In Flight Emergency

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gaspasser127

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Was on a plane recently and heard the dreaded words overhead: “is there a doctor on board?” It was an older lady who just seemed dehydrated and perked up with a little hand holding and some ginger ale. I had a CRNA and an orthopod come to help as well.

Anyway - afterwards the flight attendants took note of our seat numbers and offered us each $150 flight vouchers. We all ended up accepting it. Just today though i was talking to one of my attendings and it seems like by accepting the money (or any compensation) we may have opened ourselves up to liability since the Good Samaritan law only applies to completely volunteer work with no compensation.

Anyone know if this is true or have their own experience with this?
 
Aviation Medical Assistance Act of 1998, Section 5b ("Limitations on Liability," "Liability of Individuals"):
An individual shall not be liable for damages in any action brought in a Federal or State court arising out of the acts or omissions of the individual in providing or attempting to provide assistance in the case of an in-flight medical emergency unless the individual, while rendering such assistance, is guilty of gross negligence or willful misconduct.
Click to expand...

Good Samaritan laws don't apply here because you weren't within a state's jurisdiction; you were on an airplane. The Aviation Medical Assistance Act of 1998 was designed to extend Good Samaritan laws onto aircrafts, and it contains no stipulation that the medical assistance has to be offered on a voluntary basis, or that no compensation can be accepted after the fact.

You're fine.
 
I've been summoned to some minor annoyances mid-flight, but nothing serious. Pregnant lady feeling lightheaded so we got her some OJ. Old guy felt dyspneic and couldn't walk to the restroom, turns out he was on home oxygen and didn't feel the need to use his oxygen on the plane for some reason. Nothing crazy.
 
Osminog said:
Aviation Medical Assistance Act of 1998, Section 5b ("Limitations on Liability," "Liability of Individuals"):


Good Samaritan laws don't apply here because you weren't within a state's jurisdiction; you were on an airplane. The Aviation Medical Assistance Act of 1998 was designed to extend Good Samaritan laws onto aircrafts, and it contains no stipulation that the medical assistance has to be offered on a voluntary basis, or that no compensation can be accepted after the fact.

You're fine.
Click to expand...

This.

I'm not a lawyer. I think if you don't have a practice based on airplanes resuscitation then you're covered under the good Samaritan law, as in no liability. I think anything we, as anesthesiologists, have any expertise that is done outside of a hospital is covered under good samaritan law.

But we're still waiting on the Ortho's actions.
 
now what did the CRNA say? I feel like you should have anticipated this question and answered already 😛 :corny:
 
Did this until they asked 4x each getting more frantic and it was during intern year so I didnt want to be involved. no joke classic MI sx: pain radiating diaphoretic etc etc (lady had MI already prior i learned and said hey this feels identical to what I felt before I had some stents put in).

Crazy part was 20-30min from already landing and apparently she had been on oxygen for a bit longer in back of plane, but they didnt call for is there a doctor on until her chest pain starting getting too bad that it scared the stewardesses.

I will say I was blown away by the flight drugs (atropine epi IV kit etc) BUT no freaking aspirin. Had someone give her aspirin then ambulance was waiting at the gate.

No joke, they offered me 50$ flight voucher. Thanks american!
 
I had similar event last year. Arrived to scene of college student who was dehydrated. Had my 1.5yr old in tow and threw her at my wife who had been in back of plane talking to my parents after using the bathroom. A little OJ and the student perked up. I also had an orthopod, NP and a medic arrive who all deferred to me.
 
I was platinum on Northwest/Delta for 4 straight years (clocking nearly 400K miles), and never had an overhead call. Once, while I was BSing with a flight attendant, a woman overhears and comes up with her 10 or so year old kid, with pain from an air bubble in his canaliculus. I didn't "burp" it, and yet, he was fine.

Now, a paramedic I flew out to Hawai'i, when she was flying back, had a guy who went into cardiogenic shock. And a friend of mine, who is neurorads, had a guy right in front of her seize. The funny one, though, was a flight back from Honolulu, where they asked for a doctor on board. She was thinking, "wait a minute...", and, as she waited, a bunch of doctors ring their call bells, because the ACC (American College of Cardiologists) convention had ended that day, and there were - literally - more than 40 cardiologists on the plane.
 
