I'm planning a trip to Europe this fall, and I've heard some horror stories from coworkers about medical emergencies that occurred on their flights on vacations.
Since I will have submitted a passport, they will be aware of what kinds of people are on the plane, occupationally speaking. (Not that I would hide... I'd help if no one else was willing... but you see where I'm coming from, I'm sure!)
I'm a new nurse, so I haven't really developed my "gut feelings" yet...
I know I need to utilize my BLS (and now ACLS) skills...I know airway comes first....I know that I need to work my way down the ABC's.... but it's so different when you have no equipment, no drugs, no diagnostics, and no help.
Share your stories, pointers, and any helpful hints, so I can relax on my flight to Italy :)
Not that this subject isn't already confusing enough, but here's another question. Let's say you are on a domestic US flight at cruising altitude and an emergency occurs. Is the situation governed by laws of the state over which you are flying? That could change many times during a single flight. If someone wanted to sue you (for giving or not giving aid), wouldn't it be darn near impossible to figure out what occurred at which geographic point in the flight?
Seems to me that you wouldn't be at too much risk so long as you didn't misrepresent yourself or do something ludicrous. Then again, that would be the common sense approach, and there are days when that appears to be in rather short supply.
So what if there were no medical personnel on the flight and someone was in anaphylactic shock? You still couldn't give an epi pen??? That's a scary thought!
My response was for when nurses or other qualified medical individuals are on board a flight. However, I will expand on this...
As part of operating procedures and policies, ALL US commercial airline carriers have contracts with medical services. i.e Mayo Clinic and other medical system groups. The procedures for a patient requiring medical assistance with no medical personnel onboard is for the captain to contact flight operations and patch communication to the medical services. All communications on the passengers condition, symptoms and a medical background/history is relayed to the medical staff. In the case of a medical situation requiring immediate attention, instructions are received from the medical staff to the flight crew to deliver the appropriate treatment to either stabilize or improve the condition, until futher medical assistance is available. This is accomplished on domestic and worldwide routes through stockholm radio communications. Per the airline operating procedures, the flight will most likely be diverted to the nearest airport for futher medical care. Rest assure that no passenger will be left unattended to their medical needs in the event of no medical personnel on board. The flight crew takes full responsibility of the welfare of all passengers and crew.
Not that this subject isn't already confusing enough, but here's another question. Let's say you are on a domestic US flight at cruising altitude and an emergency occurs. Is the situation governed by laws of the state over which you are flying? That could change many times during a single flight. If someone wanted to sue you (for giving or not giving aid), wouldn't it be darn near impossible to figure out what occurred at which geographic point in the flight?
Seems to me that you wouldn't be at too much risk so long as you didn't misrepresent yourself or do something ludicrous. Then again, that would be the common sense approach, and there are days when that appears to be in rather short supply.
From a license standpoint, it's safe if your BON doesn't require you to help; not safe if they do but you don't help. So NY, for example, couldn't revoke a MI license if the emergency occurred over NY. However, as for getting sued (whether you help or not), I suspect that could happen regardless of where you are licensed, where the sick individual resides, where the flight took off from, and where your plane is located at the time of the emergency. Now as for what area has that authority (i.e., where the trial would take place), I would again speculate that the plaintiff's attorney would choose the state that would have the most favorable laws for their case. I would say ask an attorney who specializes in medical mal., but it'd probably cost you some $$$ to find out. Clear as mud?
In addition to the states being flown over, jurisdictional questions would also have to include the state in which the flight originated, the destination state, and the state in which the carrier is based.
I can see it now--"Ms. Flight Attendant, what state are we over right now? Hmm, that state has less favorable Good Samaritan laws. Let me know when we cross into the next state, and I'll be glad to help then."
The difficulty, as I see it, is that this is probably territory that is not well charted because, a) it comes up so rarely, and b) there hasn't been much precedent set to establish the standards.
That said, I would do what I could for a fellow passenger. The examples mentioned on this thread involved basics like having the pt. lie down with feet elevated, administration of O2, monitoring of v/s, and admin of epi. No emergency tracheotomies to insert pen casings or anything else of that dramatic a nature. (How would you even perform said trach when there is probably nothing sharper than a butter knife on the plane anyway.)
My response was for when nurses or other qualified medical individuals are on board a flight. However, I will expand on this...
As part of operating procedures and policies, ALL US commercial airline carriers have contracts with medical services. i.e Mayo Clinic and other medical system groups. The procedures for a patient requiring medical assistance with no medical personnel onboard is for the captain to contact flight operations and patch communication to the medical services. All communications on the passengers condition, symptoms and a medical background/history is relayed to the medical staff. In the case of a medical situation requiring immediate attention, instructions are received from the medical staff to the flight crew to deliver the appropriate treatment to either stabilize or improve the condition, until futher medical assistance is available. This is accomplished on domestic and worldwide routes through stockholm radio communications. Per the airline operating procedures, the flight will most likely be diverted to the nearest airport for futher medical care. Rest assure that no passenger will be left unattended to their medical needs in the event of no medical personnel on board. The flight crew takes full responsibility of the welfare of all passengers and crew.
