Flying Safe - Medics Onboard Qantas

Hi AFF Community,

I'm sure many of you have heard whilst flying "Any medical professionals onboard please make yourself know to cabin crew". The dreadful thought runs through the minds of all onboard that someone is unwell and a pending diversion is imminent!

Fear not! As a medic I have been called upon several times to assist, flying on many different carriers. However credit needs to be given where credit is due and this belongs to Qantas.

Yesterday the dreaded call came through again on my flight, just as I was asleep and comfortable (like usual!!). I was incredibly impressed with the physician kits and equipment made available to me. The CSM and cabin crew remained calm and helpful and assistance was offered by several other passengers also.

The idea behind this post is to put fellow medics (Doctors, Nurses and Paramedics etc) minds at ease about assisting in these types of situations and to allow non medics reading an insight as to how difficult it can be managing medical emergencies onboard aircrafts. There will be strictly no discussion about clinical cases or outcomes.

The physician kits are separated and clearly defined (via a running sheet) about what is where. These kits contain licensed equipment very similar to that seen in hospitals throughout Australia. There is IV access, Airway Adjuncts, dressings, BM machine, sphygmomanometer, AED ( defibrillator), Intibation roll with disposable capnography and stethoscopes. What really impressed me was not only the quality of the kits but also the quantity made available. In a separate kit there is the medications. Anti emetics, anti spasmodics, IVABx, analgesics, vasoactives, bronchodilators, litres of NACL and CSL fluids and the usual resus drugs plus much more.

Equipment like this costs a lot of money and needs to be managed by trained medical staff. Upon enquiring I was told that Qantas has a medical division that services these kits and ensures compliance with expiry dates and stock rotation etc... They have a dedicated "TeleMed" service that can be contacted for advice on management and whether to land the plane or not.

Attending these situations may appear to be quite a stressful event onboard, even with a non critical presentation. When in reality you can manage a wide variety of situations with the equipment and advice provided, allowing onward travel and preventing serious diversions. Albeit that you may have to sit with and observe / actively treat the patient until arrival. Diverting planes (whilst very time consuming for passengers) can also be rather dangerous for the patient depending on where you are flying as there is no guarantee of suitable services upon arriving at the closest gateway airport (especially flying international or rural Australia). However these decisions are simply taken off your hands by contacting the TeleMed services as they will co-ordinate logistics with the pilots for you and the great equipment provided enables the possibility of continuing basic medical care for longer until a suitable place is found to offload the patient.

So next time your flying and you hear the distress call I do hope this article may assist in putting your mind at ease about providing essential care onboard and looking after our fellow travellers! Plus Qantas will always look after you once the event is over!

I sincerely hope I never have to meet you guys in a professional capacity onboard! Safe and happy travels to all.

Thanks dwh97 - very interesting. We do have at least a couple of doctors amongst our active posters and a couple have recounted their experiences.

Were you on domestic or international?

I've been interested in the interaction between the 'doctor attending' and the TeleMed service. If a diversion is needed, and I were the patient, I would prefer that the decision be made by the 'doctor attending' , as they would, I think, be in the best position to decide what care, and how promptly, the patient needs. This of course presumes that the 'doctor attending' considers themselves competent enough in the condition under consideration. But I understand (perhaps you can clarify) that the call is made by the TeleMeds and the Captain would take their advice over the 'doctor attending'. If this is the case, do you have an opinion on this?

If you thought "We need to get this person on the ground and to a hospital ASAP, and the city just ahead has one" but TeleMed said, "no, we think they will be OK until the scheduled destination" and the Captain deferred to TeleMed, what would be your position? Can't grab the controls of course, but would you be inclined to follow-up professionally afterwards?

BTW when you 'answered the call' - were there any inquiries by crew as to your bona fides? I'm not doubting them at all but just wondering if one says 'yes, I'm a doctor' and maybe it has 'Dr' on your boarding pass, do they go past that?

Sorry, not trying to provoke or put to in awkward situation, but genuinely interested in these things.

I was speaking with a senior Qantas on board person recently and asked if they could tell the difference between a medical doctor and a PhD via the app. They can't.

