Is there a doctor or nurse on board this flight?

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Specializes in NICU.

Has anyone else ever been on an airplane when this panicked announcement has been made overhead?

I was on a 2-hour flight last night when this happened to me. I looked around for about 30 seconds and didn't see anyone do anything - there were only about 100 people on board - so I got up and identified myself. Now, I'm a NICU nurse, and I told the flight attendent that right off the bat. She asked if I felt comfortable checking out a passenger that was having chest pains. Now, I don't have my own nursing insurance (matter of preference) but I do believe that the Good Samaritan law protects nurses in this kind of a situation, so I agreed.

He was a slightly overweight businessman who had some serious chicken and egg allergies as a child. He had eaten at a fast-food restaurant in the airport and was eating a nut snack mix (minus peanuts) on the plane. He had sudden chest pain and shortness of breath. I found him to have a strong, even pulse of 80 BPM, resps 20 per minute and shallow, diaphoretic, pale pink, rated his pain as a 6-7, breathing with no audible wheezing upon inhalation or exhalation, denied any heart or GI problems. I told the flight attendent that I didn't know what else to do, but asked if they had an AED on board just in case. She said yes, and oxygen as well. Luckily we never needed that! I suggested that it was possibly indigestion, reflux, an ulcer, or an allergic reaction. She asked me to come up and sit by him (he was in first class) and I did. I sat next to him, checked his pulse a few more times, and talked him through it. After about 20 minutes, he suddenly said, "Wow, I'm suddenly feeling a lot better." and he started breathing deeper and slower. I suggested some ginger ale to settle his stomach and he did drink a bit. By the time we landed, he was talking, chewing gum, up to the bathroom, and seemed much better. The flight attendent asked if he wanted paramedics standing by at the gate and he declined.

His coworker was going to drive him home and promised to make sure his wife knew what happened. I suggested that he go to the ER to get checked out, but he said he didn't think it was necessary. I told him to at the very least call his doctor ASAP and touch base with him, because further examination was warrented. He agreed and said he would do that. After the flight landed, he thanked me for my help and left with his coworker.

Did I do anything I should or shouldn't have?

He did hear my name - I told him my first name and also the flight attendant came by with the manifest to ask my last name "in case they heard anything" and needed to contact me. I don't think I have to worry about legal action - the flight attendants were all there and knew what was going on, and I honestly didn't think we needed an emergency landing or anything like that. I still wished he'd have let paramedics check him out, but he refused when both the flight attendants and I asked.

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Sounds like you did a great job. I can't help but wonder if he didn't get a poorly chewed nut caught in his esophagus. Have you ever had that where it gets stuck and causes really nasty pain, then when it finally goes down it's gone.

I probably woudl have most likely put some O2 on him if they had it available and not contraindicated by any sort of history. Also.... do they have a strip you can see of the AED? I might have done that? But I'm also an ER nurse so "hook em up and see what's going on". :lol2::roll

I think in those conditions you can only do what you're comfortable with as well.

Good job!!!!

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Specializes in NICU.

I did think about placing the AED on him, but it seemed almost like he was having a panic attack more than anything and I didn't want to scare him any more. Had his pulse not been so strong and regular, I'd have considered it. He definitely didn't need a shock, and I haven't seen a "public" AED that actually showed a rhythm strip, so it really wouldn't have done much.

I also considered the oxygen but he was still pink, though tachypnic, and again I wonered if his anxiety would be worse with a mask on. Plus, as a NICU nurse, it's drilled into my head all the time that oxygen is a medication, and I didn't want to place it on him if it wasn't necessary. He was talking the whole time and was able to carry on a conversation without noticable stops to catch his breath.

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Not on an airplane, but a man once had a heart attack at my daughter's band concert. They stopped the concert and asked if there was a doctor or nurse in the audience and said there was a man in the lobby having chest pain. Four people went out to the lobby to help...and probably twenty called 911. :) There was me, a CNA, an EMT, and a doctor. I rode to the hosptal with him and he had the UGLIEST EKG I have ever seen...I ended up being the paramedic that took him to Denver too. The patient sent a bunch of fruit and nuts to the fire department, the hospital, the doctor's clinic, the nursing home the CNA worked for, and the police department to thank them for helping. He remembers all of us and always says something if he sees us somewhere...that is what makes it all worth it. :)

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Specializes in PCU, Critical Care, Observation.

I probably would have applied the oxygen & asked around to see if anyone had an aspirin. You did a great job though!!!

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Specializes in Education, FP, LNC, Forensics, ED, OB.

My recent flight from San Diego was a stop in Salt Lake. About 20 minutes out, there was this call. My colleague and I responded as did a physician.

The individual was a young adult in respiratory distress. I quickly quizzed the individual about medical hx including allergies and he said he ate a snack on the flight. He indicated that he had done this before and was an allergy.

He was in obvious distress. My colleague asked the attendant for B/P cuff and I, the stethoscope. She handed me a VERY curled scope. Breath sounds equal and bilateral, mild insp and exp wheeze and no stridor. He was clammy and anxious. I asked for the O2 and applied that. V/S - B/P - low normal, P - tachy, R - 28 and labored.

Instructed the attendant to ask the pilot to have paramedics ready when we landed.

I asked the physician if he concurred and he nodded, otherwise, he stood silent. (later found out he was an ENT spec).

Administered the epi-pen.

I filled out a very detailed report per the request of the pilot.

The plane was met by the paramedics and they carried him away. Thank goodness he didn't arrest.

About 2 weeks later, I received a thank you from the president of the airlines and a free round-trip ticket to anywhere in the U.S.

