Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Filter by Categories
A Case Report
A Dedication
About Our Fellows
About Ourselves
About Professor Js Bajaj
Abstract
Abstract Article
Abstracts
Abstracts From Papers
Aero Medical Society
Aeromedical Assessment
Aeromedical Decision Making
Aeromedical Evaluation
Aircraft Accident Report
Article
Aviation Physiology
Book Review
Book Reviews
Bulletin
Bye-Laws
Case Report
Case Reports
Case Series
Case Study
Civil Aerospace Medicine
Civil Aviation Medicine
Clinical Aerospace Medicine
Clinical Aviation Medicine
Clinical Information
Clinical Medicine
Clinical Series
Concept Paper
Contemporary Issue
Contemporary issues
Cumulative Index
Current Issue
Director General Armed Forces Medical Services
Editorial
Exploring Space
Field Experience
Field Report
Field Study
Field Survey
Field Trials
Flight Trials
Guest Editorial
Guest Lecture
In Memoriam
Inaugural Address
Internet For The "Internaut"
Journal Scan
Know your President
Lecture
Letter to Editor
Letter to the Editor
Letters to the Editor
Message From Our Patron
Methods in Aerospace Medicine
Methods in Medicine
News Of The Members
Notice
Notice To Contributors
OBITUARY
Om Satya Mehra Award 1997
Oration
Orginal Article
Original Article
Original Article (Field Study)
Original Research
Our New President
Perspective
Presidential Address
Questionnaire Study
Quiz
Retrospective Study
Review Article
Short Article
Short Communication
Short Note
Society Calender
Society News
Symosium
Symposium
Teaching File
Teaching Series
Technical Communication
Technical Note
Technical Report
The Aviation Medicine Quiz
The Fellowship
Welcome Address
View/Download PDF

Translate this page into:

Letter to Editor
52 (
2
); 77-78

Utilization of emergency medical kits on commercial aircraft – A Jet airways’ perspective

Medical Officer, Jet Airways, Mumbai

Jet Airways, India’s premier commercial domestic airline, has also commenced International operations. With the recent tremendous upsurge in the aviation industry, a large number of passengers of different age groups and health status, are opting for air travel, as it is the most convenient and fastest mode of transport. An aging population combined with the increasing mobility of people with acute / chronic illnesses, have resulted in an increase in the frequency of in-flight medical events. In addition, the inherent physiological / psychological stresses of a relatively hostile environment, may also precipitate problems in passengers with a serious / potentially serious underlying disorder which may get aggravated due to the stresses of flight.

Jet Airways carries First Aid Kits (FAK) and Physician’s Kits (PK) on board its aircraft in accordance with the existing IATA / DGCA mandated recommendations / regulations. Each kit is prepared and certified by the company doctor, as a placard (sticker), listing all the contents in detail for the user’s reference, is pasted of each kit. In addition, each kit contains a comprehensive ‘Medical Incident Reporting Form’ which has to be filled by the cabin crew / doctor on-board, in the event the kit is opened for a medical emergency. All our cabin crew undergo rigorous initial and recurrent First Aid training. As per existing DGCA guidelines, cabin crew are permitted to open FAKs, whereas PKs can be opened only by Registered Medical Practitioners (RMPs).

A prospective study of the total number of kits utilized for in-flight medical emergencies, across the entire Jet Airways network, was carried out between 1st August 2006 to 30th June 2007. This study did not include in-flight medical emergencies occurring in ill / disabled passengers whose MEDIF Forms had been approved in advance, by the Jet Airways Medical Dept. Relevant Medical Incident Reporting Forms were evaluated and analyzed with the aim of: auditing appropriateness of First Aid treatment administered by the crew; assessing the adequacy of the emergency kit contents; and to Determine the etiology / frequency of various in-flight emergencies, together with the therapeutic modalities used.

