Flying as an EMR?

[busmonkey]

Hi there,

I was curious, do you guys tell Flight Attendants prior to boarding the aircraft, or do you wait and if there is an emergency, announce yourself? I am flying for the first time as an EMR (I have flown before, but not since my cert.) and I am curious if I should announce myself prior to boarding or what?

What do you guys think?

Thanks everyone

JB

 

[skivail]

I wouldn't be surpirsed if the flight attendants had a very similar level of training.

 

[jjesusfreak01]

Is that a first responder level? If so, then yes, the attendants probably have a similar level of training, at least as far as the types of emergencies you can have on a plane go. If you tell them ahead of time, you will probably look like a whacker...

If they really need someone, they will ask, or you can offer when the emergency occurs. If you are an actual doctor on a larger plane, maybe on a transatlantic flight, it might be more appropriate to tell an attendant, as you are more likely to have a simple "sick" person on a long flight than a life-threatening emergency.

 

[busmonkey]

Yes. Emergency Medical Responder will be one level above them, as they will have First Responder versus EMR which is an actual Paramedic level (as in I can work on Ambulances)... Yes I suppose if there is an emergency I will announce myself Thanks for your help guys!!!

JB

 

[Flight-LP]

Actually, most flight attendants receive specialized education on frequently encountered issues in flight. I place a lot more confidence in their abilities to assist vs. that of an EMT who has no knowledge of flight physiology or the nature of the aviation industry. Honestly, outside of CPR (which on an aircraft is frequently futile), what does the EMT / EMR level truly have to offer in flight?

 

[jjesusfreak01]

Actually, most flight attendants receive specialized education on frequently encountered issues in flight. I place a lot more confidence in their abilities to assist vs. that of an EMT who has no knowledge of flight physiology or the nature of the aviation industry. Honestly, outside of CPR (which on an aircraft is frequently futile), what does the EMT / EMR level truly have to offer in flight?

Totally depends on the injury. Commercial jets are pressurized to the equivalent of 8000ft or less, a lower altitude than say, Vail ski resort, so generally, pressure shouldn't be a huge issue unless someone has a sinus/ear infection or general airsickness (the two biggest medical problems unique to flying). You could hit a pocket of turbulent air and end up with 5 traumatic injuries. Someone could have a heart attack and need aspirin and calming down, speaking of which, someone could just be having a panic attack and need a talkdown. There are as many possible injuries in a plane as there are any other one place. An EMT could help with any one of these things, and although its possible the flight attendants would be perfectly capable of handling these situations, in some cases they might now be.

 

[AnthonyM83]

Don't announce yourself. On any given flight there will probably be other people aboard with equal and higher level of training (I'd bet money none announce themselves).

Medical people are everywhere. One time I pulled out an intro to EKGs book. The person next to me smiled and pulled out an advanced EKG book for EMS that he was editing on his way to write test items for NREMT. Flight emergencies are relatively rare even for frequent fliers.

 

[Flight-LP]

Totally depends on the injury. Commercial jets are pressurized to the equivalent of 8000ft or less, a lower altitude than say, Vail ski resort, so generally, pressure shouldn't be a huge issue unless someone has a sinus/ear infection or general airsickness (the two biggest medical problems unique to flying). You could hit a pocket of turbulent air and end up with 5 traumatic injuries. Someone could have a heart attack and need aspirin and calming down, speaking of which, someone could just be having a panic attack and need a talkdown. There are as many possible injuries in a plane as there are any other one place. An EMT could help with any one of these things, and although its possible the flight attendants would be perfectly capable of handling these situations, in some cases they might now be.

O.k., I'll bite.................

1. So you have 5 traumatic injuries from turbulence, that is actually a quite rare occurance. Every commercial flight plan includes an up to date check of current weather and pilot reports. In other words, turbulence is very rarely an acute unknown issue. If clear air turbulence is reported or observed greater than light-moderate, the seat belt sign is going to go on. So that aside, what you going to be able to contribute that will improve the injured persons outcome that could not be provided by any other passenger on the plane or the flight crew?

2. The heart attack scenerio. Are you carrying the Aspirin? If not, how are you going to administer it? Are you appropriately credentialed to do so?

3. Same with the panic attack, others can offer the same level of assistance.

4. You are correct, pressure shouldn't be an issue, but in an emergency, it is a huge issue! The flight crew is well versed in the understanding of the physiology associated with flight. Much more so than an EMT-B and in many cases, an EMT-P. Case in point, i am interested in hearing your explanation as to where you came up with the 8,000ft. figure?

Yes, an EMT can be as assisting as anyone else, but the key here is dependent on if your help will be requested, accepted, or even allowed. That decision is made by the Captain and the decision he makes is the final word and law on that flight.

Your enthusiasm is admirable, just understand your limitations and look at the whole picture before flying down the aisle.

 

[JPINFV]

Case in point, i am interested in hearing your explanation as to where you came up with the 8,000ft. figure?

Since I'm not sure if you're challenging the actual figure or the source for the figure, 8,000 was what we were told in lecture with the slide figure being sourced from Respiratory Physiology – the essentials, 8th ed.

 

[JJR512]

Here's what you do.

Wait until the steward/stewardess has just finished the pre-flight safety announcements and demonstrations, then stand up, and proclaim loudly for all to hear that you are a Trained Medical Professional so everyone can rest assured that they are Perfectly Safe. Then thank the steward/stewardess and remind him or her that if there are any problems, you're in seat # <whatever>.