I guess it's not really a philosophical question when the need arises. :mrgreen:

Hvr said:

I was speaking with a senior Qantas on board person recently and asked if they could tell the difference between a medical doctor and a PhD via the app. They can't.

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I have a work colleague who at some point many many years ago had a slightly overhelpful PA book a flight for him with the title 'Doctor.'

It seems to persist deep within the depths of the QF system and even though he now always books under 'Mr' he has on a couple of occasions been woken up in the middle of a flight to see if he can render medical assistance. Unfortunately, his doctorate is in aeronautical engineering!

Fruitcake said:

his doctorate is in aeronautical engineering!

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Very handy if the patient is actually the aircraft!

swanning_it said:

Very handy if the patient is actually the aircraft!

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Only if the plane has internal issues. Anything external will wait until landing.

Hvr said:

Only if the plane has internal issues. Anything external will wait until landing.

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Have you never heard of a space walk?

Really interesting! Not being an MD myself, but am continually amazed at the equipment available on aircraft.

I remember asking a friend who was a cabin crew member, what happens if.....? He advised there's ALWAYS a medic on board. By chance, not by choice. Interesting to read a first hand account

Hvr said:

Only if the plane has internal issues. Anything external will wait until landing.

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Is there a doctor of aeronautical engineering on board? There's a problem with the wing!

An important issue I see with crew requesting medical assistance on flights is that they immediately accept the bona fides of whoever puts their hand up. I have never seen any procedure followed to establish if the person, in fact, has any medical training whatsoever. And staff singling out passengers with "Dr" on their boarding passes is not reliable at all since even a floor cleaner could sign up as "Dr" xx_XX on their QFF membership without any qualifications at all, medical or otherwise. A fraud with a celebrity-seeking personality could potentially start sticking needles into someone just because they volunteered.

This then opens up the question of liability if something went terribly wrong because crew let an unqualified person treat a fellow passenger.

This raises a concerning aspect. If I am conscious perhaps I could ask to see their practice licence. Of course, even with that, they may be a psychiatrist which is useful if I'm freaking out, but they may be a bit rusty on some other problems.

vetrade said:

An important issue I see with crew requesting medical assistance on flights is that they immediately accept the bona fides of whoever puts their hand up. I have never seen any procedure followed to establish if the person, in fact, has any medical training whatsoever. And staff singling out passengers with "Dr" on their boarding passes is not reliable at all since even a floor cleaner could sign up as "Dr" xx_XX on their QFF membership without any qualifications at all, medical or otherwise. A fraud with a celebrity-seeking personality could potentially start sticking needles into someone just because they volunteered.

This then opens up the question of liability if something went terribly wrong because crew let an unqualified person treat a fellow passenger.

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chelzmalee said:

He advised there's ALWAYS a medic on board. By chance, not by choice.

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I guess that may be a reasonable observation, but I doubt that there'd ALWAYS be a medic on board by chance rather than choice. I must admit that I thought all the flight crew would be proficient in at least some level of emergency medical training that I'd have thought would be a higher level than just CPR/First Aid. Even to the point of being able to inject a patient following authorisation from ground based medical help. I'd be curious to hear from some flight crew about that.

vetrade said:

An important issue I see with crew requesting medical assistance on flights is that they immediately accept the bona fides of whoever puts their hand up. I have never seen any procedure followed to establish if the person, in fact, has any medical training whatsoever. And staff singling out passengers with "Dr" on their boarding passes is not reliable at all since even a floor cleaner could sign up as "Dr" xx_XX on their QFF membership without any qualifications at all, medical or otherwise. A fraud with a celebrity-seeking personality could potentially start sticking needles into someone just because they volunteered.

This then opens up the question of liability if something went terribly wrong because crew let an unqualified person treat a fellow passenger.

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Never thought about this until brought up in this thread. I always have my WA police medical photo id, mainly because pretty much anyone in the world accepts it as photo id, allowing me to keep my licence and passport safe, but also in case I need to render assistance and then find myself in a spot of bother. I think the police logo works better than the "medical" words though

Do the rest of you have any professional ID?

Just a side line question to the OP. Are you concerned of being sued if your assistance doesn't help the patient, or even makes the patient worse?

