surgery training are erased from your brain – I could probably still do a chest tube but that’s about it.
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            I do same. See if I can make out where/whats going on, but you dont want to stop someone who is more appropriate from coming forward. I have answered the call before, thankfully it was nothing at all, but it was terrifying as its just not near what I do or am comfortable with. Plus, what can you really do on the plane? You're lucky if they have water.

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            • #96


              You’re lucky if they have water.
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              They probably charge you for it.

               

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              • #97
                Sometime you get lucky also.  My son had an allergic reaction to tree nuts (unknown allergy by us as parents) ingested just prior to boarding.  Doctor who came to help was a critical care pulmonologist.  Wife could have given the epinephrine, but dosage would have been a bit of an unknown/discussion with on ground doc.

                Of course my son was willing to die once the doc rolled out all the different needle gauges from the medical kit......

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                • #98
                  I was hoping to see more stories about people responding when $hit hit the fan

                  I got to do CPR last month on a flight an hour away from the canadian coast with a guy that said he was a doctor. learned some very interesting things

                  1) ground control has medical that they talk to

                  2) ground med control can pronounce a patient and the paramedics will confirm with a 12 lead when plane lands

                   

                   

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                  • #99
                    Whenever a family member of mine comes across anything remotely medical on social media they send me a link to it.  This time it was actually amusing.

                     

                    https://youtu.be/B2f8k6cYRjM

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                    • Whenever a family member of mine comes across anything remotely medical on social media they send me a link to it.  This time it was actually amusing.

                       


                      Click to expand...


                      This is great

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                      • I was on a plane recently and noted that my daughter was breathing much harder than normal and looked pale - she'd had a URI for the past few days with fevers and in retrospect her cough was a bit barky. I called the attendant over to ask for a stethoscope and see if they could let me take a look at the medical bag. Turns out you have to call ground control or whoever for that. So I just listened with the stethoscope, which no joke was the awful throwaway kind you often find at deliveries, with the bell end membrane gone. And I really had a hard time listening for lung sounds, and I ended up requesting to listen to her way up front since it would be quieter up there. At this point the flight attendants seemed pretty concerned bordering on panicky so I kept reiterating I think she's okay but she might need some medicine (wondering if they maybe had steroids on board).

                        Long story short, she was tachypneic, tachy and pale enough that I ended up letting them call ground control, and spoke to an EM doc on the other hand through the wonky relay (noise was again a factor here). We put her on some O2 and I gave her a couple puffs of the (used) albuterol inhaler available, trying to time it with the inhale on her cries. They ended up moving us to the front row and even before that a couple of concerned passengers had offered up their seats near the front. I felt bad but I also did not feel like taking any chances, especially since I was still unsure whether she had some kind of intrapulmonary thing going on. There would have had to be a much greater sense of urgency to have them divert to a closer airport.

                        One of the attendants was a bit OCD about rules relating to where passengers can and cannot be and somewhere in the back of my mind I was irritated with her for this. For example I wanted to have my daughter sit where the flight attendants sit for a second in order to listen better, but they would not allow that so I squatted with her on my knees in order to listen. Same with them insisting I wear the O2 canister when seated. It crossed my mind briefly that if this was more of an emergency I would have insisted on having a patient be lain on the floor for a more thorough examination, and that if the patient wasn't my own daughter I might have actually had an easier time disregarding specific rules if I thought they were compromising my assessment/care. As it was I felt a bit sheepish since by the end she was looking a lot better, but nonetheless justified, because it really did seem like the O2 had improved her. I doubt the albuterol did anything. When the flight landed they asked for everyone to remain in their seats until we left the aircraft (right after the door opened) and there were the usual giant team of firefighters and paramedics waiting. They had a student do the assessment and I didn't quite realize he was a student and I don't think he understood most of my medicalese - 'yeah she was tugging and belly breathing, cap refill has been fine'. Pretty sure he got dinged by his superior once he was done with the assessment because he said she looked fine when obviously she was still having suprasternal retractions. The main paramedic asked if I wanted to do anything at this point and I gratefully told them no - I had thought that calling ground control / activating whatever system is in place might turn into a whole ordeal where they have to take her elsewhere for an examination by an[other] MD no matter what.

                        But man, I would have though the med bag would have steroids. They did have epi 1:10k. Toyed with the idea of giving it if she didn't improve with O2. Thankfully didn't have to.

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                        • I haven’t touched a patient in 5 years and really don’t travel much, but do occasionally fly. If an emergency comes up should I not volunteer?

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                          • Depends if your personality would find it stressful or amusing.... As a "RetiredERdoc" chances are high that you'll be better than 99.99% than anybody else on the plane, even if it had been 20 years since seeing a patient plus a couple cocktails percolating plus sleep deprivation plus language barrier.

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                            • I haven’t touched a patient in 5 years and really don’t travel much, but do occasionally fly. If an emergency comes up should I not volunteer?
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                              I don't care what you decide, except if I am on that same plane. If so, I better see your hand hit that call button my friend! And fast!

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