Flying Safe - Medics Onboard Qantas

[dajop]

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.

Surely there is an extremely remote chance this could happen. The chances of some falling sick on board are reasonably low to begin with, overlay this with the chance that someone is on board who might choose to misrepresent themselves as a medical doctor, it becomes an extremely small risk. [to put into context, I'm personally much much more concerned that the taxi driver who is driving my taxi at the end of the journey is actually is legitimately qualified and capable of driving that taxi safely, than falling sick on a plane and being attended to by a fake medico, and therefore would not expect airlines to put in a foolproof system of verifying qualifications. Sometimes you just have to rely on people in good faith].

 

[TomVexille]

On a similar note, the last first aid course I took was taught by a former EK FA, who was also the first aid trainer for EK's FA's and was a nurse prior to taking up the FA job with EK

 

[Pushka]

On a recent QM2 circumnavigation around Australia we were told more than 10 deaths had occurred. The morgue held 6 from memory. On ships they will never conduct surgery. There is very limited oxygen available. They have good resus equipment and monitoring. Seems its better to have a heart attack than appendicitis!

Its good to hear that airlines have excellent medical equipment available. It makes sense as this equipment might save them a very costly diversion.

 

[QF029]

I think some of the stories from doctors here include giving up their business (or god forbid, first) class seat to sit in economy and look after a patient with minimal response from Qantas. The Hippocratic oath would only take me so far!

 

[andye]

Maybe the MEL RSA rules are designed to keep the doctors off to international conferences sober so they can deliver medical assistance

 

[get me outta here]

Yes, and maybe a Dr has just got on a flight to take a well earned holiday, feeling exhausted and finally able to relax, only to fall asleep and then be awoken to find that they have to see yet another patient. I feel for them, being acquainted with some exhausted doctors.

I think some of the stories from doctors here include giving up their business (or god forbid, first) class seat to sit in economy and look after a patient with minimal response from Qantas. The Hippocratic oath would only take me so far!

 

[andye]

Interesting to think what specialty would be most useful to the FAs

e.g
GP: used to dealing with common problems with minimal equipment
ED: sees common things often but geared up for a big emergency
Intensivist/Anaesthetist: for the really sick

 

[vetrade]

Surely there is an extremely remote chance this could happen. The chances of some falling sick on board are reasonably low to begin with, overlay this with the chance that someone is on board who might choose to misrepresent themselves as a medical doctor, it becomes an extremely small risk. .

Yes, it almost certainly is a small risk but stranger things have happened....... My wife and I observed one episode on a QF dom. flight to BNE where a ditzy looking woman volunteered herself as a "nurse" to assist a passenger 2 rows in front of us. We both immediately twigged that she was certainly not a nurse since she didn't even know how to check the pulse correctly. My wife was in the aisle seat so she introduced herself and took over - pax turned out to be only nervous about flying. People are not always who they claim to be.

 

[kpc]

Interesting to think what specialty would be most useful to the FAs

e.g
GP: used to dealing with common problems with minimal equipment
ED: sees common things often but geared up for a big emergency
Intensivist/Anaesthetist: for the really sick

?Obstetrician..seriously an ED physician would probably be the best and we have at least 2 such members (to my knowledge) here on AFF

 

[Princess Fiona]

Interesting to think what specialty would be most useful to the FAs

e.g
GP: used to dealing with common problems with minimal equipment
ED: sees common things often but geared up for a big emergency
Intensivist/Anaesthetist: for the really sick

You'd want a qualified Emergency Physician for 99% of the medical emergencies onboard.
(But then I would say that, wouldn't I )
An Intensivist would also be very useful in a Resus situation and an Anaesthetist who looks after sick people in their day to day work (not all do).

 

[turtlemichael]

My partner is a now retired medical practitioner who was, even when working, well out of touch with both general practice and emergency medicine. His usual approach, particularly as he got older, was to wait for the second call before volunteering in the hope that there would be someone else who could render better assistance than him. As his specialty for 40 years was sexual health medicine that was probably a wise approach.

 

[Princess Fiona]

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?

I have my AHPRA registration card in my iPhone wallet along with my drivers licence.
I've never been asked to prove my credentials while helping on a flight but assume it might happen in somewhere like the US ?

 

[Deleted member 29185]

the taxi driver who is driving my taxi at the end of the journey is actually is legitimately qualified and capable of driving that taxi safely,

Wow......are you saying such a person exists? That's a revelation to me (and the reason I use hire car companies so much)!

 

[kpc]

I have my AHPRA registration card in my iPhone wallet along with my drivers licence.
I've never been asked to prove my credentials while helping on a flight but assume it might happen in somewhere like the US ?

I'll be very happy if asked to prove who I was, and couldn't, and was sent packing back to my seat

 

[kelvedon]

You'd want a qualified Emergency Physician for 99% of the medical emergencies onboard.
(But then I would say that, wouldn't I )
An Intensivist would also be very useful in a Resus situation and an Anaesthetist who looks after sick people in their day to day work (not all do).

An Anaesthetist should be available on all long haul flights to make the journey more bearable in Y.