I only ask as I have to renew my CPR/First Aid every 6 months and the trainers always seem to have an anecdotal story of people saving someone from a heart attack or such like and then being sued for cracking a rib whilst doing it! Is that just a furphy, or is there some fact behind those stories?

swanning_it said:

Just a side line question to the OP. Are you concerned of being sued if your assistance doesn't help the patient, or even makes the patient worse?

I only ask as I have to renew my CPR/First Aid every 6 months and the trainers always seem to have an anecdotal story of people saving someone from a heart attack or such like and then being sued for cacking a rib whilst doing it! Is that just a furphy, or is there some fact behind those stories?

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You can try to sue for anything, but almost everything (including legitimate claims) gets dismissed or settled. I've not heard of a successful case against a Good Samaritan, but I am not a medical lawyer.

Very interesting thread.

Thank you to the OP for commencing a very interesting topic of discussion.

Onboard a short domestic flight last week, I too heard the call for a Physician/Doctor/Nurse to make themselves known to a FA. A passenger besides me attended.... & with 10 minutes that person who attended the ill passenger was back in their seat & the flight continued on as per usual.
In many cases like this , the assistance of another passenger onboard to assist with fellow ill- passenger can't be thanked enough.

I have also heard the same call announced on a longer sector flight from LHR to YCC a few years ago & on that particular Occassion the flight diverted to Keflavik which was a quite a surreal experience, when i knew that the ill passenger must be suffering from a life & death experience.
The captain made the decision to dump fuel & make an emergency landing at an airport that was not served by that particular airline, I was thinking that must be quite a decision to make , but not one taken lightly.
( The Purser told me these types of diversions cost upwards of £100,000 in all the various costs involved)


Which leads me to conclude that those who assist in medical emergencies onboard are real life savers by not only assisting the passenger experiencing ill-health, but also assisting all the other stakeholders such as the pilot, fellow passengers & flight attendants not to mention those on the ground behind the scenes.

Surely the QF system could be modified to allow a checkbox to pop-up when selecting "Dr" as your title (either through a booking screen of QFF profile) that confirms you're a medical doctor. That, or they could roll out a similar system to the CSM iPad app and gradually, over time, they could update the records with who is and isn't a doctor of their status passengers.

vetrade said:

And staff singling out passengers with "Dr" on their boarding passes is not reliable at all since even a floor cleaner could sign up as "Dr" xx_XX on their QFF membership without any qualifications at all, medical or otherwise. A fraud with a celebrity-seeking personality could potentially start sticking needles into someone just because they volunteered.

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While I was Social Ambassador I considered booking a ticket with the title "Ambassador", as I doubt it'd be more likely to get me upgraded, and I technically was, just to an internet forum

Thanks to the OP for starting this thread, thinking it might turn into something similar to Ask The Pilot

Another interesting aspect of this discussion is to actually contemplate the airlines involved and the demographics of who flies them. I had a story relayed by a friend last year who was flying MEL-BNE on QF. A some point a passenger behind him had a massive heart attack and the crew sprung into action. It turned out through some miracle that the head of the cardiac unit of a major Australian hospital was in business class on this flight. He heard the commotion and quickly came and took over. The good doctor stayed with him throughout the flight and then rode with the patient to hospital in the ambulance upon arrival in Brisbane and almost certainly saved his life.

I mused to my friend later that this is actually one of the reasons I fly QF exclusively as I can tell you it's an extraordinarily unlikely scenario that the head of Cardiac surgery of any hospital is going to be flying Tiger airways. Something to ponder!

swanning_it said:

Just a side line question to the OP. Are you concerned of being sued if your assistance doesn't help the patient, or even makes the patient worse?

I only ask as I have to renew my CPR/First Aid every 6 months and the trainers always seem to have an anecdotal story of people saving someone from a heart attack or such like and then being sued for cracking a rib whilst doing it! Is that just a furphy, or is there some fact behind those stories?

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In NSW there's the Good Samaritans Law which I believe was designed to protect a "Good Samaritan" against liability.

http://www.legislation.nsw.gov.au/fragview/inforce/act+22+2002+pt.8+0+N