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Always Know Where Your Alternate Airports Are
The physician on call was conferenced in and briefed. The tone of the physician’s analysis indicated that our medical problem might not be dire. This analysis conflicted with that of the onboard doctor. I took a deep breath and sighed inwardly. It was time to put on the proverbial captain’s hat. I looked at my copilot, shook my head, unsnapped the intercom handset from its cradle and pressed the code that would chime the first-class cabin. Liz answered almost immediately. I explained that I… (www.flyingmag.com) More...
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Good story. Refreshing to hear something real life rather than all the new flight schedules and political bitching.
AMEN!
Good story and a real life lesson in decision making. A captain is damned either course he chooses when the prospect of losing a passenger vs the ire of the company for not taking the most economical course. He has to act on the sparse information at hand and his own conscience.
On one hand he has a company doctor (contracted likely) who cannot actually examine the patient and the other a volunteer "doctor" from the passengers who is actually in contact with the patient. He is lucky if the latter is an Anesthesiologist, Intensivist, Cardiologist or Internist, but it could well be a psychiatrist, a proctologist or the worst of all possibilities a government healthcare "policy" administrator...in charge of rationing.
I have been that doctor twice while crossing the Atlantic, once on what turned to be a correct call to divert and once fortunately we were close enough to destination to remove the need for alternates. In both instances (before monitors and defibrillators) there was little to assist in the diagnosis complicated by the passenger not speaking English. It was all worthwhile when I received a thank you card from the surviving "divert" patient and a hand written note from the airline in the other.
On one hand he has a company doctor (contracted likely) who cannot actually examine the patient and the other a volunteer "doctor" from the passengers who is actually in contact with the patient. He is lucky if the latter is an Anesthesiologist, Intensivist, Cardiologist or Internist, but it could well be a psychiatrist, a proctologist or the worst of all possibilities a government healthcare "policy" administrator...in charge of rationing.
I have been that doctor twice while crossing the Atlantic, once on what turned to be a correct call to divert and once fortunately we were close enough to destination to remove the need for alternates. In both instances (before monitors and defibrillators) there was little to assist in the diagnosis complicated by the passenger not speaking English. It was all worthwhile when I received a thank you card from the surviving "divert" patient and a hand written note from the airline in the other.
I've always wondered why crews ask for physicians. Aside from maybe an ER doctor, someone trained as a paramedic would be far better equipped to handle the austere medical environment aboard an airplane.
You are exactly right. Most people are still used to the call of, "Is there a doctor in the house?" But not every doctor is trained to the current standards of emergency medicine. The last time that they handled an emergency may have been years ago while in med school. Not a great time or place for a non-ER doc to try and remember stuff from med school.
Paramedics and EMT's are much better trained to handle emergencies like this. We have training to deal with situations while using minimal, or basic equipment. Normally, we work using standing orders from our department's Medical Director, the doctor whose license we practice under. Some orders are standard that are used almost everywhere in the world (like giving oxygen) and don't need a doctor's order/permission.
On a situation like this, the pilot would need to establish medical control with a physician so that the medic could identify himself and confer with the doc. He would then need to give the doc a patient status report, and then advise him of what equipment he has available on board to use. From there, they can figure out a treatment regimen using what's available.
In the over twenty years that I have been involved in 911 EMS as an EMT and medic, I've only been needed one time, and that was at the gate fortunately. I have to admit that now that I am working overseas, and all of my flights are international, the flight attendants seemed to get a little pissy when I let them know that I'm willing to help if there is an emergency. I don't understand why. The Cathay F/A's really did. Maybe they were superstitious about me even bringing it up. LOL.
Paramedics and EMT's are much better trained to handle emergencies like this. We have training to deal with situations while using minimal, or basic equipment. Normally, we work using standing orders from our department's Medical Director, the doctor whose license we practice under. Some orders are standard that are used almost everywhere in the world (like giving oxygen) and don't need a doctor's order/permission.
On a situation like this, the pilot would need to establish medical control with a physician so that the medic could identify himself and confer with the doc. He would then need to give the doc a patient status report, and then advise him of what equipment he has available on board to use. From there, they can figure out a treatment regimen using what's available.
In the over twenty years that I have been involved in 911 EMS as an EMT and medic, I've only been needed one time, and that was at the gate fortunately. I have to admit that now that I am working overseas, and all of my flights are international, the flight attendants seemed to get a little pissy when I let them know that I'm willing to help if there is an emergency. I don't understand why. The Cathay F/A's really did. Maybe they were superstitious about me even bringing it up. LOL.
That story I told about OKC yesterday; the Captain's decision to go on into OKC rather than divert on to TUL. The USAF doc that was working with the FO told him that if we had to go to TUL, the FO probably would not make it. In those days there was no company doc and it was all on the Captain, but had it not been for that I kinda figure TUL would have been an easy choice
