Doctor on board-What if I tell?

[chejus]

I am a doctor and had several "medical emergencies" during flights. Maybe 30% of my flights. I always respond to the PA and although most were not real emergencies, 2 were. I have been told that the cabin crew feels much safer if they know there is a doctor on board.
So here goes my question:
How would the chief of cabin or purser (excuse my ignorance) feel if I let them know that I am a physician and that I do not mind being called for help if anything happens? Like if I go and say: "Hi, my name is Diego I am in seat xxx, I wanted to let you know that I am a physician and if there is anything you need, I will be glad to help".
Will they feel "who the hell does he think he is?" or "i don´t care" ...etc.? Or would you (directed to cabin crew) like the fact that someone is announcing this to you?

[Getoutofmygalley]

My point of view as a Purser, I would be more than happy if a Doctor, Nurse or a Paramedic announced on boarding that they were there and would be willing to help in the event of an emergency.

I would not think anything negative of that person and it would be quite comforting to know that there is someone else onboard who can help considering that cabin crew only have limited first aid training.

Over the last few months I have had 1 case of suspected Hypoglycaemia, 1 case of suspected Stroke and yesterday what we thought might have been appendicitis which was actually stomach cramps caused by a female pax's time of the month.

I would have loved a doctor to have been onboard during those events, but unfortunately there wasn't.

[Virgin Boi]

I wouldnt advise you to introduce yourself. Believe me, as a purser myself, if I needed a doctor, I would be on the PA requesting one faster than you can ask for a Gin and tonic! :ok:

What I'm saying is, theres no need. The more cynical between us (maybe myself included!) would suspect that you might be after a little freebie, perhaps an upgrade, or some drinks!? Im not suggesting you are, just looking at it from a crews point of view...

I would just recommend that you relax and enjoy the flight and dont bring attention to yourself by exhibiting any unusual behavior.

And as a side note, where on earth are you flying too, Lourdes!? If I needed to PA for a doctor on 30% of my flights I think I'd have to quit flying with the stress! :eek:

[Glamgirl]

I'm in two minds about this... On one hand it's good to know that there's a doctor on board, on the other hand, would that person interfere in our procedures?

Thing is, doctors, no matter who, are not allowed to touch our de-fib. It's not up for negotiations, and there are certain things only the crew are allowed to do, same as we carry medication only doctors can administer.

I've had a medical incident where we called for a doctor, she showed us id and proof (to make sure she wasn't a doc of philosophy or something), and she then caused such a panic for the casualty that we had to send her away again and deal with it ourselves. This, of course, is rare, but does happen.

I'd recommend for you to take your seat, sit back and enjoy the ride. If you're needed, there'll be a call for a doctor. If you see the crew struggling with a medi case and haven't made a pa for a doc, then feel free to offer your help, although don't be surprised to be turned down. We're not being rude, it's just that we have our way of dealing with things.

I know I'm rambling but I hope some of this makes sense.

[obgraham]

If you see the crew struggling with a medi case and haven't made a pa for a doc, then feel free to offer your help, although don't be surprised to be turned down. We're not being rude, it's just that we have our way of dealing with things. I actually agree with your advice to the would-be-travelling doc, Glamgirl, but it's the rest of your comment that astounds me. Are you saying that if you were dealing with a cardiac problem and had a calm experienced cardiologist next to you, you'd tell him to "sit down and let me follow my procedures"?
Unfortunately, having been told similarly by EMT staff once when I offered some help, I believe you are not alone.
Seems to me the goal should be to marshall what resources you have to do the best thing for the victim. And yes, if that means sending the panicky doc off, so be it.

[Captb747]

Taking all comments onboard, I think it would be a nice idea for any Doctor to make himself known on boarding, and this is my reason why.......

Pax falls ill.....Crew know exactly where a doctor is sitting so do not need to make a PA and get other pax agitated, nervous or anything else, they can have a quiet word in said Doctors ear and no commotion is caused.
(not that I am saying commotion is caused, just another take on the matter!!):ok:

[slim_slag]

One suspects you are a recent addition to the club captb747.

Get on the plane, sit down and keep quiet. If they need a doc they will PA. Wait and see if anybody else gets up, if they do then remain sitting down and be quiet. Hopefully somebody else will get up first and you can continue enjoying your G&T. If they don't then I guess you should wander over and see if you can help, but remember the other older and wiser docs on board are probably waiting for somebody else to get up first :) The last thing you need is having to spend the rest of the flight sitting next to somebody who is anxious because it's bumpy out.

google medlink and don't worry about things too much.

I share obgraham's amazement.