 

[JPINFV]

Here's what you do.

Wait until the steward/stewardess has just finished the pre-flight safety announcements and demonstrations, then stand up, and proclaim loudly for all to hear that you are a Trained Medical Professional so everyone can rest assured that they are Perfectly Safe. Then thank the steward/stewardess and remind him or her that if there are any problems, you're in seat # <whatever>.

...and ignore the laughter from the physicians on the flight, because there's probably at least 1 on board.

 

[Aidey]

I wouldn't volunteer the information unless there was some sort of in flight emergency and they were doing the whole "Is there a doctor on the plane" and it didn't appear that anyone was responding.

I think JP is probably right, that there is usually at least one physician on board. The only question is what type they are. There was an story in JEMS or on one of the EMS websites about in flight emergencies, and in one of the cases there was a doctor on board, but it was someone who had been practicing Dermatology for the last 40 years and they deferred to the Paramedic.

 

[ffemt8978]

Don't announce yourself. On any given flight there will probably be other people aboard with equal and higher level of training (I'd bet money none announce themselves).

Medical people are everywhere. One time I pulled out an intro to EKGs book. The person next to me smiled and pulled out an advanced EKG book for EMS that he was editing on his way to write test items for NREMT. Flight emergencies are relatively rare even for frequent fliers.

I'll bet you didn't know you were seated next to RidRyder911. h34r:

 

[AnthonyM83]

Haha.
I would be quite mad if he skipped the Dayton EMS cadaver workshop with the EMTCity crew to go write test questions! (That's why I was one the plane)

 

[WTEngel]

I was on a flight from Chicago to DFW with my wife and mother in law last year when they asked if there were any nurse on board (they specifically asked for a nurse for whatever reason.)

My wife AND my MIL are both nurses (yes it was a ridiculously long weekend to say the least!)

Anyway, my MIL decides she wants to volunteer, which is hilarious, because she has not been in the clinical setting for at least 20 years (my father in law is a physician, so she was able to retire a long time ago.) At this point, my wife, who is a pediatric ICU nurse with 9 years of experience decided she better accompany the MIL and help.

Now don't get me wrong, when it comes to incredibly sick kids, my wife is second to none! Heart defects, cardiac surgeries, ECMO, you name it, she even has CCRN and all the alphabet soup... But even she will admit she doesn't like adults, and really doesn't care to have much to do with them.

So all this is to say that they get up and volunteer, I kind of linger in the background, and within about 30 seconds they decided they wanted a paramedic consult from me, apparently they really didn't know where to start.

Luckily, we hadn't pushed back from the gate yet, the patient was weak with a low blood pressure blah blah blah, so her family decided to take her off and not fly. Southwest upgraded us to business class and comped all of our drinks (alcohol included) and treated us like royalty.

Needless to say, I got a lot of mileage out of the fact that the flight attendant specifically asked for a nurse. My wife, who is easily the smartest person I know, and excellent clinician, just finished her masters, and has years of ICU experience decided she would rather have me deal with it...which to this day I don't let her forget! Probably the only time I will ever have a leg up on her clinically..

Thought of this funny story when I read this thread...I would not announce yourself.

"Better to remain silent and have others think you are a fool, than to speak up and remove all doubt" I forget who said it, but it rings true...

 

[JPINFV]

Haha.
I would be quite mad if he skipped the Dayton EMS cadaver workshop with the EMTCity crew to go write test questions! (That's why I was one the plane)

They need to stop having that right in the middle of the week right before exams. Grr...

 

[JPINFV]

I think JP is probably right, that there is usually at least one physician on board. The only question is what type they are. There was an story in JEMS or on one of the EMS websites about in flight emergencies, and in one of the cases there was a doctor on board, but it was someone who had been practicing Dermatology for the last 40 years and they deferred to the Paramedic.

I can see it happening, but I think it's a little more complicated than that.

Physician vs EMT is different than physician vs paramedic, regardless of the physician's specialty.

Specialties outside of emergency medicine can easily surpass the abilities of a paramedic, especially anesthesiology, intensivests, urgent care, and a handful of others. This is also before matching up specialty to complaint.

There's only a handful of tools and drugs available. Yes, a paramedic should be better at intubation than the family physician, but does it matter if you don't have the tools available to intubate?

Finally, the physician has the ultimate trump card. S/He's a physician. If the paramedic wants to do the entire, "I'm the paramedic, this is an emergency, I'M IN CHARGE HERE" routine (and, admittedly, there are plenty of physicians who are willing to do that), fine, what ever. I guarantee you that even if the physician is deferring to the paramedic, they're still analyzing the patient and the treatment conditions and that trump card is going to be played if the paramedic wants to do something that the physician considers unreasonable.

 

[MrBrown]

All commercial jets carry an AED and a physicians kit which is basically an IV roll with standard advanced airway supplies and drugs. Most airlines allow the Captain to release it for use to a doctor upon sighting credentials however this may not extend to ambulance Paramedics, Brown knows of one or two airlines where this is the case.

Brown, CPL-C

 

[medicRob]

It has been my general experience that there is usually either an RN or a Physician on the plane, especially on large flights. I wouldn't really worry about announcing myself, it just seems a little over the top and showy.

 

[JJR512]

...and ignore the laughter from the physicians on the flight, because there's probably at least 1 on board.

No...Just tell the physicians that you will ask for their help if you need it.