Researchers Advocate for Tracking of all In-Flight Medical Emergencies eInterview with:
Adam Z. Tobias, MD, MPH Assistant Professor of Emergency Medicine University of Pittsburgh School of Medicine Pittsburgh, PA  15261Adam Z. Tobias, MD, MPH
Assistant Professor of Emergency Medicine
University of Pittsburgh School of Medicine
Pittsburgh, PA  15261 What are the main findings of the study?

Answer: We reviewed records of 11,920 in-flight medical emergency calls from five domestic and international commercial airlines to a physician-staffed medical communications center at the University of Pittsburgh.  We found that during the study period, there was one medical emergency per 604 flights (16 per 1 million passengers).  The most common problems were syncope or pre-syncope, respiratory symptoms, and nausea and vomiting.  Aircraft diversion to an alternative landing site occurred just over 7% of the time. About one quarter of patients were transported to a hospital and only 8.6% were admitted. Were any of the findings unexpected?

Answer: We found that a physician passenger rendered assistance in nearly half of the cases.  In another quarter of the cases, other medical personnel traveling privately (such as nurses and paramedics) responded.  We also found that some of the most-feared problems, such as obstetrical emergencies and cardiac arrests, were exceedingly rare.  Similarly, only 0.3% of cases resulted in death. What should clinicians and patients take away from your report?

Answer:The vast majority of in-flight medical emergencies can be managed conservatively and do not result in aircraft diversion.  Commercial aircraft are equipped with essential medications and equipment (including automated external defibrillators), and ground-based consultants with expertise in managing these emergencies are typically available for real-time consultation. What recommendations do you have for future research as a result of this study?

Answer: We advocate for systematic tracking of all in-flight medical emergencies, including subsequent hospital care and other outcomes.  Research in this area will better guide interventions in this sequestered population.


Outcomes of Medical Emergencies on Commercial Airline Flights
Drew C. Peterson, M.D., Christian Martin-Gill, M.D., M.P.H., Francis X. Guyette, M.D., M.P.H., Adam Z. Tobias, M.D., M.P.H., Catherine E. McCarthy, B.S., Scott T. Harrington, M.D., Theodore R. Delbridge, M.D., M.P.H., and Donald M. Yealy, M.D.

N Engl J Med 2013; 368:2075-2083
DOI: 10.1056/NEJMoa1212052 May 30 2013

Last Updated on September 19, 2013 by Marie Benz MD FAAD