In the Loop

News and views from across Mayo Clinic

April 1, 2014

Medical emergencies at cruising altitude

By Elizabeth Harty
Image of passengers in an airplane cabin

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Imagine that you've just boarded a plane. (You pick the destination.) You've stowed your carry-on luggage, fastened your seatbelt, and listened intently to all of the pre-flight safety instructions. (Just humor us.) Then, shortly after take-off, you hear the captain announce that a passenger needs medical help. What do you do?

Joseph Sirven, M.D., chair of Neurology at Mayo Clinic in Arizona, doesn't need to imagine, because he's been in this very situation no less than five times (so far) during his career. The most recent occurrence, which Dr. Sirven recounted for KJZZ 91.5 FM in Tempe, Ariz., happened during a flight from Phoenix to Rochester. "A passenger had passed out, and my duty was to help the captain decide whether it was safe to continue on or if we needed to land the plane urgently," Dr. Sirven writes. (Now that's a pressurized cabin.)

Dr. Sirven tells us that he went to the passenger's seat, evaluated the situation, and took the patient's vital signs while talking with family members about any previous medical history. And after determining that it was a non-life-threatening situation, Dr. Sirven says he "pretty much just comforted" his fellow passenger.

Fortunately, the other in-flight medical emergencies Dr. Sirven's been a part of have turned out much the same way. Still, he says the same flood of questions and concerns go through his mind at the start of each one. "My first thought is, 'What is the emergency, and how bad is it?'" he tells us. "Will the patient be okay?' That's the most important concern I have." His next concern is whether the plane is equipped with the medical supplies he needs. "Most airliners have an emergency medical kit that's stocked with stethoscopes, gloves, some aspirin, and sometimes a little bit more if you're lucky," he writes. And if he can't find what he needs, he says he'll ask the other passengers onboard before requesting an emergency landing, if that's what the situation calls for.

Even though the odds of being called into action during a flight are low, Dr. Sirven says it's no longer unheard of. "A recent study has shown that the number of in-flight emergencies is increasing because of the steadily rising number of air travelers with acute and chronic illnesses that are now more mobile," he writes. Should you find yourself in such a situation, Dr. Sirven says the most important thing is to stay calm, and ask for help if you think you need it. "If you need help, ask the captain to patch you through to the airline's ground medical service," he says.

In his KJZZ piece, Dr. Sirven sums up his recent experience with this comment:  "The airline's compensation for my efforts: a $2.00 drink coupon at the Minneapolis Airport ... My personal reward: priceless."

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