Fatalities Above 30,000 Feet

Rotta, Alexandre T.; Alves, Paulo M.; Mason, Katherine; Nerwich, Neil; Speicher, Richard; Allareddy, Veerasathpurush; Allareddy, Veerajalandhar

doi:10.1097/pcc.0000000000000220

Cited by 16 publications

(8 citation statements)

References 10 publications

(11 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Rotta et al reported that pediatric IMEs comprise 9.3% of all in-flight emergencies or 2.24 events per 1 million passengers [4]. This number is close to 12.04% reported by Baltsezak et al [25], 9.15% reported by Moore et al [5], and 9% reported by Weinlich et al [17].…”

Section: Resultssupporting

confidence: 52%

“…Collected and reported data commonly included patients' demographic information, type of medical or surgical complaint, utilization of the medical kits, presence of medical volunteers, and rates of diversion of the aircraft. Few studies have focused on a specific subset of patient population such as pediatric [4, 5], neurologic [15], and psychiatric [7]. 12 out of 25 included studies reporting data on both pediatric and adult patients [2, 3, 7–10, 16, 17, 20, 25–27]; ten studies either did not specify the age range of the patients' whose records were analyzed or did not include data on age altogether [11–15, 18, 21–24]; for these studies the population column in Table 1 is marked as unknown.…”

Section: Resultsmentioning

confidence: 99%

“…12 out of 25 included studies reporting data on both pediatric and adult patients [2, 3, 7–10, 16, 17, 20, 25–27]; ten studies either did not specify the age range of the patients' whose records were analyzed or did not include data on age altogether [11–15, 18, 21–24]; for these studies the population column in Table 1 is marked as unknown. Two articles explored pediatric-only in-flight emergencies [4, 5]. Age data was not applicable for reporting in one study; thus the population column in Table 1 is marked as N/A [19].…”

Section: Resultsmentioning

confidence: 99%

“…Average age for pediatric in-flight emergency patient was 6.8 years reported by Moore et al [5] and 7.3 years reported by Weinlich et al [17]. Median age for a pediatric patient suffering a fatal event on board of commercial aircraft was 3.5 months [4]. The most common pediatric medical complains were infectious (27%), neurological (15%), and respiratory (13%) [5].…”

Section: Resultsmentioning

confidence: 99%

“…With increasing number of travelers overall, pediatric passenger population is also increasing; however very little is known about pediatric IMEs. Despite comprising almost 10% of the IMEs, there are only two studies to date that have been dedicated solely to pediatric IMEs [4, 5]. Our objective was to systematically review the published most recent evidence on the subject of in-flight emergencies with a specific focus on pediatric population.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

A Systematic Review of Pediatric and Adult In-Flight Medical Emergencies

Sul

Badawy

2018

International Journal of Pediatrics

View full text Add to dashboard Cite

In-flight medical emergencies (IMEs) are acute onboard events of illnesses or injuries with potential immediate risk to a passenger's short- or long-term health, or life. IMEs are significant events that are related to public safety concerns. With the increasing amount of annual air travel every year, it is expected that the number of encountered IMEs will continue to grow. Thus, it will be critical to develop and implement appropriate measures to manage IMEs with the best possible outcome. Despite the fact that most IMEs are self-limited with no serious adverse events, serious IME can lead to death, disability, or other unfavorable health outcomes, particularly as a result of suboptimal medical care. In this article, we systematically reviewed the published up-to-date evidence on the subject of in-flight emergencies with a specific focus on pediatric population.

show abstract

Section: Resultssupporting

confidence: 52%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A Systematic Review of Pediatric and Adult In-Flight Medical Emergencies

