I recently went on vacation & was on an airplane. A person on the plane had a seizure & then went into full arrest. There was another RN on the plane with me. We are both ER nurses & ALCS certified. We used a BVM & an AED. We started an IV and gave epi. All supplies were from the plane. My license is in California. We Diverted to Nevada.
Looking back I wonder if I was covered under the good Samaritans law or did I practice outside my state & scope of practice. Technically, although we left California we landed in Nevada so I wasn't in my state. Also, there was no doctor on the flight who gave the epi order.
creativekari, well done heeding the call! I imagine if it were me, I would have jumped up to help, but would have been terrified to, at the same time. My experience with ACLS thus far has been as a participant, but not the one calling the shots.
As for IV vs. IM epi, aren't the boxes that the epi comes in labeled? I know the anaphylaxis epi I've worked with has been labeled quite clearly - single dose IM for under/over 50 lb person. Since the person administering the IV epi on an airplane may not be able to prove they're trained, it might make sense to put it in individually dosed vials or pre-filled syringes. (I've never been the one prepping the ACLS meds, so if epi only comes pre-filled or single dose, ignore that last part.)
Was it cardiac epi or anaphylaxis epi (dose wise) I assumed you checked
Some airlines have physician protocols that can be used by a licensed professional as standing orders
Do commercial airplanes actually have an RN and/or paramedic on staff on each flight? That seems prohibitively expensive. Or can the flight attendants perform ACLS?
Or or are the ACLS medical equipment and medications on the plane simply for the scenario where one of the passengers happens to be a physician or RN?
New account? Smells like homework for an ethics class. Sorry, just my opinion....
Personally it sounds like care went FAR beyond "good Samaritan" and most certainly would not be covered by that umbrella should (God forbid) any kind of lawsuit be forthcoming.
Now I'm sitting back to see if OP even comes back. There is that trend out there right now
Specializes in Complex pedi to LTC/SA & now a manager.
Do commercial airplanes actually have an RN and/or paramedic on staff on each flight? That seems prohibitively expensive. Or can the flight attendants perform ACLS?
Or or are the ACLS medical equipment and medications on the plane simply for the scenario where one of the passengers happens to be a physician or RN?
In case nurse, physician, medic. Flight attendants are limited to bcls
Specializes in Med-Surg and Ambulatory Care (multispecialty).
I had a similar experience a few months ago. Hubby and I were flying from Bahamas into North Carolina. Just as we landed and people were exiting the plane there was a commotion. He and I look at each other and sure enough the flight attendant starts yelling "Is there a doctor or nurse on board?". I tell him to yell that I'm an RN and I start heading forward. A 20-30ish guy with an insulin pump was seizing a few aisles ahead of us. An ER nurse and an ICU nurse also were coming forward. We checked his blood sugar & vitals and he started to come around. We gave him glucose gel until paramedics could get on board and take over. He started to come through so I left after giving the flight attendant my name and contact numbers. Hubby and I then had to RUN across the airport to make our connecting flight home. I hope the guy ended up ok. Never heard from anyone about that.
I have a friend who is a flight attendant. They are trained in basic life support.
They also told me that in a mid flight medical emergency such as a cardiac arrest/seizure they always ask passengers if anyone is a doctor/nurse/medic to provide experience and direction.
They do carry IV start kits however rely on there being someone onboard who can start an IV as they do not receive this training.
As being part of the responding code team ACLS is a protocol therefore no physician medication order requirement. We frequently start pushing meds before responding code physicians arrive. One of the purposes of being ACLS trained and being a code responder is being capable of running a full code. So long as you are ACLS certified I see no issues.
I have a friend who is a flight attendant. They are trained in basic life support.
They also told me that in a mid flight medical emergency such as a cardiac arrest/seizure they always ask passengers if anyone is a doctor/nurse/medic to provide experience and direction.
They do carry IV start kits however rely on there being someone onboard who can start an IV as they do not receive this training.
Huh. Two of my friends have been on flights where they were asked to provide emergency medical care, and both times the only medical supplies were a first aid kit, an AED, a BP cuff, a stethoscope, and oxygen. No IVs, no meds.
I gotta stop flying budget airlines. If I'm in that situation I want all the options.
I just hope the people that say yes I am a dr or nurse actually are! While I understand why its done that way it still seems a lil scary
I've responded, it was a deteriorating pt. Not a cardiac arrest. I had to provide my registration details to the senior attendant. Turns out guy was 6 weeks post renal transplant and was returning from Dubai where he had been for 2 weeks. Most likely bowel obstruction from adhesions. We were 90 min out from landing so we continued on with me hanging out with him in first class (cause I don't care for the cattle class:-))
ixchel
4,547 Posts
creativekari, well done heeding the call! I imagine if it were me, I would have jumped up to help, but would have been terrified to, at the same time. My experience with ACLS thus far has been as a participant, but not the one calling the shots.
As for IV vs. IM epi, aren't the boxes that the epi comes in labeled? I know the anaphylaxis epi I've worked with has been labeled quite clearly - single dose IM for under/over 50 lb person. Since the person administering the IV epi on an airplane may not be able to prove they're trained, it might make sense to put it in individually dosed vials or pre-filled syringes. (I've never been the one prepping the ACLS meds, so if epi only comes pre-filled or single dose, ignore that last part.)