Dominate the most common in-flight emergencies with tools and tips from this classic Curbsiders episode. Our guest, Angelica Zen MD, (formerly an IM Chief Resident at UCLA), recounts a harrowing tale of heroism at 30,000 feet and schools us on how to throw down in an in-flight emergency. We review what’s available in the standard medical kit, common conditions encountered, and the medical legal implications of responding to in-flight emergencies. This episode is a must listen before you next step on a plane. Original air date November 21, 2016.
Written, produced and edited by: Matthew Watto MD, FACP
Cover Art by: Matthew Watto MD, FACP
Hosts: Stuart Brigham MD; Paul Williams MD, FACP; Matthew Watto MD, FACP
Guest: Angelica Zen MD
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20:05 Contents of the standard in-flight medical kit
22:10 What Dr. Zen would have done differently
23:05 How to use available resources in-flight
24:20 Medical legal implications
28:07 How to respond to common in-flight emergencies and how to respond
29:35 Syncope and presyncope
31:55 Hypoxia altitude simulation test (HAST)
33:15 Altered mental status
35:34 Stroke and acute coronary syndrome
36:55 Dr. Zen’s take home points
In-Flight Emergency Pearls
Stay Calm! If you freak out, so will everyone else.
Think outside the box and be prepared to improvise from available resources. (e.g. ask another passenger for a glucometer)
Standard medical kit contains – manual BP cuff, stethoscope (cheap), gloves, oropharyngeal airways, CPR masks, bag-valve masks, IV set, 500 ml saline, needles, syringes, analgesic tabs, antihistamine (tabs or injection), aspirin, atropine, inhaler (bronchodilator), Dextrose 50%, Epi (1:1000 and 1:10000), IV lidocaine, nitroglycerin tabs, supplemental oxygen.
Don’t forget to utilize the ground medical team!
Legal repercussions very unlikely unless there is “gross neglect” or “intentional harm”. DON’T treat patients if YOU’VE BEEN DRINKING!
Common emergencies in order of decreasing frequency – syncope and presyncope, dyspnea, acute coronary syndrome, altered mental status, psychiatric emergencies, stroke, cardiac arrest
Listeners will comprehend their role and potential liabilities during in-flight emergencies and effectively utilize available resources for triage, patient care, and decisions about diverting the plane.
By the end of this podcast listeners will:
Be familiar with the contents of the standard medical kit
Think outside the box to identify, improvise and utilize the available resources for patient care
Recognize the medical legal consequences of providing emergency medical care on a plane
Confidently evaluate and manage common in-flight emergencies using the available resources
Dr. Zen reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.
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Zen A, Brigham SK, Williams PN, Watto MF. “#19 In-Flight Emergencies.” The Curbsiders Internal Medicine Podcast http://thecurbsiders.com/episode-list. Original air date November 21, 2016.