Sul

Badawy

2018

International Journal of Pediatrics

View full text Add to dashboard Cite

show abstract

In-Flight Medical Emergencies

Martin‐Gill

Doyle

Yealy

2018

JAMA

View full text Add to dashboard Cite

n-flight medical emergencies (IMEs) are unique events for which traveling physicians, nurses, and other health care professionals may render medical assistance. Cruising at 35 000 ft with limited medical equipment, often hours away from the closest medical facility, creates an unfamiliar care challenge for many health care professionals. This clinical review focuses on IME data and offers guidance to assist medical professionals who may encounter these events using both literature and the authors' insights providing airline care guidance for IMEs. MethodsA literature search was conducted in MEDLINE using PubMed for English-only articles published between January 1, 1990, and June 2, 2018, using the terms air emergency, air emergencies, air passenger, air travel, aircraft, airline, aviation, commercial air, flight, and fitness to fly (n = 14 842). Scanning the titles to identify appropriateness and searching bibliographies yielded the final list of relevant articles (n = 765). Each article was assessed for completeness of data reporting and importance to management and prevention of IMEs. Based on this assessment, a total of 317 articles were included in the review. Frequency data were extracted and means and 95% confidence intervals were calculated when appropriate. Observations EpidemiologyThe estimated prevalence of IMEs is 1 in 604 flights based on a review of 11 920 requested ground consultations from 5 large IMPORTANCE In-flight medical emergencies (IMEs) are common and occur in a complex environment with limited medical resources. Health care personnel are often asked to assist affected passengers and the flight team, and many have limited experience in this environment.OBSERVATIONS In-flight medical emergencies are estimated to occur in approximately 1 per 604 flights, or 24 to 130 IMEs per 1 million passengers. These events happen in a unique environment, with airplane cabin pressurization equivalent to an altitude of 5000 to 8000 ft during flight, exposing patients to a low partial pressure of oxygen and low humidity. Minimum requirements for emergency medical kit equipment in the United States include an automated external defibrillator; equipment to obtain a basic assessment, hemorrhage control, and initiation of an intravenous line; and medications to treat basic conditions. Other countries have different minimum medical kit standards, and individual airlines have expanded the contents of their medical kit. The most common IMEs involve syncope or near-syncope (32.7%) and gastrointestinal (14.8%), respiratory (10.1%), and cardiovascular (7.0%) symptoms. Diversion of the aircraft from landing at the scheduled destination to a different airport because of a medical emergency occurs in an estimated 4.4% (95% CI, 4.3%-4.6%) of IMEs. Protections for medical volunteers who respond to IMEs in the United States include a Good Samaritan provision of the Aviation Medical Assistance Act and components of the Montreal Convention, although the duty to respond and legal protections vary across countries. Medical vol...

show abstract

Modified hypoxic challenge testing in children needing nocturnal ventilation: An observational study

Riley

Brotherston

Kelly

et al. 2022

Pediatric Pulmonology

View full text Add to dashboard Cite

Background: Guidelines for air passengers with respiratory disease focus on primary lung pathology. Little evidence exists to guide professionals advising children needing ventilatory support because of neuromuscular or central hypoventilation conditions; these children might risk hypoxia and hypercapnia if unable to mount an adequate hyperventilation response.Objective: This study assessed the response to low ambient oxygen using a modified hypoxic challenge test. In addition to measuring pulse oximetry and response to supplementary oxygen, we also measured transcutaneous carbon dioxide and response to ventilatory support. Methods: Twenty children on nocturnal ventilatory support aged 1.6−18 years were recruited in a pragmatic sample from outpatient clinics; 10 with neuromuscular weakness and 10 with central hypoventilation. Participants underwent a two-stage, modified hypoxic challenge test; a conventional stage, where oxygen alone was titrated according to SpO 2, and a new stage, where participants used their routine ventilatory support with oxygen titrated if needed. Participants were interviewed to understand their experiences of testing and of air travel.Results: Thirteen participants needed supplemental oxygen during the conventional stage, but only two did when using ventilatory support. Transcutaneous carbon dioxide remained within normal range for all participants, on or off ventilatory support. Whilst some participants found testing challenging, participants generally reported both testing and air travel to be valuable. Conclusions:Evaluating response to patients' usual ventilation through "fitness-tofly" assessment aids decision making when considering whether children who receive nocturnal ventilation can travel by air, since for some using a ventilator reduces or avoids the need for supplemental oxygen.

show abstract

Fatalities Above 30,000 Feet

Cited by 16 publications

References 10 publications

A Systematic Review of Pediatric and Adult In-Flight Medical Emergencies

A Systematic Review of Pediatric and Adult In-Flight Medical Emergencies

In-Flight Medical Emergencies

Modified hypoxic challenge testing in children needing nocturnal ventilation: An observational study

Contact Info

Product

Resources

About