Juliana
Well, in that case, why don't they do just that? Instead of calling out for any one on board, who may or may not want to get involved, who may or may not want to be exposed to any liability, who may or may not know what they're doing, depending on the individual, and who may not do any better than the flight crew. The responsibility does lie with the airline and its employees, not with another passenger. They want to rely on the medical personel on board, let them pay someone to ride each flight assuming that responsibility and liability, like that would ever happen.
In addition to the states being flown over, jurisdictional questions would also have to include the state in which the flight originated, the destination state, and the state in which the carrier is based.
I can see it now--"Ms. Flight Attendant, what state are we over right now? Hmm, that state has less favorable Good Samaritan laws. Let me know when we cross into the next state, and I'll be glad to help then."
The difficulty, as I see it, is that this is probably territory that is not well charted because, a) it comes up so rarely, and b) there hasn't been much precedent set to establish the standards.
That said, I would do what I could for a fellow passenger. The examples mentioned on this thread involved basics like having the pt. lie down with feet elevated, administration of O2, monitoring of v/s, and admin of epi. No emergency tracheotomies to insert pen casings or anything else of that dramatic a nature. (How would you even perform said trach when there is probably nothing sharper than a butter knife on the plane anyway.)
Would you actually do that, perform a tracheotomy?
if you are helping and you know it's the only thing that could save a life, could you let them die? Personally I don't know that I have the ability to start a trach, but in an emergency, who knows.
BTW ... here's a brush-up from your history of nursing course ... did you know that the first flight attendants had to be nurses? Probably for eventualities such as this...
I was gonna mention that myself; I was a travel agent before going into nursing. I'm not sure what FA's are qualified to do these days, but I'll bet they receive pretty extensive BLS training. I was talking to a pilot one day and he loved to tell passengers, "The FAs are not there to KISS your a**, they're there to SAVE your a**."
Specializes in Did the job hop, now in MS. Not Bad!!!!!.
Here's a PS RNcDreams,
it doesn't matter if you are in flight, stuff happens.
I had just rec'd my RN and was a week away fr starting orientation on my first job as a new grad. My friends and I were finishing lunch out at a local deli when there was a scream and that dreaded call, "is there a doctor (yah, never a nurse!) in the house?!"
A man had slumped to the floor in front of the register at teh front door. My best friend shouts across teh restaurant as I'm squooshing out of the booth seat, "Chloe's a nurse, she can help!"
Of course I'm terrified, of course I question everything I do, but gut instinct drops me to the floor and all my ABC's and assessment skills kick into gear.
And I felt like a silly "pro" when the BIG hook n ladder truck showed w/ nearly 20 EMT's and Paras taking over and I gave my simplistic "report" to one standing by.
He told me I did good and I called my clinical instructor from the road on teh way home and she validated every lil thing I did. Better yet she told me there's nothing else she could have done differently and not knowing the repercussions, she said other than the assessment and palliative care I gave, the only other thing I could have done until the EMT's arrived would be give an aspirin, which we both agreed would have been a tragedy (see above posts).
But I'm still scared it could happen again.
G-d bless you first responders out there. You absolutely rock!!! :yelclap::rckn:
Specializes in Gyn Onc, OB, L&D, HH/Hospice/Palliative.
...and how does one get sued for not helping?
Does the 'victim' in question summon the occupations of all passengers and whoever could have rendered aid but didn't get summoned? Hmmmm,sounds a bit far fetched to me....or maybe when they page for medical assistance, we should not answer Yes! I am a nurse, but No! I will not help ! :selfbonk: Maybe we could all carry disclaimer forms that the 'victim' or those closest could have to sign before rendering aid, then we would be all set!!!!
At this point I think it would be best if all medical personnel would simply stop flying. In fact all forms of travel should be completelyeliminated . Yep,that's my opinion, who's with me???
rn/writer, RN
9 Articles; 4,168 Posts
Not that this subject isn't already confusing enough, but here's another question. Let's say you are on a domestic US flight at cruising altitude and an emergency occurs. Is the situation governed by laws of the state over which you are flying? That could change many times during a single flight. If someone wanted to sue you (for giving or not giving aid), wouldn't it be darn near impossible to figure out what occurred at which geographic point in the flight?
Seems to me that you wouldn't be at too much risk so long as you didn't misrepresent yourself or do something ludicrous. Then again, that would be the common sense approach, and there are days when that appears to be in rather short supply.