This book functions as a practical guide for health care professionals encountering medical emergencies during a commercial flight.
A second edition to its successful predecessor, this text covers the most common emergencies encountered during flight, both general medical emergencies and those specifically tied to the effects of flying, including cardiac, respiratory, and neurological issues. Medicolegal issues are considered in depth for both United States domestic and international flights, as there is potential legal risk involved in giving medical assistance on a flight.
This new edition includes expanded and updated original chapters revised based on available new research material. Additional chapters examine how to handle disruptive passengers experiencing acute behavioral issues during flight, emerging infectious diseases. This issue is particularly relevant due to COVID-19, specifically concerning the anxiety and readjustment challenges of resuming everyday travel. This edition includes a new chapter recounting the history of the handling of in-flight medical events.
In-Flight Medical Emergencies, 2nd ed functions as an essential resource for physicians and all healthcare professionals who travel regularly.
Author(s): Jose V. Nable, William J. Brady
Edition: 2
Publisher: Springer
Year: 2023
Language: English
Pages: 220
City: Cham
Foreword
Contents
1: Setting the Scene
Introduction
History of Handling In-Flight Medical Events
Epidemiology of In-Flight Medical Events
On-Board Medical Resources
Ground-Based Consultation Services
Challenges of In-Flight Medical Care
Diversion
Our Flightpath
References
2: Commercial Air Transport: The History of Inflight Medical Emergencies
References
3: Pathophysiology of Flight
Introduction
The Atmosphere
The Gas Laws
Dalton’s Law
Boyle’s Law
Henry’s Law
Pathophysiological Consequences of Flight
Effects of Altitude
Effects of Temperature
Effects of Altered Humidity
Effects of Acceleration and Deceleration
Effects of Noise
Effects of Vibration
Effects of Fatigue and Stress
Motion Sickness
Cabin Atmosphere and the Spread of Respiratory Pathogens
Summary
References
4: Medicolegal Issues Arising from Inflight Medical Emergencies in Commercial Travel
Introduction
The Aviation Medical Assistance Act
The Do Not Board List
The Montreal Convention—International Carriers
In-Flight Medical Encounters
Important Considerations Before Giving Care
Conclusion
References
5: International Flight Considerations
Introduction
Background
Differences in Medical Emergencies on International Flights
General Medical Conditions Affected by Long-Haul International Flights
Vector and Insect-Borne Diseases on International Flights
Risk of Deep Venous Thromboembolism in International Travelers
Special Medical Equipment Needs for International Flights
Emergency Medical Kits on International Flights
Special Areas for Critical Patients on International Flights
Legal Issues
Other Considerations of International Flight
Future Recommendations
References
6: In-Flight Evaluation and Management of Cardiac Illness
Introduction
Cardiac Arrest
Acute Coronary Syndrome
Syncope
Congestive Heart Failure
Summary
References
7: Respiratory Emergencies
Introduction and Epidemiology
The Physiology of Flying
Preparing for Air Travel
Preflight Recommendations by Disease Process
Obstructive Airway Disease (asthma, COPD)
Pneumothorax/Recent Thoracic Surgery
Obstructive Sleep Apnea (OSA)
Pulmonary Hypertension (PH)
Interstitial Lung Disease
Respiratory Muscle Weakness
Heart Failure
In-Flight Emergency Management
Conclusion
References
8: Neurological Illness
The authors have nothing to disclose. Epidemiology
Stroke
Seizure
Altered Mental Status
Dizziness
Headache
Head Injury
Risk Stratification
Management
Stroke
Seizure
Altered Mental Status
Dizziness
Headache
Head Injury
Documentation
References
9: Psychiatric Emergencies
Introduction
Initial Approach
Specific Illness
Anxiety/Panic Disorder
Psychosis
Treatment Options
Anxiety/Panic
Agitated Patients
Suicide
Conclusion
References
10: The Disruptive Passenger In-Flight
Introduction
Assessment of Disruptive Passengers
Psychiatric Conditions
Medical Conditions
Air Rage
Drug or Alcohol Intoxication
Management of Disruptive Passengers
Physical Restraints
Medical Management
Conclusion
References
11: Pediatric Considerations
Overview
The Neonate
APGAR Scoring
Neonatal Resuscitation of the Full-Term Infant
Neonatal Resuscitation of the Preterm Infant
The General Pediatric Patient
Respiratory Issues
Cardiac Issues
Neurologic Issues
Endocrine Issues
Infectious Disease
Gastrointestinal
Dermatologic
Trauma
References
12: Obstetrics and Gynecology Considerations
Introduction
Vaginal Bleeding in Pregnancy
Contractions, Labor, and Delivery
Complications
Gynecology
Female Pelvic Anatomy
Female Reproductive Physiology
Vaginal Bleeding
Abdominal Pain of Gynecologic Origin
Travel After Gynecologic Surgery
References
13: Infectious Diseases
Introduction
Patient Evaluation and Passenger Protection
Emerging Infectious Diseases
CDC Reporting
International Flights
Conclusion
References
14: Emerging Infectious Diseases
Covid-19
In-Flight Covid Transmission
In-Flight Covid Prevention
In-Flight Covid Illness and Management
Ebola Virus Disease
In-Flight Ebola Illness and Management
References
15: Other Inflight Medical Presentations
Introduction
Acute Urinary Retention
Anaphylaxis
Gastrointestinal Illness
Toxicology
Traumatic Injuries
Conclusion
References
16: Preflight Medical Clearance: Non-urgent Travel Via Commercial Aircraft
Introduction
General Considerations
Cardiovascular
Pulmonary
Neurologic
Surgical/Trauma
Infectious Disease
Pregnancy
Psychiatric
Decompression Illness
References
17: Preflight Therapies to Minimize Medical Risk Associated with Commercial Air Travel
Introduction
Considerations of Physiological and Psychological Stress Related to Air Travel
Respiratory Disorders
Venous Thromboembolic Disease
Cardiovascular Disease
Pregnancy
Behavioral Disorders
Fractures and Trauma
Eyes
Ear, Nose, and Throat
Decompression Illness
Neurologic
Conclusions
References
18: Ground-Based Medical Support
Introduction
Ground-Based Medical Support Personnel
Types of Ground-Based Medical Services Provided
In-Flight Medical Emergencies
Passenger Pre-flight Screenings
Medical Assessment for Repatriation
Occupational Health and Crew Fitness for Duty
Public Health Notification
Process of Managing an In-Flight Medical Emergency with GBMS
Decision to Contact GBMS
Communications Systems Between Aircraft and GBMS
Management of an In-Flight Medical Emergency Utilizing GBMS
Medical Decision-Making
Role of the GBMS Provider
Role of an Onboard Medical Volunteer
Decision to Divert an Aircraft
Special Circumstances
Inability to Divert an Aircraft
Passenger Death
Emergency Medical Kits
Emergency Oxygen
Data Collection and Documentation
Telemedicine and Future Data Transmission with GBMS
Liability for GBMS Providers
Quality Assurance and Improvement
Conclusions
References
19: Use of Commercial Aircraft for Emergency Patient Transport
Introduction
Various Medical Evacuation Services on Commercial Aircrafts
Installation
Oxygen
Medical Clearance
Use of Commercial Airliners for the Simultaneous Transport of Multiple Patients
References
20: Responding as a Nonphysician Healthcare Provider
Introduction
Good Samaritan Laws and the Aviation Medical Assistance Act
Scope of Practice
What Can You Do?
What Supplies Are Available?
Environment of Care
Definitive Care Decisions
Handover of Care/Documentation
Conclusion
References
Index
