The call,
“Is there a doctor on board?”
is a familiar line in Hollywood movies involving plane flights but what is your legal risk to assist in an in-flight emergency?
The laws of the country where the plane is registered apply when it is in the air, as do a doctor’s professional code of conduct which in most cases requires them offer help in emergency situations. Most countries provide protection for people who assist in emergencies, provided they are not negligent and in situations where the airline has requested assistance form a health professional, it is likely to be the airline that would have a claim brought against them. There are to date no documented cases of a physician being successfully sued for providing assistance during an in-flight incident.
What else doctors need to know
Doctors considering providing assistance during an in-flight medical emergency should be aware that first aid kits are usually basic but commercial planes are usually required to carry defibrillators and CPR equipment. An increasing number of airlines contract an on-ground medical service and in some instances volunteers require permission from that service to open and use the medical kit.
The incidence of medical emergencies during flights is unknown but a report published in 2000 using data from British Airways estimated it to 1 per 11,000 passengers. Another study suggests a medical emergency occurs every 604 flights on average. Syncope or feeling faint accounts for a large number of in air emergencies and can often be contributed to dehydration, fatigue or low cabin pressure. Breathing difficulties are also a significant cause of emergencies along with chest pain and gastrointestinal complaints.
There are currently no universal guidelines for volunteer medical professionals about managing unwell passengers on board a commercial flight, however various articles have been published which offer guidance for both healthcare providers and travelers about handling mid-air medical emergencies. These include health professionals advising their level of training to allow someone to take a lead role in the event of multiple volunteers, and recommending the plane be diverted if the patient’s condition requires immediate medical attention although it should be noted that the final decision to divert is made by the pilot. Research shows that a doctor’s recommendation is followed in only a small percentage of cases. Chest pain and cardiovascular events are the most common cause of flight diversions.
A large component of managing in-flight medical emergencies is prevention. Doctors are encouraged to discuss the potential for a medical emergency with patients who may be at risk due to medical conditions or who may be susceptible to the physical and psychological stresses of plane travel.