Legalities in Flight Emergencies

Nurses General Nursing

Published

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.

Specializes in ER.

I watched the video and liked several great responses. My two cents:

1. I have and will respond because I may be the best person available. I'll take a paramedic or an ER RN over a dermatologist an orthopedist in most emergencies if I can choose who is going to help.

2. The case study is a strong reminder of the danger of writing off hyperventilation and complaints of SOB as a panic attack. "There was talk of breathing into a bag..." Hyperventilation, clear lungs, anxiety and an O2 sat of 100% may be present in a panic attack. Those same findings may be present several life threatening situations where a paper bag for a minute or two can be the difference between life and death.

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Specializes in Pediatric Critical Care.

Boy, use those two alcohol swabs wisely.

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Since following ZDoggMD on Facebook

I lost you here (I'm familiar with his youtube channel). Look, I like the music videos and the fact he is not a fan of Dr. Oz. Outside of that, I don't know the guy, I don't know how respected of a Dr. he is, etc. Use your own judgement, if it is something you are not familiar with or uncomfortable with, express your limitations (as stated by others). Just because you are a nurse, doesn't mean you're going to save everyone. I've worked more than my fair share of CPR's and other critical situations and the fact is...people are going to die (at worst). If it's by the hands of someone that has experience or not. At the very least, you're a nurse, you have the basic skills to assess someone, and have BLS training, the worst that can happen is you bouncing up and down on someones chest. The rest of it is up to luck (from a critical patient standpoint).

With that said, if you choose not to respond, don't feel guilty. This isn't a movie and not every individual that works in the field can respond to everything that is thrown at them. Don't feel guilty, you can only do so much. It's not like someone throws a RN symbol in the sky, you run to the bathroom to change into your scrubs and....BAM! SUPER RN!

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Specializes in Public Health, TB.

I have heard the request for medical personnel twice in the past 12 months, but both times someone else responded. Mostly because dh insists on sitting in the rear of the plane. But the first time there was a call for a glucometer from the passengers, which I don't see on the FDA list. dh now packs one in his carry-on, just in case.

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Specializes in NICU/Mother-Baby/Peds/Mgmt.

I flew Cathay Pacific from LAX to Hong Kong in 2000 and responded to an emergency. They didn't have a urinary catheter with a balloon so I made do. They also didn't have a couple other things, but they weren't anything life threatening. I could have run a code with the meds available. I was really impressed with their emergency bag.

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Ask the crew if they have an 'indemnity form'. Many airlines carry a form of this nature but will not automatically offer it. In other words, all you need to do is ask. í ½í¹‚

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I would take the lead, assist, or stand out of the way depending on the qualifications and skill levels of other responders. I would do this with absolutely no fear of consequences.

My take on this is a bit different as I am an ER RN as well as EMT, and am comfortable dealing with emergencies outside of a hospital. That being said: Anybody, whether trained as a CNA or a trauma surgeon, can be in over their head in certain situations. The expectation is that you do your best. Believe me, I do not want to encounter a breech birth in an airplane bathroom. On the other hand, a simple cardiac arrest laying in the aisle and it's game on.

Could I be sued, or held legally accountable? Absolutely. Just like I could every day at work. I am not "under" my hospital's insurance, or legal protection. Nobody is. You think I did a bad job taking care of you, call Dewey, Cheatem, and Howe to get an estimate of what your case is worth.

Is it likely I will be sued for volunteering to help a fellow passenger on an airplane? No. That type of case is rare, and I would have to do something pretty egregious for it to happen. Law makers, judges, and juries want you to help them if the need it. On the other hand, if you do compressions on the face and try to ventilate the chest after you removed the AED pads to prevent an electrical shock- well, that could cause a problem.

As luck would have it, if Dewey, Cheatem, and Howe manage to successful sue me for all I am worth, they will get 1/3 of not much. Maybe net enough for a box of those big yellow pads. So they probably won't take the case.

There is some degree of risk in everything I do. I am planning on driving my car, paddling a kayak, and operating a BBQ grill today. I feel that all of these present more potential risk to my well being then helping out on an airplane.

As an nurse, a PT often has a a negative outcome despite my doing my best. It really does not bother me. On the other hand, a fellow human being having a negative outcome because I didn't even try? That would bother me.

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I think the reason this prompted me to worry was because I recently just attended a medical emergency at a restaraunt and felt very helpless when the staff just left me to deal with it on my own.

You're an RN. You might not work trauma or ED, but the basics are still the same that you learned in your first semester of nursing school....ABC, vitals, head to toe eval, etc. Treat what you find to the best of your ability.

If you are really that nervous about treating emergent situations I'd suggest taking the ACLS class or even a Wilderness First Responder or Wilderness Medicine for the Professional Practitioner course through the NOLS Wilderness Medicine Institute. The course may or may not apply as CEU in your state. But learning to treat emergent medical problems in the wilderness setting with a lack of supplies and facilities is relevant to treating them in most nonhospital situations.

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Exactly ONE pair of gloves. Hope they fit.

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Specializes in ED, Pedi Vasc access, Paramedic serving 6 towns.

Hi,

Does anyone know for sure if any communication with the doctor on the ground is recorded? I would assume it is... One would hope.

Annie

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Hi,

Does anyone know for sure if any communication with the doctor on the ground is recorded? I would assume it is... One would hope.

Annie

I can already a picture a SNL skit based on this scenario....

Computer: "Thank you for calling OhCrap Air Emergency Hotline. This call may be recorded for training and quality purposes. Please press 1 if your patient may be experiencing a cardiac emergency, to be connect to our OhCrap Air Emergency Cardiac Response Team. Please press 2 if your patient is experiencing a pulmonary emergency..."

Dermatology Nurse: Desperately mashing the 1 button

Computer: "Im sorry but I do not understand your request. Please press 2 if your patient is experiencing a pulmonary emergency, to be connected to our OhCrap Air Emergency Pulmonary Response Team. Please press 3 if your patient is giving birth, to be connected to our OhCrap OB Response Team."

Dermatology Nurse: still madly pressing 1

Computer: "I did not understand your selection. Let me connect you with one of our customer service agents."

Dr Karen: (Obvious Indian Male Accent) "Hello this is Dr. Karen speaking who do I have the pleasure of speaking with and how may I help you today?"

Dermatology Nurse: "Dr...Karen? I have a 60 year old male patient with a history of myocardial infarction, pulse is weak and rapid..."

Dr Karen: "I am sorry but before we get started today I need to know your full name, and your OhCrap Air Emergency account number so that we can access your records."

Dermatology Nurse: "What!?!?"

Given all of my past encounters with phone based customer care this is exactly how I picture this call going...

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Specializes in Pediatric Critical Care.
Exactly ONE pair of gloves. Hope they fit.

Whenever there is only one pair of gloves supplied, they are guaranteed to be one-size-fits-nobody.

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