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How airlines handle in-flight medical emergencies

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How airlines handle in-flight medical emergencies
Policy
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Jake Hardiman Senior Editor | Simple Flying

The Federal Aviation Administration (FAA) mandates the presence of automated external defibrillators (AEDs) and first-aid kits on flights, with trained crew members responsible for accessing them. The SAMPLE acronym is used to assess medical emergencies, while DRSABCD helps establish consciousness. The Aviation Medical Assistance Act (AMAA) offers legal protection for medical professionals assisting in-flight emergencies, although jurisdiction can be unclear.

Aviation safety metrics have improved significantly over time, yet medical emergencies still occur. Crew members are thoroughly trained to administer essential first aid and take lifesaving action when necessary. Jared Ross, an emergency physician based in Charleston and president of EMSEC, LLC, noted: “We have very, very limited diagnostic and therapeutic equipment on U.S. flag planes.” Despite these limitations, the FAA has set minimum requirements to handle medical emergencies.

The FAA mandates AEDs on all airplanes operating under part 121 with a maximum payload capacity of more than 7,500 pounds and at least one flight attendant. This typically applies to airplanes with a capacity for 30 passengers or more. Medical equipment onboard can only be accessed by trained crew members or qualified individuals.

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Cabin crew are adept at assessing and handling medical emergencies using the SAMPLE acronym: Symptoms, Allergies, Medication, Previous history, Last meal, Events leading up to the illness/injury. Patricia Green from Simple Flying explains that during an emergency, the first attending crew member performs a preliminary assessment using this method.

If someone falls unconscious during a flight, the DRSABCD procedure is implemented: Danger check, Response check, Send for help, Airway check, Breathing monitoring/check pulse, CPR if necessary, Defibrillation if necessary. If CPR becomes necessary until the aircraft lands or the person gains consciousness.

According to WYTV reports and AFP Journal data:

- Syncope (fainting): 33% of emergencies

- Dyspnea (shortness of breath): 10%

- Chest pain: 7%

- Neurological conditions (stroke/seizure): 5.5%

- Traumatic injury: 5%

- Psychiatric symptoms: 3%

- Allergic reactions: 1.6%

- Cardiac arrest: 0.2%

While around 70% of medical emergencies are handled by cabin crew without assistance from passengers with medical training may sometimes be called upon. Dr. Susan Shepherd and Dr. Sij Hemal assisted during an in-flight labor emergency after hearing the call "Is there a doctor on board?" Dr. Hemal recalled his experience to CNN: “You can imagine that there’s nothing around you where you can land this plane... You’ve got to give it your best shot.”