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My recent flight from San Diego was a stop in Salt Lake. About 20 minutes out, there was this call. My colleague and I responded as did a physician.

The individual was a young adult in respiratory distress. I quickly quizzed the individual about medical hx including allergies and he said he ate a snack on the flight. He indicated that he had done this before and was an allergy.

He was in obvious distress. My colleague asked the attendant for B/P cuff and I, the stethoscope. She handed me a VERY curled scope. Breath sounds equal and bilateral, mild insp and exp wheeze and no stridor. He was clammy and anxious. I asked for the O2 and applied that. V/S - B/P - low normal, P - tachy, R - 28 and labored.

Instructed the attendant to ask the pilot to have paramedics ready when we landed.

I asked the physician if he concurred and he nodded, otherwise, he stood silent. (later found out he was an ENT spec).

Administered the epi-pen.

I filled out a very detailed report per the request of the pilot.

The plane was met by the paramedics and they carried him away. Thank goodness he didn't arrest.

About 2 weeks later, I received a thank you from the president of the airlines and a free round-trip ticket to anywhere in the U.S.

Sounds like one of my trips to NYC. Only it was just a paramedic and myself. And we both go a free round-trip ticket as well. The ticket wasn't necessary but it was appreciated, it was first class.

Grannynurse

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Forgot to add, our guy arrest 35,000 feet in the air. We successfully resuscitated him, landed at Charlottville and paramedics wisked him away. We both need a drink after we took off again. And were given all we could drink-two was my limit.

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Specializes in NICU.
My recent flight from San Diego was a stop in Salt Lake. About 20 minutes out, there was this call. My colleague and I responded as did a physician.

The individual was a young adult in respiratory distress. I quickly quizzed the individual about medical hx including allergies and he said he ate a snack on the flight. He indicated that he had done this before and was an allergy.

He was in obvious distress. My colleague asked the attendant for B/P cuff and I, the stethoscope. She handed me a VERY curled scope. Breath sounds equal and bilateral, mild insp and exp wheeze and no stridor. He was clammy and anxious. I asked for the O2 and applied that. V/S - B/P - low normal, P - tachy, R - 28 and labored.

Instructed the attendant to ask the pilot to have paramedics ready when we landed.

I asked the physician if he concurred and he nodded, otherwise, he stood silent. (later found out he was an ENT spec).

Administered the epi-pen.

I filled out a very detailed report per the request of the pilot.

The plane was met by the paramedics and they carried him away. Thank goodness he didn't arrest.

About 2 weeks later, I received a thank you from the president of the airlines and a free round-trip ticket to anywhere in the U.S.

Wow, I'm glad he did okay for you!

I didn't even think to ask for a stethescope and BP cuff - I would have thought the flight attendant would have offered them to me if they had them because at one point I said, "Without any equiptment, I can't tell you much" and she agreed.

I didn't give aspirin for the same reason as the oxygen - it was a med and I didn't feel comfortable giving it. If we were on the ground and someone had already called 911, I might have. But we were mid-flight and this is a man with a history of anaphylactic shock - albiet to poultry - and also had a penicillin and egg allergy. With those kinds of more serious allergies, I was somewhat afraid to administer aspirin because there are people allergic to that and I didn't want him to go into anaphylactic shock on the plane. I had Benadryl and Rolaids in my purse as well but didn't offer them to him either, even though it appeared he was suffering from allergies or indigestion.

I'm glad that no one has said that I should have sat there and not told anyone I was a nurse!

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Specializes in critical care transport.

If I'm with my husband, I know stuff like this happens.

I've been on two flights, one of them with my husband, that had a person who fell out of their chair as soon as they stood. *Of course*...Anyways, hubby goes up there (Mr. Firefighter) as does some ambulance employee (probably also an EMT). We got a bottle of champagne (we don't drink).

Of course there's nothing they can do but take vitals.

I'm telling you, my husband has been 1st on scene to so many things, you'd think there was something going on with that. He manages to get on television, to see accidents 1st, etc, all the time. It's weird.

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Specializes in many.

Who were you guys flying on when you got a free ticket, and where is mine?

June of last year I was coming back from Boston to NC and heard the call. I went from sleeping to halfway down the aisle in less than 2 seconds. (jumped 2 passengers in the process) The Peds NP sitting on the aisle in my row said she had never seen anyone move so fast.

A Pediatrician and I responded to an obese male appearing > 60 y.o. with CP and lightheadedness who was "assisted to the floor" at the back of the pain after taking a nitro tab. By the time the MD and I got there he was awake but groggy.

The flight attendant offered to lift his legs, we encouraged him not to and asked for O2, AED and whatever else they had on board.

BP of 80/nothing, pulse was 90 and thready, diaphoretic and chest pain 10/10. We applied the AED and checked a rhythm, no need to shock. I continued assessing while the MD got as much history as he could from the pt and his s/o. He had had a triple bypass about 6 months before.

We asked for and got expedited landing at the nearest airport and medics had him off the plane in less than a minute. (Philly)

Took the time afterwards to explain to the flight attendant that if a pt has heart problems the last thing they need is increased blood volume on the heart.

No need for caffeine after that, adrenaline kept me up for about 3 hours.

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I probably would have given the ASA and O2...but...as a paramedic, I can practice pretty independently as long as I follow my medical director's protocols. I don't really know how the rules would differ if I were in the air, but even out of state, I am usually good to go, as long as I don't deviate from protocols and I follow my scope of practice. If I weren't a paramedic, I don't know if I would give meds or not...especially if I didn't generally take care of adults. I am pretty comfortable following ACLS protocols, but if I didn't have ACLS, I would hesitate.

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