[SXB]

As a far paying pax as I have to say all this talk about sending doctors away is somewhat disturbing.

Should a doctor, or a nurse, be on board an aircraft then I would expect that the casualty be handed over to them, cabin crew don't have sufficient medical training to diagnose anything but the most obvious medical emergency. As any doctor will tell you the only condition which is fairly easy to diagnose is death. With regard to the comment referring to defib equipment, who handles this equipment is not important (as long as they are properly trained), it's the decision on whether to use it or not which is important.

Am I right in assuming that most airlines will imdemnify any medical professional from legal action ?

My understanding is that BA cabin crew receive medical training to a far higher level than the Locos. The first aid kit and medical kits carried by BA is also extremely comprehensive, carrying everything from a stethoscope to adrenaline, a lot of it designed for use by a doctor. Some of the Locos don't carry such comprehensive equipment. This isn't a pop at the locos, just a statement of fact.

[RevMan2]

Think this through logically...

A physician informs the crew on boarding of his/her presence on board, the purser doesn't think he/she is looking for an upgrade and notes availability and seat number.

There's a medical emergency, purser contacts physician (who - for the sake of argument - is recently qualified) and is blissfully unaware of a potential pool of specialists/consultants/surgeons with years of experience and specialist knowledge dispersed around the aircraft.

This is like hiring the very first applicant who fills the job requirement and telling the others to go home.

I don't do that in business and I wouldn't like to think it would happen in an infinitely more critical environment

[TightSlot]

Interesting thread.

First up, thanks to chejus for being kind enough to consider this action in support of the crew (and fellow passengers): Not all Doctors are of the same mind.

Personally, I don't feel that a Doctor should need to identify themselves on boarding - it's their flight/holiday too, and everybody is entitled to time 'off-duty'. As several people have already mentioned, if we need help we tend to PA for a doctor very quickly, and volunteers will be very welcome. It's worth noting that Murphy's Law will usually apply - if you need one they're not on board. That said, they have helped me many times - the most spectacular incident being when we had to perform CPR for just over 3 hours (no divert possible) with defib and all the bells and whistles, helped by a surgeon off duty: The airline sent the doctor a champagne hamper and a long thank you letter, and that Doctor gets my undying gratitude, even though the patient didn't make it in the end!

slim_slag mentioned Medlink (part of Medaire) (http://www.medaire.com/comm_air.asp): This is a medical service available to subscribing airlines. Contact is made via HF radio with a team of aviation specialised medical staff, and Medlink is, in most cases, the first port of call when a serious incident arises. Medlink personnel are aware of the medical training of the crew, and the available medical equipment on board: The are also familiar with airine operations and are therefore well placed to make a decision on a diversion. Medlink will sometimes advise that a PA for medical assistance be made on board. They are very good. Recently, I was dealing with a passenger with breathing difficulties: The Medlink advice was to descend to a lower flight level rather than to divert, and the results were miraculous. Their advice avoided the costs and inconvenience of a diversion, a resultant delay due to crew duty hours and the depletion below legal minimum of the aircraft cabin oxygen bottles.

There are rules about the use of a defib on board. The good news is that the device is usually fully automated, not the hand-on device with paddles that you may see on television. Once the aircraft device is connected, it analyses the heart beat patterns, advises if a shock is required, delivers the shock (when a human tells it to) and then continues to monitor the heart and deliver further shocks if required. A log is maintained by the machine and is available for medical staff when the patient is handed over. What I'm driving at here, is that although a Doctor may not use the device, he/she can easily monitor what is going on, and the device can be used by a relatively untrained medical person (i.e. the Cabin Crew) leaving the skilled person to do what they do best - make decisions.

Another piece of equipment available on board is a Doctors kit - this can only be opened and used by a certified (and verified) medical Doctor. Cabin Crew may not use the contents.

I cannot see circumstances under which I would send a trained medical person away from an incident, but there are circumstances where I would take their advice and filter it through my knowledge of the aviation circumstances. The Captain has the ultimate responsibility for the situation, and any other decision relating to the safe continuance of the flight. In order to reach a decision, he will in part rely on my assessment of the incident within the context of the cabin.

[WHBM]

It seems reasonable for BA to carry a larger kit than the low-costs because the latter can normally start an immediate descent to an alternate whereas BA have many sectors that will be hours away from ground support.

I am given to believe that airlines carry an insurance indemnity policy against any medical person who lends assistance on board being sued by the passenger they assist. Can someone confirm whether this is so ?

