Hypothetical Question...

Nurses General Nursing

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Say you are on a flight. The flight attendant calls for medical personnel. You are the only nurse on the plane and there is no doctor. There is a man who is having 10/10 chest pain radiating to his L arm. You happen to have 325 mg ASA with you; you give him the aspirin. Is it OK to ask anyone if they have Nitro with them, and if someone on the plane DOES have Nitro, is it OK to give this man a Nitro tablet even though you have no way of taking his BP and it is NOT his prescription and you are NOT a doctor?

Was just flying and thinking of hypothetical questions and what is within our scope of practice in a Good Samaritan situation.

Thanks!

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Specializes in MCH,NICU,NNsy,Educ,Village Nursing.

I wouldn't. But, I WOULD give O2 and tell the flight attendant that in my opinion, the plane better land and get this man to a hospital asap! (There's a former airline pilot on this site, so perhaps he will weigh in about what he as a nurse would do and would have done as a pilot).

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I don't think it would be ok. Being a good samaritan does not automatically allow you to prescribe and dispense.

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Would it still be ok to give the Aspirin since it is OTC?

What if a passenger was having an anaphalactic reaction and his/her airway was shutting and someone happened to have an Epi Pen? Would this be the same situation as the Nitro?

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Specializes in Clinical Research, Outpt Women's Health.

I would have the flight attendant put me on the air with medics or the airport emergency providers and seek their authorization. I believe this has been done in the past.

And if it came down to it I would give the ASA as long as he wasn't allergic and maybe even the nitro because time is muscle and while i value my license I feel the benefit outweighs the risk.

If I am wrong and pay the price so be it.

Unless of course the patient was a total jerk off.............:smokin::smokin::smokin:

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Specializes in Clinical Research, Outpt Women's Health.
Would it still be ok to give the Aspirin since it is OTC?

What if a passenger was having an anaphalactic reaction and his/her airway was shutting and someone happened to have an Epi Pen? Would this be the same situation as the Nitro?

I wouldn't hesitate to jab that pen right into their thigh. It is a reasonable action to take when the alternative is almost certain death.

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Specializes in psych, addictions, hospice, education.

I think giving an ASA is of a bit of concern too. As a non-professional you could give it, but once it's known you're a nurse, you're held to your scope of practice. Even if no one else knows you're a nurse, morally you're still held to your scope of practice too. What if something goes wrong and you mis-judged what was needed?

And I agree that we need to do whatever we can in a life-threatening situation...it's kind of a catch-22, isn't it?

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Specializes in ED, ICU, Education.

If you given nitro to a patient with a right sided MI, you've just killed them.

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Specializes in Infectious Disease, Neuro, Research.

I agree with Crunch.;) Statistically, you're fine with ASA- provided the pt is AAO, you can ask. Nitro- maybe. That is very much like the, "Tourniquet Question" for pre-hosp care. Yes, you may cause further injury, yes they may die as a direct result of application, but they will definitely expire w/o application(no, I'm not saying nitro will "save" them, but I hope the direction is clear...). How far is the airport? Compressions in a 2' wide space isn't fun and tends to be ineffective, but...

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Specializes in Clinical Research, Outpt Women's Health.
If you given nitro to a patient with a right sided MI, you've just killed them.

Yep, a real qaundry. Killed them or saved them. That is why i would want to be patched through to a doc. Then it is all on him/her...........

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Specializes in Hospice / Psych / RNAC.

I've been on a plane with not quite the same scenario but similar. It was an older women who didn't speak english well and had just had an open heart. She was white as a ghost, shaking, frail and experiencing sever chest pains. She had no meds with her and didn't know what she took. Her pulse was barely palpable. The stewardess came with some ASA and I told the women to take it and we then put her on her back and traveled the next 5 hours overseas on egg shells. EMS was there when we landed ... she didn't look to good but I am confident that she would've been far worse off if she didn't take the ASA.

There also was nitro from another passenger and I informed them that I wouldn't do that but I was colliding with a doc who was on the plane who said it might be a good idea ... hmmmm. The stewardess listened to me due to the doc was young and couldn't make up her mind.

One of my more finer moments. What the overhead speaker actually said was "Is there a doctor or nurse on the place who can assist the crew?" I sat in my seat looking over at my then 8 month old in his carrier and thought OMG!, this is it, I get to save a life.

I never imagined that it would happen to me.

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