Legalities in Flight Emergencies

[MNRNBSN]

Let's say you are an RN passenger on an airplane and an announcement is made asking all medical professionals to assist in a medical emergency. What if your experience as a nurse is not in critical or emergency care and have not run a code. My thoughts are I could at least help to the best of my ability and it may or may not save the persons life but at least I tried. If I didn't at least try and that person perished I would have to live with guilt the rest of my life. Since following ZDoggMD on Facebook he has brought to light all the legalities involved in assisting a flight emergency. He states you should know you are competent before responding, get written consent from the person (verbal if that's not possible), document everything, and communicate with the flight crew at all times. He said that the Good Samaritans law may not apply if you commit gross negligence. How do I know if I am competent in that situation until I know what the situation is? Can I legally back out and say I do not know how to handle it? How do I get consent and document in that setting? Can I simply assess the situation and allow the on-call doctor to advise me based on my assessment? What if I don't catch something? What if something goes wrong and it turns into their word against mine? I don't want to end up in legal trouble. You'd think this is a rare occurrence but I was surprised to find out how often this happens and how often the medical equipment in the plane's malfunction or are not up to par. I want to be prepared and be able to protect myself from legal trouble. This short video is what triggered this question

A Young Nurse Dies On A Plane; What Could Have Been Done?

[video=youtube_share;TIHQIvSUXiA]

If you have any knowledge or experience in the legal side of this please share. Thank you.

[ruby_jane, BSN, RN]

I haven't watched the video, but my interpretation of what you wrote is:

Do - Come forward, give your credentials, and state ways you might be able to help, "I'm a new nurse. I have no critical care experience, but I can take vital signs and I know CPR." If someone more competent arrives, step aside and let them take the lead.

Don't - Come barreling down the isle screaming, "I'm an RN and this person needs an airway! Does anyone have a pocket knife so I can make one?"

Sour Lemon, you win the internets today!

[BostonFNP, APRN]

I responded once (because my son volunteered me) and I would be very hesitant to do so again.

If you are going to respond:

1. Know the limits of your training/experience and your scope. There will be an on-call physician/provider available most times.

2. Attempt to get consent (even if pt is unconscious, witnesses will confirm your attempt).

3. Clearly identify yourself to the patient and the flight crew. If other medical personnel respond make sure you are very clear on who each person is and what their qualifications are, especially if you are relinquishing care to another person.

4. If you are alone, talk out loud.

5. Be familiar with the fact there is a standard med kit and the meds in that kit and know how to start an IV and give IM meds including what needles to use.

6. Be prepared you may need to give your recommendations to the flight crew regarding diverting the flight.

7. Be aware they may be a lengthy debrief after touchdown.

8. While you can/should be aware of the legal ramifications, also remember there is a real person in front of you and their life my depend on you.

[Nurse SMS, MSN, RN]

I was the only medical person on a flight once recently when a call for a nurse or doctor was made overhead. I spoke to the physician on-call and shared my patient assessment with him along with recommendations, which were then ordered and administered and I stayed with the patient for monitoring. I was there to hand the passenger/patient off to the paramedics once we landed. I felt really proud to be a nurse that day.

[Leader25, ASN, BSN, RN]

I assisted an MD on an international flight,the emergency kit on board was missing items such as glucometer or even strips to run a quick check.Where were close to destination so no diversion.The crew was very helpful.I was surprised how obnoxious the emts were upon entering the plane.

[Horseshoe, BSN, RN]

I was the only medical person on a flight once recently when a call for a nurse or doctor was made overhead. I spoke to the physician on-call and shared my patient assessment with him along with recommendations, which were then ordered and administered and I stayed with the patient for monitoring. I was there to hand the passenger/patient off to the paramedics once we landed. I felt really proud to be a nurse that day.

What drugs do they keep on board airplanes?

[Nurse SMS, MSN, RN]

What drugs do they keep on board airplanes?

I do not know comprehensively. I gave diphenhydramine and had an epipen on standby.

[Nurse SMS, MSN, RN]

I assisted an MD on an international flight,the emergency kit on board was missing items such as glucometer or even strips to run a quick check.Where were close to destination so no diversion.The crew was very helpful.I was surprised how obnoxious the emts were upon entering the plane.

The ones I handed off to were extremely dismissive of me. Oh well. That says more about them than about me.

[Purple_roses]

I wonder if it would be appropriate to have someone record the event? I'm not sure if that would breach HIPAA law, but people usually do whip out their phones for anything these days. I feel that I would feel better knowing that someone was recording and I would almost narrate everything. Like if I went to use some piece of medical equipment and it malfunctioned, I would announce "the equipment that I have been provided with is not functional." again, I'm not sure if recording would be appropriate.

[RNrhythm, BSN, RN]

Is is true that that if you are performing CPR on a commercial flight, that they will make you stop CPR and resume your seat, buckle-in, etc, for landing?

[BostonFNP, APRN]

What drugs do they keep on board airplanes?

https://www.faa.gov/documentLibrary/media/Advisory_Circular/AC121-33B.pdf

This is the FAA document.

[KelRN215, BSN, RN]

I wonder if it would be appropriate to have someone record the event? I'm not sure if that would breach HIPAA law, but people usually do whip out their phones for anything these days. I feel that I would feel better knowing that someone was recording and I would almost narrate everything. Like if I went to use some piece of medical equipment and it malfunctioned, I would announce "the equipment that I have been provided with is not functional." again, I'm not sure if recording would be appropriate.

HIPAA wouldn't apply in this situation since, as a volunteer on board on an airplane, you won't be billing the patient's insurance for any of the care you provided.

[BostonFNP, APRN]

I wonder if it would be appropriate to have someone record the event? I'm not sure if that would breach HIPAA law, but people usually do whip out their phones for anything these days. I feel that I would feel better knowing that someone was recording and I would almost narrate everything. Like if I went to use some piece of medical equipment and it malfunctioned, I would announce "the equipment that I have been provided with is not functional." again, I'm not sure if recording would be appropriate.

Narrate if alone! I can't imagine an emergency on an airplane that someone wasn't recording.