In flight Emergency with the proper equipment

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Question: you are on an airline being asked to intervene in a "medical emergency"...chest abd pain of 10. You open the airline's med bag and the morphine is in ampules. Of course no filter needle.... The MD is on the radio telling you to give it anyway. What do you do? What are you liable for?

Specializes in L & D; Postpartum.
The second time, I had a bunch of people who thought they were Dr's, but no actual medical personel, and we had to divert the flight.

My husband flew across the pond and back for 38 years. Oh, the stories he tells. Once, he had 6 docs on board. I said, "let me guess. It was like the keystone cops." They all wanted to be the one in charge, so he asked what specialty each of them were/had (?) and he picked the one most likely to know something pertinent.

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Specializes in ER, Trauma, ICU/CCU/NICU, EMS, Transport.

Hi chyna016 -

Thanks for your post - I found it to be useful.

yes, next time I fly, I'll ask the crew if I can see what they got; when would be a good time to do this, while boarding or be the last one off (If i'm not in a rush to catch a connecting flight?)

I don't identify myself before boarding, but when I step on board, I have a business card with my name, credentials and contact information, and on the back I write my seat number and hand it to the attendant I pass at the front, saying, "in case you need anything, I'm a paramedic" and I hand them the card showing them my seat number - They have always accepted it (sometimes a little confused) with a very energetic "thank you!"...

So, that being said, let me ask you this...

If a medical emergency came up, AND, I had already identified myself to them when I boarded, would they discretely approach me and tell me of the "situation" or would they page overhead "Mr So-and-so" or "is there a doctor on board"?

Second question - would it be more useful upon initially introducing myself to the crew to say I'm a paramedic or a emergency nurse practitioner? (I'm both). I have always said paramedic, b/c I figure everyone knows what a medic is, but not everyone knows what a NP is...yet. Advice?

Thanks!

-Mark Boswell

MSN FNP-BC CEN CFRN CTRN CPEN NREMT-P

"Support CEN Certification and your local ENA"

I am a flight attendant who will be starting nursing school in JAN. One airline I worked with used medlink, and we were told that there is no liability to the medical personnel on the plane if they follow what the Dr on the radio says to do.

The kits do vary by airline, I fly for a regional so we may not carry the same items that an overseas flight would have. The kits should all have a color coded card in the front, and the contents should also be color coded to make it easier to find items. I have been told the stethoscopes are not the greatest in the kit, but it could also be all the airplane noise that contributes to that.

I would post exactly what we have, but there are all sorts of warnings against doing that in my manual, but I can tell you we have epinephrine. I love it when I am halfway through the cabin serving peanuts, and then someone tells me they are allergic....

If you are curious what is in the kit, and you are on a longer flight the flight attendant will probably show you the list of items if you show them some credentials. We love to know when there is medical personnel on board. I have had two medicals in flight, once had two RNs and a Dr, and they were great. The second time, I had a bunch of people who thought they were Dr's, but no actual medical personel, and we had to divert the flight.

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ask and you shall recieve...

the US congress and senate passed what is know as the "Aviation Medical Assistance Act" in 1998 indemnifying medical personnel from liability while airborne.

"SEC. 5. LIMITATIONS ON LIABILITY.

(a) LIABILITY OF AIR CARRIERS.—An air carrier shall not be

liable for damages in any action brought in a Federal or State

court arising out of the performance of the air carrier in obtaining

or attempting to obtain the assistance of a passenger in an inflight medical emergency, or out of the acts or omissions of the

passenger rendering the assistance, if the passenger is not an

employee or agent of the carrier and the carrier in good faith

believes that the passenger is a medically qualified individual.

(b) LIABILITY OF INDIVIDUALS.—An individual shall not be liable

for damages in any action brought in a Federal or State court

arising out of the acts or omissions of the individual in providing

or attempting to provide assistance in the case of an in-flight

medical emergency unless the individual, while rendering such

assistance, is guilty of gross negligence or willful misconduct.

...

(3) the term ‘‘medically qualified individual’’ includes any

person who is licensed, certified, or otherwise qualified to

provide medical care in a State, including a physician, nurse,

physician assistant, paramedic, and emergency medical

technician."

http://www.medaire.com/FAA_OnboardMedicalKits_pl105170.pdf

and here is the minimums listed in the FAA regs

http://rgl.faa.gov/Regulatory_and_Guidance_Library/rgAdvisoryCircular.nsf/8e17c23e2f26e8018625726d006ce776/82c231fbaba1cf3e86256c2a004c7f3b/$FILE/AC121-33.pdf

to the OP question regarding no filter needles.

filter needles are not needed for an IM injection, they are nice to have but by no means necessarily. I would give the MS as ordered however I would give IM.

hope this helps you all out. I personally would help if needed. I would rather have a ER RN calling the shots than a podiatrist...

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Specializes in ER, IICU, PCU, PACU, EMS.
Hi chyna016 -

Thanks for your post - I found it to be useful.

yes, next time I fly, I'll ask the crew if I can see what they got; when would be a good time to do this, while boarding or be the last one off (If i'm not in a rush to catch a connecting flight?)

I don't identify myself before boarding, but when I step on board, I have a business card with my name, credentials and contact information, and on the back I write my seat number and hand it to the attendant I pass at the front, saying, "in case you need anything, I'm a paramedic" and I hand them the card showing them my seat number - They have always accepted it (sometimes a little confused) with a very energetic "thank you!"...

So, that being said, let me ask you this...

If a medical emergency came up, AND, I had already identified myself to them when I boarded, would they discretely approach me and tell me of the "situation" or would they page overhead "Mr So-and-so" or "is there a doctor on board"?

Second question - would it be more useful upon initially introducing myself to the crew to say I'm a paramedic or a emergency nurse practitioner? (I'm both). I have always said paramedic, b/c I figure everyone knows what a medic is, but not everyone knows what a NP is...yet. Advice?

Thanks!

-Mark Boswell

MSN FNP-BC CEN CFRN CTRN CPEN NREMT-P

"Support CEN Certification and your local ENA"

Many moons ago, I was a flight attendant. If you had given me your card, I would have asked you to speak to me in private when a medical problem occurred. As a F/A, you want the passengers to be calm and not draw attention to any problems. I would see no reason to use the PA and needlessly worry the other passengers.

I would also mention the NP. I believe it varies between airlines on which medical personnel are allowed to use the kit.

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Hi mwboswell,

The business card is perfect. A lot of FAs may not know what a NP is, but they all know a paramedic is great to have in a medical emergency. If you would like to know what is in it I would ask during a slow time in flight, usually after the beverage service is good. Most FAs would be happy tell you what is in the kit if you show credentials.

If I knew a paramedic was on board, I would go to them before I started paging for assistance. Anything serious we will land as soon as possible which is usually 15 minutes in the lower 48. I have never heard of a paramedic not being allowed to open the kit, but it doesn't hurt to tell them about being an NP too.

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Specializes in ED.
ask and you shall recieve...

the US congress and senate passed what is know as the "Aviation Medical Assistance Act" in 1998 indemnifying medical personnel from liability while airborne.

to the OP question regarding no filter needles.

filter needles are not needed for an IM injection, they are nice to have but by no means necessarily. I would give the MS as ordered however I would give IM.

hope this helps you all out. I personally would help if needed. I would rather have a ER RN calling the shots than a podiatrist...

Thanks, great answer.

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Specializes in Emergency Dept, ICU.

Filter needles, really... Are you an ER nurse?

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