In flight medical emergencies

[MikeEMTB]

Was listening to a medic friend of mine discuss in flight medical emergencies and it got me curious so I googled a little bit and found out about the available Med kits on board passenger planes as well as ground based Med control. My question however is, as an EMT-B, to what extent of your normal scope of practice can you use on board a flight? Technically you have ground based Med physicians, does this mean you can administer Epi, nitro, ASA, Albuterol as most on/offline local protocols state? or is it more of an off-duty BLS restriction? Anybody actually responded to an in flight medical emergency before?

 

[STXmedic]

Unless you are on shift, or your medical director has explicitly told you otherwise, you are a layperson who can administer basic first aid and CPR.

 

[Summit]

Unless you are on shift, or your medical director has explicitly told you otherwise, you are a layperson who can administer basic first aid and CPR.

Incorrect. Few medical directors are capable of authorizing such a thing. Airplanes are Federal territory... or foreign soil depending.

On a US airline:

If you identify yourself to the flight crew and the captain authorizes it, then you are a good Samaritan limited to good Samaritan interventions in an effectively austere environment. So only do what you know how to do, have good defensible reason to do, and can do correctly... and hopefully what the aircraft's sat-link to online-medical control authorizes.

 

[MMiz]

When I offered assistance in 2005 I was told that I had full access to a stocked drug box.

I administered nitro and aspirin, though neither were in my local protocols.

An ER nurse was standing next to me.

 

[kev54]

Really good talk on the subject. Presented at SMACC Chicago and it also has a list for the minimum required medical supplies for airlines. The talk also has slides as well. I found it a fun listen and med control is out of Tempe Arizona for the majority of airlines. It also covers applicable legal statues.

http://www.smacc.net.au/2016/03/is-there-a-doctor-on-the-plane-joe-lex/

 

[EpiEMS]

On a US airline:

If you identify yourself to the flight crew and the captain authorizes it, then you are a good Samaritan limited to good Samaritan interventions in an effectively austere environment.

So as a BLS provider, does that necessarily mean I cannot, say, administer nitro?

When I offered assistance in 2005 I was told that I had full access to a stocked drug box.

I administered nitro and aspirin, though neither were in my local protocols.

An ER nurse was standing next to me.

Curious if the ER RN has a broader SOP, considering the circumstances. What do you think?

I would imagine that if there were a physician who was kind enough to "authorize" you to perform procedures within your training, etc., would that not constitute some degree of direct medical oversight?

 

[Summit]

Your local protocols don't enter into it except so far as you can say that you could say that you have a reasonable level of understanding and basis for your actions if the situation matches. Or perhaps you received knowledge elsewhere (CE, initial cert, whatever).

I said nothing about an EMT being able to give, or not, nitro spray... or aspirin... or atropine.

The question is whether your are competent in your intervention, whether you have a good reason to use it, and if the flight crew authorized you to do what you think is best (assuming OLMC is unavailable to authorize or advise).

IANAL

 

[MikeEMTB]

Interesting replies. I'm with EpiEMS in that I would have thought any medical direction would serve as on-line authorization as long as you have been trained in whatever intervention you are giving and don't move out of your scope. For me that would be IM Epi via epipen or IMJ via draw & inject, ASA, Albuterol, glucose, narcan etc.

 

[Summit]

So the counter message to my posts above is that you go beyond your competence and there is a bad outcome, you might be hosed from several directions.

And that OLMC over the sat link is a good thing. Ask for the headset if you want to get fancy to CYA.

I know that if there is no headset or doc, I'm doing everything that makes sense to do for the patient, that I know how to do, with the resources I have.

 

[STXmedic]

Incorrect. Few medical directors are capable of authorizing such a thing. Airplanes are Federal territory... or foreign soil depending.

I worded that poorly. I was referring to a more general off-duty policy, not specifically on a plane. As in a medical director authorizing one of his providers to work within their scope within the county/state while off duty. Agreed 100% while on a flight.