 

[PaulST]

I have my AHPRA registration card in my iPhone wallet along with my drivers licence.
I've never been asked to prove my credentials while helping on a flight but assume it might happen in somewhere like the US ?

I shiver at the reference to those people...
A colleague identified herself as a doctor quite a few years ago on a SAA flight and when she was unable to provide ID proving her claims, she was asked to sit down. I must admit I don't carry any ID other than having the AMA logo on my Amex card. Most of my colleagues I've asked don't carry anything either.

On the topic of someone claiming to be a health care professional who isn't. It would be rare and you'd probably get an indication of their level of competence fairly quickly. With reference to the above comment about a "ditzy" looking person who claimed to be a nurse, she may well still have been one. I know multiple competent nurses and doctors who come across as quite ditzy. Maybe they were feeling a pulse, maybe they were doing something else?

The decision about redirecting and landing due to a medical emergency would be made by the captain in liaison with the docs onboard as well as their doctors over the radio. But the boss in the end of the day would be the captain but obviously they'd take the advice seriously.

I recall reading that the A380 had the option of a room to store bodies but I'm not sure if any airlines picked that option.

 

[PaulST]

An Anaesthetist should be available on all long haul flights to make the journey more bearable in Y.

Dr Sauvignon Blanc FANZCA.

 

[dwh97]

Hi all,

Many thanks for your replies! I was a little concerned as this is my 2 ever post!

Very interesting regarding the Dr of aero nautical engineering! I really hope that they don't need to be consulted during my next flight on Sunday!!!

Bona Fide accreditation is exactly what airlines use (possibly on purpose) as I do believe that medical practices onboard are considered "extreme situations" and fall under the Good Samaritan laws of the country of registry of that aircraft. it would become abundantly clear that if a non medical doctor, (such as a Vet - which happened once before!) put their hand up to offer assistance, upon discussions with them they would show no signs of correct, relevant or up to date clinical care. However if in the event no medical staff are onboard, that same Veterinarian, will possess skills most likely to gain IV access or similar. I can only assume these type of protocols allows airlines to limit their liability in regards to negative patient outcomes onboard.

In regards to who has right of way about landing the plane. The decision would be wholly mine. No doctor on the other end of a phone would prefer to take full responsibility for a patient when a doctor (or other medic) is at point of care delivery. However if you have an acute renal failure patient and you are an anaesthetist, then contacting a renal specialist over the phone for advice is a fantastic opportunity that should be utilised in every situation. In my experience the captain or 1st officer will always ask for an informal discussion with the treating medic about what the thoughts and concerns for the patient are and will always act in the best interest of the patient. You could argue that airlines have a zero tolerance approach to putting lives at risk and will always land the aircraft if indicated by a medic onboard.

Albeit the discussion can be quite serious. Once I had to land a plane,, the crew where very compassionate about sharing responsibility for the diversion and never was I left feeling like I was responsible for interrupting 300 travellers onward plans. However I do recall a very upset business passenger on that flight who was obviously distressed about missing their onward connections. But that's the reality of flying with large amounts of populations! There will always be someone who is taken ill.

 

[dwh97]

Haha I love this!

An airway adjunct, propofol infusion and wiff of O2 should do the job! Wake me up when we land! However I don't think this would render me any use to someone actually fell ill! I'm sure they will be asking for my AHPRA and GMC cards then!

 

[PaulST]

Hi all,

Many thanks for your replies! I was a little concerned as this is my 2 ever post!

Very interesting regarding the Dr of aero nautical engineering! I really hope that they don't need to be consulted during my next flight on Sunday!!!

Bona Fide accreditation is exactly what airlines use (possibly on purpose) as I do believe that medical practices onboard are considered "extreme situations" and fall under the Good Samaritan laws of the country of registry of that aircraft. it would become abundantly clear that if a non medical doctor, (such as a Vet - which happened once before!) put their hand up to offer assistance, upon discussions with them they would show no signs of correct, relevant or up to date clinical care. However if in the event no medical staff are onboard, that same Veterinarian, will possess skills most likely to gain IV access or similar. I can only assume these type of protocols allows airlines to limit their liability in regards to negative patient outcomes onboard.

In regards to who has right of way about landing the plane. The decision would be wholly mine. No doctor on the other end of a phone would prefer to take full responsibility for a patient when a doctor (or other medic) is at point of care delivery. However if you have an acute renal failure patient and you are an anaesthetist, then contacting a renal specialist over the phone for advice is a fantastic opportunity that should be utilised in every situation. In my experience the captain or 1st officer will always ask for an informal discussion with the treating medic about what the thoughts and concerns for the patient are and will always act in the best interest of the patient. You could argue that airlines have a zero tolerance approach to putting lives at risk and will always land the aircraft if indicated by a medic onboard.

Albeit the discussion can be quite serious. Once I had to land a plane,, the crew where very compassionate about sharing responsibility for the diversion and never was I left feeling like I was responsible for interrupting 300 travellers onward plans. However I do recall a very upset business passenger on that flight who was obviously distressed about missing their onward connections. But that's the reality of flying with large amounts of populations! There will always be someone who is taken ill.

I'm not sure how you would diagnose ARF/AKI on an aeroplane or what a renal consult what achieve.