I don't like the idea either of the pax touting the purser on boarding about their medical background, this looks too much like Angling For An Upgrade, Version 8,283,348. It may also upset the next pax boarding who overhears it. It's far quicker and more accurate to ask if needed; on a large aircraft there will often be several ranging from nurses to specialists, they can then decide among themselves who is best placed to assist the particular situation.

[Saintsman]

I am an aircraft engineer, should I announce that on boarding or maybe I'm a lawyer or a travel agent.....

If the crew need help I'm sure they will ask.

[christep]

This is like hiring the very first applicant who fills the job requirement and telling the others to go home.
I don't do that in business and I wouldn't like to think it would happen in an infinitely more critical environmentAs a pax who has only just thought this through, I can only say - excellent point, well made.

[apaddyinuk]

The thing with BA is because we use MEDLINK it is policy that they be our first port of call and only if the situation becomes dire are we encouraged to PA for a doctor or nurse. Needless to say our M5 Medical kits do have a whole section which can only be used by medical professionals and although we are trained to know whats in it and what the various tools or for we are not trained to actually use them...thank god because im rather squimish not that it would stop me helping out in a real emergency!

So to answer your very veru relevant question Chejus...if you are flying BA you could indeed introduce yourself but you will only ever be called upon should the absolute worse occur! But sure Ill still pop you down a glass of bubbly for being polite and helpful!

[obgraham]

I agree with Slotty's comments completely.
The lawsuit issue is a red herring. Here in the Land Where Lawyers Rule, laws protect the docs in such circumstances. I wouldn't worry about the liability 7 miles above Libya.
I know it happens a lot, but I have moral objections to docs who won't stand up and offer assistance if they are qualified to. Society offered them the training, and the skill, and the cash, and they can't be bothered give a bit back. Disgusting.

[WHBM]

I know it happens a lot, but I have moral objections to docs who won't stand up and offer assistance if they are qualified to. Society offered them the training, and the skill, and the cash, and they can't be bothered give a bit back. Disgusting.
I've known lots of medical people over the years, in various countries (including the Land of the Lawyers) and I can honestly say there is not one who would ever think twice about offering their assistance wherever and whenever they see it is required. Most with experience have many such situations under their belt.

This included one surgeon and his wife stopping to assist a road accident and thus getting to the airport as pax late, describing the circumstances, transferring to the next flight, but being charged the full transfer fee for it. Perhaps aviation had better get its own procedures in place first.

[chejus]

Interesting comments guys. Some thoughts:

- Even if you know there is a doctor on board, you should still go for the PA because there may be someone more qualified than the one met in the first place.
- I do not believe doctors would look for an upgrade (most of the times). Recently in flyertalk.com there was a post informing that LH would credit extra miles to those that let the people at check-in know they are doctors. In my opinion this is disgusting and they want to sort of "pay" doctors with 5000-6000 miles! Ridiculous. See link here http://www.flyertalk.com/forum/showthread.php?t=607504&highlight=doctor
- In the end I will not let the cabin crew in advance because if I do, some may get irritated and that´s certainly not the idea at all. Let there be some problem and I´ll get up and help as I have always done.

Guys, thanks for your comments and opnions, this has turned out to be a great subject!:ok:

[Captb747]

Revman2,

You do raise a very good point however, even if a doctor is newly qualified, he IS still qualified none the less..........:\

[RevMan2]

Qte even if a doctor is newly qualified, he IS still qualified none the less End qte
Indeed, but if you have the choice between a gynecologist and a cardiac specialist and a patient with chest pains, it's a no brainer.
In fact, if you have more than one doctor, you've got automatic 2nd/3rd/4th opinions and a rapid peer selection of the lead operative will take place.

[Captb747]

Revman2..............

Point Taken.:)

[Glamgirl]

The reason I said about turning a doctor away, is that in our yearly re-current training we are told that our de-fib is not like the ones doctors use in hospitals, therefore it's only us who should use them. I know a de-fib isn't rocket science, but I'm doing as I'm told. Also, we are told about some doctors trying to take over the situation. As we have to be able to pass on info and details to Medlink, we need to be in charge of the situation.

So there's my reasoning behind my statement. Sorry if I caused confusion or offense. If I had a calm, and helpful doctor wanting to assist with a medical incident, I'd be really happy and relieved.

[Albert Driver]

Are you sure you really want to do this, Chejus?