I feel like I want to steer clear of these situations since everyone has their stupid phones out to record everything. Don't want to get my face plastered on YouTube as ammo for the person in case they want to use that against you or something, never know! I've heard stories from partners about the most frivolous things patients tried to sue over to make a buck (that were thrown out immediately) but still have to get their name dragged out and all the unnecessary paperwork done. One time on vacation, I and another doc ran to help 2 kids who had near drowning and couldn't breathe properly, handful of people are great and helping and then other dumb*sses making a circle and bystander's recording with their phones. I mean really wtf are you going to do, watch this traumatic event on your free time again?
 
TimesNewRoman said:
Pro-tip: If you’re drunk you’re considered incapacitated and can’t respond.
Click to expand...

When I was an intern I did an EM rotation in an ED that had one of those air-triage centers, that phone was ringing almost constantly, it was an assigned shift for the docs. I would think we are approaching the time where most in-flight emergencies are triaged thru one of you EM guys, you’re probably protocolizing it all so that when all of us are traveling we can relax.
 
Robotic Wis-Hipple said:
When I was an intern I did an EM rotation in an ED that had one of those air-triage centers, that phone was ringing almost constantly, it was an assigned shift for the docs. I would think we are approaching the time where most in-flight emergencies are triaged thru one of you EM guys, you’re probably protocolizing it all so that when all of us are traveling we can relax.
Click to expand...

There is an airline doc, not necessarily EM. Interestingly, it’s often times cheaper for the airlines to take on the liability for potential wrongful death/malpractice than divert a full, large plane. The purpose of the doc is more to say whether or not they should land.
 
wolfpackMD said:
Was on a plane recently and heard the dreaded words overhead: “is there a doctor on board?” It was an older lady who just seemed dehydrated and perked up with a little hand holding and some ginger ale. I had a CRNA and an orthopod come to help as well.

Anyway - afterwards the flight attendants took note of our seat numbers and offered us each $150 flight vouchers. We all ended up accepting it. Just today though i was talking to one of my attendings and it seems like by accepting the money (or any compensation) we may have opened ourselves up to liability since the Good Samaritan law only applies to completely volunteer work with no compensation.

Anyone know if this is true or have their own experience with this?
Click to expand...
Wow you guys should have replaced her hip while you were at it 🙂
 
OP -
I'm not a lawyer, but would suspect you are in the clear.

The stories of others are a very interesting read.

My story was on the flight back from Vegas...
Heard the overhead from the flight attendant; a couple of folks arrive - an RN, an Ob, and me.
We state our backgrounds. The Ob defers to me and leaves.
Flight attendants ask for my "proof or credentials".
I said "Well. I didn't overhead for help. I don't have those with me. Good luck".
 
bigdan said:
We state our backgrounds. The Ob defers to me and leaves.
Flight attendants ask for my "proof or credentials".
I said "Well. I didn't overhead for help. I don't have those with me. Good luck".
Click to expand...

When I was 19 or 20 years old I was taking an EMT course to pad my application for med school. On one of my ridealongs we got a call to the airport to meet an in-flight emergency. I don't remember a lot of the details (syncope) but the alleged doctor who responded on the plane said some weird stuff. At one point he said was he wanted the medics to give "IV sugar". The paramedics I was with were convinced he was a fraud. They kept asking him for ID and his license. He said he didn't carry that. We took the patient and left.
 
wolfpackMD said:
Orthopod: "hey I'm an orthopedic surgeon how can I help?"
Me: "hey man I'm an anesthesia resident."
Orthopod: "oh you probably know what to do better than me then. thank god."

and lol nope... not a DNP.
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Lol! I had the exact same conversation with a dermatologist a few years ago flying to a meeting.
 
TimesNewRoman said:
There is an airline doc, not necessarily EM. Interestingly, it’s often times cheaper for the airlines to take on the liability for potential wrongful death/malpractice than divert a full, large plane. The purpose of the doc is more to say whether or not they should land.
Click to expand...
From the flipside, when I worked in Hawai'i, one of the hospitals was the closest to HNL. In 2011, I had 5 patients from 4 times the plane turned around (one European just tagged along for her infected tattoo). Out of those 5 patients, you know how many I admitted? Zero. Every single one was discharged. If someone on the flight talked to someone on the ground, I don't EVEN know what they said. One guy was a retired psychiatrist. He told flight crew that he had to lay down after taking his Flomax. That's all. He just wanted to lay down on the floor in back, near the galley. I worked nights then, so these were all red-eye flights (as many from HI to the mainland are). It's not like people are all up and milling around. As I say, I don't know if there was a doc on that flight (besides the pt), or they talked to someone on the ground, or what. But, every other one of the people on those flights was hindered. They all had to be rescheduled, and this was around 2am HST (because, if they're more than halfway there, they just keep going - if it is to PDX or SeaTac, they reroute to SFO or LAX - due to the curve of California, SF and LA are nearly equidistant from HI). I don't know if any of them ever knew how they'd gotten screwed like that. It was clear that there was no life threat - at all - even on cursory inspection.
 
bigdan said:
OP -
I'm not a lawyer, but would suspect you are in the clear.

