In-flight medical emergencies during airline operations: a survey of physicians on the incidence, nature, and available medical equipment

Hinkelbein, Jochen; Neuhaus, Christopher; Böhm, Lennert; Kalina, Steffen; Braunecker, Stefan

doi:10.2147/oaem.s129250

Cited by 14 publications

(20 citation statements)

References 19 publications

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“…19 A recent German study in 2017 is in accordance with these results, reporting chest symptoms, circulatory collapse and altered mental status as the commonest cause of diversions. 20 Unsurprisingly, medical incidents causing diversions are associated with a higher death rate of 22%, compared with only 0.7% of all on-board medical emergencies. 16 This previously reported figure of 0.7% is similar to the 0.66% death rate (as a proportion of all emergencies) observed in our study.…”

Section: Discussionmentioning

confidence: 99%

Frequency and clinical spectrum of in-flight medical incidents during domestic and international flights

Epstein

Forbes

Futter

et al. 2019

Anaesth Intensive Care

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Most medical practitioners are not specifically trained to diagnose or manage in-flight medical incidents, yet there may occur a moral obligation to do so when least expected. We felt that knowledge of the frequency of emergency versus non-serious medical incidents, in addition to the clinical spectrum of incidents most often encountered, would be of interest to medical practitioners and, in particular, critical care physicians, who happen to find themselves asked to assist with such events. To this end we collaborated with the Department of Medical Services of a major Australian airline to define the incidence, severity, and type of all in-flight medical events encountered over the course of a year's flights. We audited in-flight medical data collected over a continuous 12-month period, which covered 131,890 international and domestic flight sectors transporting more than 27 million passengers. There was an average of 296 medical events per month (3555 in total) making the per-flight incidence of a medical event approximately 1:40 (2.7%). Of these in-flight incidents, 915 (26%) were graded as emergencies, with the commonest descriptors of such incidents being either loss of consciousness (37%) or a suspected cardiovascular event (12%). Six of these 915 emergencies proved fatal. Twenty-one flights were diverted due to medical incidents (<0.016% of all flights), with 52% of these attributed to suspected cardiac events. In this series, medical in-flight events were recorded in approximately one in 40 flights, whereas medical emergencies occurred in approximately one in 150 flights.

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Section: Discussionmentioning

confidence: 99%

Frequency and clinical spectrum of in-flight medical incidents during domestic and international flights

Epstein

Forbes

Futter

et al. 2019

Anaesth Intensive Care

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“…The findings from the current study indicate a higher number of incidents (n=3306 and 155/million passengers) versus 1312 (130/million passengers) medical incidents between 2011 and 2013 of a major flight company operating charter flights for less than 5 hours in Eurasia. 3 There were also more incidents per number of passengers; one event per 6432 passengers versus one event per 14 000 to 39 600 passengers as reported by other publications, 4 or one medical event per 50 flights versus one event per 63 flights reported in a German study. 7 The findings from the current study may possibly be attributable to the increased number of medical incidents on the international routes of the African airline (one medical event per 12 flights or 61 incidents per million passengers).…”

Section: Discussionmentioning

confidence: 79%

“…12 Cardiovascular disorders (40.0%) and neurological problems (17.8%) were the most frequent diagnoses described by aviation medicine physicians in Germany during an online survey. 4 The potential explanation for increased cardiopulmonary symptoms is that the reduced cabin pressure leads to a further reduction in oxygen saturation, which lowers even more with increasing flight times and can exacerbate medical conditions in passengers with pre-existing cardiac, pulmonary, and hematological conditions as they have a reduced baseline oxygen partial pressure (PaO2). 2 Oxygen was used in 46% of cases in this study, similar to the 48% in another study 12 but much higher than the 14% reported in Eurasian flights.…”

Section: Medical Conditions Encounteredmentioning

confidence: 99%

“…Current estimates are that medical events occur 1:10 000 to 1:40 000 passengers, which equates to 25-100 per million passengers. 3 A more recent publication cites figures of inflight emergencies as one event per 14 000-39 600 passengers 4 with one medical emergency reported per 604 flights. 5 In 2007, British Airways flew 36 million passengers, and 31 200 medical incidents were reported, which translates to an incidence of 867 cases per million passengers.…”