You're on a flight from BA to London and you've informed the crew of your presence. During the first meal service you are politely asked if you would take a look at a passenger with chest pain. You examine the passenger to the best of your ability, given the limited medical equipment available. You decide there is no immediate danger but the passenger needs to be kept under observation. Meal service is now over and the senior cabin crew member thanks you for your assistance. He informs you he is now going to take his break and if the passenger gets any worse please would you let the Purser in First Class know. He now goes off to bed for five hours. London is still eleven hours away. In the eyes of the cabin crew you've volunteered to take over their problem, thank you very much. Even if you succeed in handing back the problem to another crew member are you going to be able to relax, let alone sleep, for the next eleven hours?

On the other hand, if you merely respond to a PA call for assistance the dynamics are quite different. You may be one of several responding medics on board, one of whom may be a specialist. If not, you have the option of allowing the crew to radio Medlink and merely comment on the advice received if you think it appropriate. Most importantly, you can give your own advice and then retire from the scene.

You could even manage to get nearly as much sleep as the crew undoubtedly will.

[TightSlot]

I think, Albert, that you're using the opportunity of this thread to take a few cheap snipes at cabin crew: Your view may, or may not, be valid, but I don't see that this thread is the appropriate venue for you to express it.

Please all remember that the original post on this thread was well-intentioned: We may agree, or disagree, butwe shouldn't lose sight of the fact that this is a person trying to help...

[slim_slag]

Glamgirl,

Would you take the wishes of your patient into consideration?

[Albert Driver]

How on earth did you come to that conclusion, Tightslot?

It is my experience that non-medics are always pleased to hand over a medical problem to someone medically qualified even if that qualification is only distantly relevant to the problem in hand. I have seen the dynamics at work both as a crew member and travelling as passenger with medically-qualified family members.

This casts no aspersions on cabin crew, who will always do their utmost in an emergency but who would naturally prefer someone more qualified took over.

Volunteer doctors can easily find themselves rather more hands-on than they intended. If that is what they wish then all well and good. Doctors who perhaps are not such regular travellers should think it through and decide what level of support they are willing to give.

Medical forums are full of threads about incidents encountered by doctors flying to holiday destinations or to conferences. Often it is apparent they have given their all and frequently they vent their disappointment at the scant acknowledgement by the airline afterwards. This is because in the airline's view the cabin crew do not need assistance, having all the training they are deemed to need.

My comment about the cabin crew simply affirms that they are legally required to take a specified rest period on a long sector and they will organise things so that they are able to do so. A volunteer doctor should do the same.

Not a shot at cabin crew, cheap or otherwise.

[HKPAX]

I'm not a doctor, nor an aviator for that matter, but my point is this: the passenger manifest (on CX anyway) records the fact that I am a XYZ grade pax on their frequent flyer scheme. Can't the fact that such pax is also a doctor (of medicine rather than theology though some say that may help in extremis) be logged to show on the manifest. I'd say medical doctors who quietly "volunteer" in this way should get some better deal anyway e.g. fewer points to get to next tier etc. Would this help?

[slim_slag]

The only place I've seen that sort of thing is on the back of the form you use to book a ticket on Indian Railways. I have a mate who actually got his passport reissued early to have 'Dr' taken off so he wasn't approached for help.

This thread has changed my mind about how these medical events are handled by airlines. If Glamgirl is correct and she is only doing as instructed by the airline then I am appalled. Kill the wrong person and the punitive damages would be immense, and quite rightly so.

I also think the limitation that only verified doctors can open the drug bag is wrong. I know of plenty of people in related trades who I would rather have working on me than a recently qualified doctor. If a flight nurse offered to help would they really be sent away? What about a firefighter who was trained to the high standards of paramedic as you find in the USA? Would a midwife be sent away in preference to a newly qualified doctor, who in quite a lot of places in the world might never have delivered a baby before?

Anyway, I am glad to see the BA medical kit (which is very well thought out, IMO) has a urinary catheter. Not sure I would wish urinary retention on anybody in mid atlantic. I am less keen on this being inserted by a member of cabin crew who quite understandably has never done this before. Nurses are well versed in this procedure, but it sounds like they would be sent away too.

[SXB]

I am less keen on this being inserted by a member of cabin crew who quite understandably has never done this before. Nurses are well versed in this procedure, but it sounds like they would be sent away too.

Yes, I'm with you on that SS :ok:

To be fair to Glamgirl she is more clear in her last post about the circumstances under which a Doctor's help would be welcome. Her comments regarding the defib probably just echo company SOPs and as I said in my last post the important thing is not whose using the device but who's making the decision.

As regards the use of the Doctor's medical kit on board BA I'm not sure about it's use by someone who isn't a Doctor, a quick look through the list of contents reveals some fairly lethal sounding drugs. Ok, we all saw John Travolta adminster adrenalin directly into Uma Therman's heart in Pulp Fiction though I'm not sure the procedure is as straightforward as it appeared.