The stories of others are a very interesting read.

My story was on the flight back from Vegas...
Heard the overhead from the flight attendant; a couple of folks arrive - an RN, an Ob, and me.
We state our backgrounds. The Ob defers to me and leaves.
Flight attendants ask for my "proof or credentials".
I said "Well. I didn't overhead for help. I don't have those with me. Good luck".
Click to expand...

I've read a few news reports of being harassed about credentials when responding to in-flight emergencies (seems to happen more frequently to females/minorities, unfortunately), and I've always thought that my response would be identical to yours. It's like seriously, bro, I didn't walk up here and ask if anyone was having an emergency I could help with for ****s and giggles. Who carries their medical license with them while traveling anyway?
 
Ya.

I’m black. Never thought about the “credentials” thing in that way until some of the stuff in the news came out.

Who knows.
 
pgg said:
When I was 19 or 20 years old I was taking an EMT course to pad my application for med school. On one of my ridealongs we got a call to the airport to meet an in-flight emergency. I don't remember a lot of the details (syncope) but the alleged doctor who responded on the plane said some weird stuff. At one point he said was he wanted the medics to give "IV sugar". The paramedics I was with were convinced he was a fraud. They kept asking him for ID and his license. He said he didn't carry that. We took the patient and left.
Click to expand...

When I was working as a medic, we had a call at the airport for a plane that was about to land with a "critically ill" patient on board. We rolled the whole cavalry out and ended up getting onto like an Embraer 140 with an aisle significantly narrower than our stair chair. The patient was a super nice Honduran lady, but she didn't speak much English and she was a bit dry and lightheaded and sounded like she had been fighting the flu for a couple of days. We put an N95 on her at the captain's request and, as it turns out, putting a mask on a non-American woman of darker complexion on an aircraft in the middle of the 2014 flu (EBOLA) season was a good way to freak the hell out of 40 passengers. I imagine it was the fastest disembarkment that airport has ever seen though.
 
I was flying from Jackson Hole to Salt Lake City when the call came for a doctor on board. I looked at my wife, who is an anesthetist, and we headed a few rows back. Lady in the middle seat is diaphoretic, appears apneic, and unconscious. My wife does a jaw thrust and I check a pulse (absent). About the time we are going to drag her into the aisle to start compressions, she jerks, then comes to. Turns out she had recently had an AICD placed and that thing just saved her life! We slapped some oxygen on her and made sure she felt better before heading back to our seats. We had a tight connection in Salt Lake so we declined filling out paperwork. Paramedics met us at the gate and I gave a verbal report and we went on our way.

I did ask the flight attendant what they had for medical gear. This plane only had the tank of oxygen and mask we used. No drugs, no ambu bag, nada.
 
camkiss said:
I did ask the flight attendant what they had for medical gear. This plane only had the tank of oxygen and mask we used. No drugs, no ambu bag, nada.
Click to expand...
Checking the Jackson Hole airport right now, Delta is the only airline going JAC-SLC, and the metal for that is an Airbus A319, which, despite a short, 80 minutes flight, seats 124- 156, depending on configuration. This, I would venture, has the whole setup. I was thinking you were on one of the little puddle jumpers, like an Embraer ERJ or Bombardier CRJ700. I can see those having oxygen and that's it.
 
Studying for the Texas JP exam:

Let's say you're on an instate flight from Dallas to Houston. Do you still take your southwest voucher??
 

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bigdan said:
OP -
I'm not a lawyer, but would suspect you are in the clear.

The stories of others are a very interesting read.

My story was on the flight back from Vegas...
Heard the overhead from the flight attendant; a couple of folks arrive - an RN, an Ob, and me.
We state our backgrounds. The Ob defers to me and leaves.
Flight attendants ask for my "proof or credentials".
I said "Well. I didn't overhead for help. I don't have those with me. Good luck".
Click to expand...
This exact story happened to me on a flight. Asked for proof of credentials. I showed my BLS card. I was not offered any compensation nor would I have accepted.
 
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