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Another in flight emergency…

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  • White.Beard.Doc White.Beard.Doc 
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    So…. we are sitting in business class, enjoying our canapés over the Atlantic on a 10 hour international flight. Some overhead announcement is made but barely registers in my brain, given the hum of the engines as I focus my taste buds on the interesting and delicious salmon tartare. It was a busy day at the hospital and I am pleasantly anticipating a nice dinner before having the mattress pad applied to my flat bed for some well deserved rest. However, my spouse elbows me, perhaps a bit too forcefully, asking, “It’s happening again, did you hear that, they need you again!” I regain my focus, so much for vacation mode. “Is there a medical doctor on board?”

    The flight attendant says thank you for offering to help, and politely asks for an ID to verify the MD credentials. He apologizes, “Company policy, thank you for understanding.”

    There are a few moments of confusion as things get lost in translation. The state ID in my wallet only certifies me as a “PHYSICIAN”, however they are looking for a medical doctor. “Why doesn’t your ID say MD?” After a quick phone call to medical control on the ground, with an explanation to the flight attendant regarding the definition of a physician, we are on our way to the back of the plane.

    As I pondered the situation, I figured it couldn’t be too much of an emergency as the crew spent several minutes verifying my credentials before taking me to my mile high patient.

    My intuition was correct. It turns out I am faced with a febrile infant with a very concerned mom. The medical kit on board was much more extensive than I expected, with perhaps 30 different IV and oral meds. There were both an oral and tympanic thermometer, a stethoscope, and IV supplies, but no liquid meds for kids. My head to toe exam in front of 75 of my new friends revealed a well appearing febrile infant with normal findings other than yellow nasal discharge. He was feeding well and easily consolable.

    Diagnosis: likely viral infection. We got some ibuprofen suspension from some other better prepared parents on board, and I carefully dosed the child while recalling to the best of my ability the skills of my favorite pediatric nurses. I managed to dose the ibuprofen with all of it ending up where it belonged and none of it on the baby’s or my clothing. And best of all, we continued our progress across the Atlantic without interruption. The flight attendant asked me to complete a medical evaluation report, which I happily did as I appreciated the forgotten simplicity of documenting with a pen. And finally, I politely declined the offer of frequent flier miles added to my account.

    As this minor event wound down, I reflected on my surprise that I was the only physician volunteer on a flight with over 300 passengers. We were on Turkish airlines, and I also started to wonder about variability in volunteerism in various cultures. Does it seem unusual that I was the only doc to reply to a call for help among so many international flyers?

    hatton1 hatton1 
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    Interesting.  You can “volunteer” your services only if you remembered to bring your hospital ID badge.  The badge must say Medical Doctor not physician.  My hospital badge has Hatton1 MD but medical doctor is not spelled out.  Of course when I travel I do not have any MD ID on me at all.  I always remove anything I do not anticipate needing.

    #209677 Reply
    ENT Doc ENT Doc 
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    “It’s happening again.”  LOL

    Statistically it’s not unusual for there to be 1 person on a 300 person flight who is a physician.  Would have loved to see the flight attendants deal with the “doctor of nursing practice” degree card, if there is such a thing.

    But come on man, take the frequent flier miles.

    Avatar hightower 
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    That’s a weird one.  I wouldn’t have been able to help since I don’t carry anything but a drivers license and it doesn’t say anything about me being a physician (thankfully).

    #209680 Reply
    White.Beard.Doc White.Beard.Doc 
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    I didn’t take the frequent flier miles for a few reasons.

    First of all, I doubt I will fly Turkish Airlines often enough to even use them.

    And perhaps more importantly, I am a Good Samaritan protected by the fact that I volunteered to help in an emergency, without compensation. At least that law protects me in the USA, but who knows what Turkish law says?

    #209681 Reply
    Lithium Lithium 
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    Glad it was you and not me.  Also sounds like another reason not to fly with infants across the ocean.  One wonders what the outcome would have been if you had not stepped up.  Seems like these airlines face a difficult cost/benefit analysis when these emergencies come up vis-a-vis whether or not they should land the plane.  I’d be pretty uncomfortable telling them to do anything other than make an emergency landing and get the patient to a hospital.  Expensive, wreaks havoc for the airlines, and may anger a lot of passengers, but it’s better than being sued.

