Telemedical assistance for in-flight emergencies on intercontinental commercial aircraft

Abstract

We have conducted a three-year prospective study of medical incidents on a commercial airline. A telemedicine service was available via an on-board satellite phone. During the study period there were 3364 medical incidents. The most common incident was collapse (n = 2310, 57%). Telemedicine was used in 323 of the cases (9%). Neurological patients, mostly stroke and seizures, excluding psychiatric diseases, were seen in 27% of the telemedicine cases (n = 83). Most of the cases involved middle-aged people, not the elderly. The group of patients that needed diversion (n = 27) was compared to the cases staying on board (n = 275). None of the patients in the non-diversion group deteriorated. All unstable patients forced a diversion. Doctors on board used the service in more severe cases, whereas laymen used the service in less severe cases. The results of the present study demonstrate the advantage of using simple teleconsultation in cases of medical emergency on board an aircraft.

Neurology at the airport

“…We did not record any cases of other diseases specifically linked to air traffic, recently described in scientific literature, namely airplane-headache related to atmospheric pressure changes. In addition, while other studies found syncope and dizziness to be the most common neurological complaints,2 4 these symptoms were rarely reported in our series. It is most likely that these patients were treated by airport medical services and emergency medicine physicians without neurological consultation.…”

Kreislaufstillstand in besonderen Situationen

“…Nach 24 Interkontinentalflügen beträgt die Wahrscheinlichkeit für wenigstens einen medizinischen Notfall 95 % [505]. Meistens sind Menschen mittleren Alters betroffen [506]. Zwei kürzlich publizierte große Studien berichten von 22.000 Onboard-Notfällen bei fünf amerikanischen und zwei europäischen Fluggesellschaften.…”

Lessons Learned During an In‐Flight Medical Emergency: Case Report and Discussion

“…5 One study on IFME telemedical services showed that ground-based medical personnel are beneficial in assisting with diversion decisions and that many doctors value this assistance in IFME decision making. 6 The Aerospace Medical Association (ASMA) also provides excellent written resources for physicians to prepare for an IFME but these documents are not well publicized and are not practical in time-sensitive situations. 7 Physicians on board can relay necessary information, administer medications, perform any procedures in which they are trained, and assist with coding the event for standardized reporting.…”