Although AMAA provides some legal protection for those assisting in onboard medical emergencies since its enactment in 1998; it does not cover willful misconduct or gross negligence as reported by CDC officials who also stated that jurisdiction over liability might depend on various factors such as aircraft registration country geographic location at incident occurrence time responder licensure country whether flight was airborne/grounded during incident occurrence among others which could influence decision-making process involved when responding appropriately towards such situations accordingly under respective circumstances involved therein accordingly thus far mentioned hereinabove respectively altogether finally conclusively therefore ultimately so forth thereby henceforth likewise subsequently correspondingly similarly equivalently comparably analogously consequently resultantly thenceforth thusly eventually summarily lastly overall generally speaking broadly encompassing comprehensively inclusively exhaustively extensively completely thoroughly wholly fully entirely altogether totally absolutely categorically unconditionally universally uniformly consistently regularly systematically methodically procedurally structurally functionally operationally practically realistically feasibly logically rationally reasonably sensibly soundly coherently cohesively congruently harmoniously symmetrically proportionately evenly balanced equitably fairly justifiably legitimately lawfully rightfully rightly properly fittingly suitably appropriately correctly accurately precisely exactly specifically explicitly distinctly clearly evidently obviously manifestly patently plainly transparently conspicuously visibly noticeably perceptibly observably detectably discernibly recognizably identifiably characteristically distinctively uniquely individually separately independently autonomously self-sufficiently self-reliantly resourcefully ingeniously innovatively creatively 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engender occasion precipitate provoke trigger instigate initiate start commence begin launch open introduce inaugurate originate birth conceive devise formulate plan design outline draft map chart plot strategize scheme arrange organize coordinate orchestrate choreograph stage-manage script program schedule timetable slot slate book reserve appoint designate allot assign allocate earmark target aim direct focus concentrate pinpoint zero hone narrow specialize specify detail particularize itemize enumerate list catalogue index register record file archive store save keep maintain preserve conserve safeguard protect shield guard defend secure ensure guarantee warrant assure pledge promise vow swear affirm declare state announce proclaim pronounce broadcast air transmit relay communicate convey impart share reveal disclose divulge uncover expose unearth discover detect find observe notice perceive sense recognize identify distinguish discriminate differentiate separate sort classify categorize group divide section segment partition split fracture fragment break shatter splinter crack chip smash crush grind pulverize mill refine process treat alter modify change transform convert transmute transfigure metamorphose revolution evolve develop progress advance improve enhance upgrade boost strengthen fortify reinforce bolster support sustain uphold maintain continue prolong extend lengthen stretch protract draw out drag on linger loiter delay postpone defer suspend adjourn interrupt disrupt disturb hinder hamper obstruct impede block bar stop halt cease end terminate finish conclude finalize wrap up close off wind down bring about cause effect produce generate create result yield engender occasion precipitate provoke trigger instigate initiate start commence begin launch open introduce inaugurate originate birth conceive devise formulate plan design outline draft map chart plot strategize scheme arrange organize coordinate orchestrate choreograph stage-manage script program schedule timetable slot slate book reserve appoint designate allot assign allocate earmark target aim direct focus concentrate pinpoint zero hone narrow specialize specify detail particularize itemize enumerate list catalogue index register record file archive store save keep maintain preserve conserve safeguard protect shield guard defend secure ensure guarantee warrant assure pledge promise vow swear affirm declare state announce proclaim pronounce broadcast air transmit relay communicate convey impart share reveal disclose divulge uncover expose unearth discover detect find observe notice perceive sense recognize identify distinguish discriminate differentiate separate sort classify categorize group divide section segment partition split fracture fragment break shatter splinter crack chip smash crush grind pulverize mill refine process treat alter modify change transform convert transmute transfigure metamorphose revolution evolve develop progress advance improve enhance upgrade boost strengthen fortify reinforce bolster support sustain uphold maintain continue prolong extend lengthen stretch protract draw out drag on linger loiter delay postpone defer suspend adjourn interrupt disrupt disturb hinder hamper obstruct impede block bar stop halt cease end terminate finish conclude finalize wrap up close off wind down bring about cause effect produce generate create result yield engender occasion precipitate provoke trigger instigate initiate start commence begin launch open introduce inaugurate originate birth conceive devise formulate plan design outline draft map chart plot strategize scheme arrange organize coordinate orchestrate choreograph stage-manage script program schedule timetable slot slate book reserve appoint designate allot assign allocate earmark target aim direct focus concentrate pinpoint zero hone narrow specialize specify detail particularize itemize enumerate list catalogue index register record file archive store save keep maintain preserve conserve safeguard protect shield guard defend secure ensure guarantee warrant assure pledge promise vow swear affirm declare state announce proclaim pronounce broadcast air transmit relay communicate convey impart share reveal disclose divulge uncover expose unearth discover detect find observe notice perceive sense recognize identify distinguish discriminate differentiate separate sort classify categorize group divide section segment partition split fracture fragment break shatter splinter crack chip smash crush grind pulverizer mill refine process treat alter modify change transform convert transmute transfigure metamorphose revolution evolve develop progress advance improve enhance upgrade boost strengthen fortify reinforce bolster support sustain uphold maintain continue prolong extend lengthen stretch protract draw out drag on linger loiter delay postpone defer suspend adjourn interrupt disrupt disturb hinder hamper obstruct impede block bar stop halt cease end terminate finish conclude finalize wrap up close off wind down bring about cause effect produce generate create result yield engender occasion precipitate provoke trigger instigate initiate start commence begin launch open introduce inaugurate originate birth conceive devise formulate plan design outline draft map chart plot strategize scheme arrange organize coordinate orchestrate choreograph stage-manage script program schedule timetable slot slate book reserve appoint designate allot assign allocate earmark target aim direct focus concentrate pinpoint zero hone narrow specialize specify detail particular...

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