Results

A total number of 10 million passengers traveled on our flights during the period under review, and the kits were opened on 3,771 occasions, for in-flight medical problems ranging from trivial to life-threatening emergencies. A doctor was available to render assistance on board on 171 (4%) occasions and the PK was used on 163 occasions . In the remaining 3,600 (96%) cases, where a doctor was not available, the cabin crew rendered First Aid and the FAKs were utilized on all the occasions. Both FAKs and PKs were used on 153 occasions. Of the total number, 3,543 (94%) emergencies occurred in adults (commonest age group being 40-60 years), while 228 (6%) cases belonged to the pediatric population (0-12 years).

The most frequent medical complaints encountered in-flight in the adult group, included severe upper respiratory tract infection (URTI) with headache, fever, malaise; gastrointestinal complaints e.g. vomiting, diarrhoea, abdominal pain; breathlessness, mainly due to asthma; chest pain, high blood pressure and vasovagal syncope. The most frequently used medications included Tablet Dispirin, Tablet Avil, Otrivin Nasal Drops, Tablet Paracetamol, Tablet Domstal, Tablet Norflox, Tablet Cyclopam, ORS, Asthalin Inhaler, Tablet Deriphyllin, Tablet Sorbitrate. Continuous in-flight oxygen was adminstered in 91 cases mainly ----- hear disease (IHD) asthma.

Similarly, in the paediatric population, gastrointestinal symptoms as above, fever with / without convulsions, URTI, breathlessness / cyanosis (mainly conjected heart disease CHD), were the most frequently reported problems. Medication used most frequently included Paracetamol (Drops / Tablet), Colimex Drops, Tablet Cyclopam, Tablet Domstal, Tablet Avil, ORS. Continuous oxygen was adminstered during the flight in 15 cases mainly breathlessness / convulsions).

Of the 3,771 cases, 3,670 patients responded well to the treatment given on-board and required no further assistance on deplaning. 92 cases (mainly IHD, severe acute asthma, severe hypertension, convulsions), had to be urgently hospitalized on arrival at destination city, while 9 cases (IHD 3, CHD 1, severe hypertension 2, hematemesis 2, convulsion -1), were critical enough to necessitate a flight diversion / air return of aircraft to originating station. Fortunately, there were no deaths on board during the period under review.

20 (11.5%) of the attending doctors felt that the kit contents were inadequate and needed augmentation. The commonest medications / equipment that were recommended for addition to the existing list included Ranitidine (Injection and Tablet), Inj. Ondansetron, Voveran (Inj. and Tablet), Inj. Buscopan, Injection Phenargan, intravenous fluids with IV Set, NTG Patch, Insulin Syringes, and Glucometer.

Conclusions

Several points of interest emerged from this study , 1 of every 2,653 passengers & 1 of every 29 flights experienced an inflight medical emergency, About 96% of the inflight medical emergencies were handled by the cabin crew, while a doctor was available to offer medical assistance in only 4% of the cases; The First Aid given by the cabin crew was appropriate, and the level of training imparted to them was for considered adequate RS, GIT, CVS, CNS were the commonest systems affected 2.5% of the medical emergencies (mainly cardiac, respiratory, CNS), were serious enough to warrant urgent hospitalization on landing. Incidence of flight diversion was 0.23% (mainly due to cardiac / respiratory / neurological problems). In view of availability of newer / more effective therapeutic modalities, contents of the emergency medical kits should be reviewed and augmented periodically, so that the level of in-flight first aid / medical care provided by cabin crew / doctor-on-board, can be enhanced.

References

  1. . Medical guidelines for air travel. Aviat Space Environ Med. 1996;67(10):1-16.
    [Google Scholar]
  2. , , . Inflight medical care : An update In: US Departmement of Transportation, Federal Aviation Administration, Washington DC, USA, AM-97/2. .
    [Google Scholar]
  3. , . Medical emergencies in commercial air travel. 1997251-60.
    [Google Scholar]
  4. , . Air Transport Medicine Committee, Aerospace Medical Association. Aviat Space Environ Med. 2007;78(12):1170-1.
    [Google Scholar]

Fulltext Views
204

PDF downloads
64
View/Download PDF
Download Citations
BibTeX
RIS
Show Sections