    Has anyone heard of a medical emergency being called for all the ESA’s?  “Excuse me, is there a veterinarian on board?”  Seems inevitable….  Eventually either Fluffy dies and someone sues, or a plane lands and it makes more headlines.

    #209688 Reply
    Lordosis Lordosis 
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    You dosed that Ibuprofen like a pro!  Great job.

     

    I do not carry any ID that would identify me as a physician when I travel other then a business card.

    “Never let your sense of morals prevent you from doing what is right.”

    #209690 Reply
    Avatar ticker 
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    I think I had just finished medical school when I responded to the second call for help on a flight (after all, I was an MD only in the most rudimentary sense).  Seizure resolving, then postictal.  One other physician also responded to the second call.  When I came back to my seat, I learned an anesthesiologist was sitting across the aisle from me, an orthopod in the row in front of me.

    There’s a good chance you were not the only physician on the flight.  Regardless, thank you for being the kind to respond.

     

    p.s. Sounds more like Ebola to me.  You feeling ok?

    Avatar DCdoc 
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    I’ve never flown with my hospital ID. I’m surprised you have an ID identifying you as a doctor. What would they have done if you didn’t? Refuse to let you take care of the child? 🤔 kudos to you.

    #209709 Reply
    MPMD MPMD 
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    I just always keep my ID in my bag and I take my bag with me when I travel.

    There is really no possible downside to being able to identify yourself as a physician and some small but real chance of upside.

    I mean let’s say your on vacation and there is some kind of mass casualty event. Is it bad to be able to help?

    #209718 Reply
    CordMcNally CordMcNally 
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    You’re a better person than I am. Once they started questioning the credentials, I probably would have went back to my salmon tartare.

    “But investing isn’t about beating others at their game. It’s about controlling yourself at your own game.”
    ― Benjamin Graham, The Intelligent Investor

    #209725 Reply
    Avatar Peds 
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    Status: Physician
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    Joined: 01/08/2016
    It turns out I am faced with a febrile infant with a very concerned mom.

    Click to expand…

    i am proud of you.

     

    but i am disappointed in everyone else around you.

    unless unvaccinated or <30 days, there is no emergency for infant with a fever ………… did they literally call you just to ok giving motrin i wonder?

    #209726 Reply
    White.Beard.Doc White.Beard.Doc 
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    I think they called me to response to this “emergency” due to the panicked mother. “My baby is very sick and we won’t be landing for 8 more hours!” Once the flight attendants are notified, they face potential liability should there be any bad outcome.

    In the past, in flight emergencies that I responded to have varied from an anxiety attack on the benign end of the spectrum, to unstable angina with acute pulmonary edema as a more challenging diagnosis to test my wilderness medicine skills.

    #209737 Reply
    Liked by Docbeans, Peds
    Zzyzx Zzyzx 
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    Interesting.  You can “volunteer” your services only if you remembered to bring your hospital ID badge.  The badge must say Medical Doctor not physician.  My hospital badge has Hatton1 MD but medical doctor is not spelled out.  Of course when I travel I do not have any MD ID on me at all.  I always remove anything I do not anticipate needing.

    Click to expand…

    flight attendants are supposed to ask for your pocket state medical license card, not hospital ID.  have never heard about the physician terminology, most state medical licenses state physician & surgeon. EMT’s & RN’s are also considered appropriate medical personnel for in flight medical emergencies

    I just always keep my ID in my bag and I take my bag with me when I travel.

    There is really no possible downside to being able to identify yourself as a physician and some small but real chance of upside.

    I mean let’s say your on vacation and there is some kind of mass casualty event. Is it bad to be able to help?

    Click to expand…

    medical emergencies are considered within a physician’s scope of practice so you’re on your own med mal (doubt that USA good sam rules will apply on international flights like this one).  pilots will ask you whether they need to land which again puts your liability on the line (i.e. don’t land and the patient tanks then was it preventable?).  For ER you may not worry about these things, but for many specialists we remain glued to our seats

    It’s psychosomatic. You need a lobotomy. I’ll get a saw.

    #209741 Reply
    Liked by benign_user
    Avatar Kamban 
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    Status: Physician
    Posts: 2561
    Joined: 08/01/2016

    Both my hospital badges double as parking lot entry NFC readers, so I leave them in my car.

    However in my wallet I carry an old, partly faded old hospital ID from over a decade ago. If that that does not suffice I will return to my seat.

     

    #209742 Reply
    Liked by hatton1

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