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confidence: 99%

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Epidemiology of Medical Events on a Commercial African National Airline Carrier Between 2009 and 2011

Parker

Mahomed

2019

Int J Travel Med Glob Health

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Introduction: An estimated 3.8 billion passengers traveled on commercial aircraft in 2016, of whom close to 1.5 billion crossed international boundaries. Modern commercial aircrafts can carry up to 800 passengers and can fly more than 18 hours. Although not very common, in-flight medical incidents can result in flight diversions that are costly and extremely inconvenient. The aim of the current study was to review in-flight medical incidents on a commercial African carrier between 2009 and 2011. Methods: A secondary analysis of data collected by air stewards during in-flight medical events that were recorded in a register were retrieved for the 3-year period 2009-2011. All medical documented data was evaluated. Results: A total of 3306 medical events equating to an average of 155 cases per million passengers per year were documented over the 3-year study period, of which 3279 were specified into medical categories. Cardiovascular cases (1124; 34.0%) gastrointestinal (727; 22.0%), muscular-skeletal (302; 9%), and respiratory (202; 6%) were the most common cases. Most incidents (74%) were managed by the cabin crew. Five of the medical incidents led to diversions. There were 9 deaths on board over the 3-year period. Conclusion: In-flight medical incidents are rare events. Comparisons with other airlines is difficult due to the non-standardization of recording methods. A global uniform reporting format across all airlines is necessary. Further research is required to determine the factors associated with medical incidents so that pre-emergency preparedness plans can be strengthened.

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“…The literature (described in Table 1) shows that medical incidents had been happening long before that but there are diverse themes related to their description and management (adequacy of medical resources (Hinkelbein et al, 2014;Hinkelbein, Neuhaus, Bö hm, Kalina, & Braunecker, 2017;Costa, 2015;Naouri et al, 2016), medico legal issues (Peterson et al, 2013;Costa, 2015;Bukowski & Richards, 2016), etc.). Researchers are watching at diverse ways of categorizing these medical incidents, as it concerns either number of flights or number of passengers.…”

Section: State Of the Artmentioning

confidence: 99%

Discovering frequent patterns for in-flight incidents

Sene

Kamsu-Foguem

Rumeau

2018

Cognitive Systems Research

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Objectives: In order to get a clearer idea of in-flight medical emergencies management, the application of Data mining tools can be useful to facilitate knowledge discovery from data collected by existing studies. The objective of this work is to conceptualize the construction of a Clinical Decision Support System (CDSS) in three stages corresponding to the representation levels necessary to extract knowledge from information and raw data. Method: The method can be summarized in three parts: (1) in-flight medical incident data search, (2) the validation of this data using Data mining tools, (3) the construction of the CDSS in 3 steps corresponding to the levels of knowledge representation. These three steps will be carried out using tools such as EORCA (Event Oriented Representation for Collaborative Activities) which includes action codification with regard to an ontology and event representation. Result: Data processing services provide a good structuration for information about in-flight medical incidents from which useful knowledge can be generated could improve the handling of other incidents by adapting the medical emergency equipments, for example. This structuring can be facilitated by the use of CDSS to fill in any gaps, increase coherency, and provide decision makers with a more complete picture of options that might be involved in a critical situation. Conclusion: We proposed an evolving framework facilitating the description of in-flight medical emergencies with adequate data collection and appropriate information that are required for producing interesting rules and better decisions. The data collected nourishes the organization of information, which can be improved over time by continuous integration of evidence gained from the number of incidents treated. Finally, it is proposed to strengthen requirements concerning the medical equipments available on-board, particularly in the light of knowledge resulting from the selection and approval of interesting rules.

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In-flight medical emergencies during airline operations: a survey of physicians on the incidence, nature, and available medical equipment

Cited by 14 publications

References 19 publications

Frequency and clinical spectrum of in-flight medical incidents during domestic and international flights

Frequency and clinical spectrum of in-flight medical incidents during domestic and international flights

Epidemiology of Medical Events on a Commercial African National Airline Carrier Between 2009 and 2011

Discovering frequent patterns for in-flight incidents

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