Flying Safe - Medics Onboard Qantas

[RooFlyer]

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

Ho! Where have I heard that type of line before? Love to hear of your own experiences, rather than question others

 

[Princess Fiona]

Ho! Where have I heard that type of line before? Love to hear of your own experiences, rather than question others

I'm not sure that the example given was an actual experience necessarily.

 

[PaulST]

Ho! Where have I heard that type of line before? Love to hear of your own experiences, rather than question others

It was a rhetorical question. You can't make that diagnosis without a blood test (which you couldn't do at 35,000ft).

I've fortunately never had to render assistance on an flight.

For those interested, I've pulled this from my insurance company:

In-flight Emergencies and Good Samaritan Acts | Defence Update

If a call for emergency assistance is made, an issue of concern may be the possibility of being sued in the event of an adverse outcome. The potential liability of a doctor who responds to an in-flight emergency is complex. While in Australia there is legislative protection for Good Samaritans, the law relating to Good Samaritan acts varies from country to country. The determination of jurisdiction of any action on an international flight may range from the country in which the aircraft is registered through to the country of citizenship of the passenger or doctor.
In any event, many major airlines have insurance policies which will indemnify doctors who come forward to assist in an emergency and, if required, doctors should seek written confirmation of indemnity from the aircraft captain. Also, the US Aviation Medical Assistance Act 1998 protects doctors who provide assistance on aircrafts registered in the US.

 

[blackcat20]

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:

You mean my DNA testing skills aren't required?

 

[dwh97]

Haha this is true! I was just using it as an example... Would be great if they introduced U & E's, ABG's etc what a treat! Imagine that! We could get full time work on these planes! Haha!

 

[PaulST]

Haha this is true! I was just using it as an example... Would be great if they introduced U & E's, ABG's etc what a treat! Imagine that! We could get full time work on these planes! Haha!

Another colleague was employed by the producers of Survivor to sit around and relax (oh, and be on call incase there was an emergency with the contestants). We were all jealous! Of course she never actually had to do anything!

 

[dwh97]

Hi Paul,

Thanks for the insurance article, very interesting!

I will go and have a look at mine now also... Litigation is never foremost in my mind when treating in emergencies! Maybe it should be now though....? I just assumed that Australian airlines indemnify within the Good Samaritan act... This could be a very costly assumption!

 

[PaulST]

Hi Paul,

Thanks for the insurance article, very interesting!

I will go and have a look at mine now also... Litigation is never foremost in my mind when treating in emergencies! Maybe it should be now though....? I just assumed that Australian airlines indemnify within the Good Samaritan act... This could be a very costly assumption!

No it shouldn't. Do what you're trained to do and nothing more. And you'll be fine. No one has been sued for doing their job. The only instances of where docs and others have been successfully sued is where they did things that they wouldn't even have done in a hospital.

 

[RooFlyer]

<snip>

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.

<snip>.

<snip>

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. <snip>.

Thanks for those replies, and note I've snipped some of the accompanying words (I don't mean to change meaning). I'll try and find the thread and comments when this was discussed before. I recall (but may be wrong) that the replies were then firmly that the TeleMed types on the radio were the ones who ultimately informed the Qantas pilots.

 

[Princess Fiona]

Thanks for those replies, and note I've snipped some of the accompanying words (I don't mean to change meaning). I'll try and find the thread and comments when this was discussed before. I recall (but may be wrong) that the replies were then firmly that the TeleMed types on the radio were the ones who ultimately informed the Qantas pilots.

I believe JB747 has also answered this question.

 

[Mac502]

Where do I get these AHPRA cards everyone is talking about? I only have the dodgy attachment they send me via email.

 

[Princess Fiona]

Where do I get these AHPRA cards everyone is talking about? I only have the dodgy attachment they send me via email.

It comes with your confirmation of registration. Its a tear out flimsy piece of plastic covered paper. The back of the card has your Specialty listed if you have Specialty Registration as well as General.

 

[PaulST]

Where do I get these AHPRA cards everyone is talking about? I only have the dodgy attachment they send me via email.

Give them a call, then you'll be put through to the wrong person. Then they'll apologise but be unable to transfer you. Ring again and they'll put you through to someone else who'll be on leave so you'll have to leave a message on an answering machine. Repeat 3 times and several weeks after you retire, something will arrive in the mail.

 

[RooFlyer]

Give them a call, then you'll be put through to the wrong person. Then they'll apologise but be unable to transfer you. Ring again and you'll put you through to someone else who'll be on leave so you'll have to leave a message on an answering machine. Repeat 3 times and several weeks after you retire, something will arrive in the mail.

Sounds like I should apply. I can always say "I believe my registration is in the mail."

 

[wandering_fred]

Will the airlines be among the first to apply in actual use, the smart phone apps (and associated blood analysis probes) designed to minimize time and cost of medical testing? Certainly would make some diagnoses more certain.

Any speculation on the time line for general use of such devices?

Happy wandering

Fred

 

[vetrade]

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?

Do the ditzy doctors and nurses you know check the pulse with their thumb on the inside of the wrist?

 

[PaulST]

Will the airlines be among the first to apply in actual use, the smart phone apps (and associated blood analysis probes) designed to minimize time and cost of medical testing? Certainly would make some diagnoses more certain.

Any speculation on the time line for general use of such devices?

Happy wandering

Fred

I'd doubt it to be honest as more equipment and tests just complicates things. In the air, all you want to do is keep the patient comfortable and deal with any real emergencies the best you can (ie. defib a cardiac arrest). But anything further should be done on the ground in a hospital. That as well as the fact that medical emergencies in flight aren't that common would mean that a lot of that equipment would rarely/never be used.

From what I've gathered, places that tend to be at the forefront of management of critically ill patients are the army and American hospitals desperate to perform well and attract money.
The Korean and Vietnam War improved the management of trauma, in particular, and I expect that things learnt in field hospitals in Afghanistan and Iraq recently will save many road accident victims over the next few years as things learnt there transfer across to civilian hospitals.

Having said all of that, things change correctly and my predictions may all be wrong. If you'd told me in 1900 that by the 1960s people would be flying around in 300 tonne aircraft, I'd have laughed at you.

 

[PaulST]

Do the ditzy doctors and nurses you know check the pulse with their thumb on the inside of the wrist?

The thumb isn't ideal but it would work. The inside of the wrist is the correct location (assuming we mean the same thing about "inside of the wrist") What were they doing with their other fingers? It's possible they were stabilising their hand with their thumb and using their fingers to palpate a pulse. But anywho.

 

[vetrade]

The thumb isn't ideal but it would work. The inside of the wrist is the correct location (assuming we mean the same thing about "inside of the wrist") What were they doing with their other fingers? It's possible they were stabilising their hand with their thumb and using their fingers to palpate a pulse. But anywho.

You're being pedantic, PaulST. Any trained medical person knows not to use their thumb to check the radial pulse. Conversely, anyone who uses their thumb clearly hasn't been trained.

 

[PaulST]

You're being pedantic, PaulST. Any trained medical person knows not to use their thumb to check the radial pulse. Conversely, anyone who uses their thumb clearly hasn't been trained.

Yes but I don't think you can conclude that someone is faking their nursing qualification just because they looked ditzy to you or they used the incorrect technique to palpate the radial pulse. Put under pressure, especially juniors, do silly things.