[TightSlot]

Well Albert, it was the bit that went
You could even manage to get nearly as much sleep as the crew undoubtedly will.
But if I've been overly sensitive, then please accept my apologies.

Rest breaks on long sectors for Cabin Crew are not a legal requirement, but a local company agreement. Many airlines operating long sectors do not even have a crew rest area.
This is because in the airline's view the cabin crew do not need assistance, having all the training they are deemed to need.

I can only point out that this is not the policy of my employer, quite the reverse, in fact.

[gdiphil]

"Qte even if a doctor is newly qualified, he IS still qualified none the less End qte
Indeed, but if you have the choice between a gynecologist and a cardiac specialist and a patient with chest pains, it's a no brainer.
In fact, if you have more than one doctor, you've got automatic 2nd/3rd/4th opinions and a rapid peer selection of the lead operative will take place."
Which reminded me of an amusing (for me) medical emergency. I and a friend were on a Thai International flight BKK-LHR back in the late 1980's when it became apparent that a young lady pax in front of us in Y became very ill very quickly. So much so that the crew became visibly alarmed and put out a message for medically qualified people to make themselves known to the CC. Gales of laughter erupted from behind us and numerous people stood up gesticulating to the crew. It turned out there had been some major gynaecological conference in Bangkok. I felt very sorry for the patient. She didn't get a moments rest all trip, a long one as you know. Different doctors were constantly checking on her, I don't remember seeing the same one twice, although that is probably an exaggeration. It was also very amusing to see and hear the case conferencing going on. And of course seeing the "rapid peer selection" appearing. Every illness known to the profession seemed to be discussed. Clearly she was in good hands and survived the flight and indeed walked off it. I got the impression the docs were pleased to help out and alleviate the boredom of a long flight.

[Glamgirl]

Slim, you are entitled to your opinion of course, but some of your comments are uninformed to say the least.

I don't think you realise what my training involves. We're not just trained in CPR, but it includes a whole array of issues and medical conditions.

The doctor's side of the BA medical kit contains drugs etc that can only be administered by doctors. However, if Medlink tells us that a midwife, nurse or similar can do it, then we can allow them to administer. If Medlink tells me that I can administer something from the doctor's side, then I am LEGALLY covered for this. For the record, I cannot use the catheter, only a doctor.

This boils down to legalities. Simple. Am I going to let a guy who says he's an American fire man administer a drug? No. Not because I'm a control freak or not flexible, but in case he gets it wrong. Only crew and doctors are covered by the indemnity papers on the medical kit. Anyone else can get their behind sued. So that's why I may seem not flexible or a robot or whatever you want to call me.

It's difficult to give a general answer as to why a doctor should or shouldn't introduce themselves on a flight. It depends on the situation if a medical incident happens. It is assessed as and when it happens.

[slim_slag]

I don't think you realise what my training involves. We're not just trained in CPR, but it includes a whole array of issues and medical conditions.Well you got me there. What does your training involve with respect to the subject being discussed? How many hours specifically spent on the subject?

[SXB]

Quote:
Originally Posted by glamgirl
I don't think you realise what my training involves. We're not just trained in CPR, but it includes a whole array of issues and medical conditions.

Well you got me there. What does your training involve with respect to the subject being discussed? How many hours specifically spent on the subject?

The thing with medical training and laymen (or women) is that it's mostly theoretical. At the moment I work for a well known European organisation and they insist that I do four week residential medical training course every two years and a two week course every other year, because of the places I visit. Before that I worked for both the UN and the OSCE and they had similar policies for staff working in the 'Field' These courses are mainly based around major traumas which might be caused by anti-personnel mines, vehicle mines, gun shots and other explosive devices (I've worked in Kosovo, Chechnya, various parts of Bosnia including a year during the siege in Sarajevo, Nagorno Karabakh, N&S Ossetia and various other warzones) The aim of such courses is to be able to prolong someones life until they can be attended by professional medical care and transported to a suitable environment. Despite such training I'm fairly useless because I lack experience and have had to deal with serious situations only on a handful of occasions. If a Doctor happens to be around then you say 'thank god' and let him get on with it. Cabin crew should do the same.

With regard to medical staff who are not Doctors, their value should not be underestimated. Most 'medics' in warzones are not Doctors, again their job is to stabalize a patient ready for transportation to a suitable medical environment and these people are very good. An aircraft is not a warzone but the principal of preparing a patient for a suitable environment is the same.

Out of interest I'm also interested in the level of medical training given to Cabin Crew.

[rjtjrt]

2 points
1. All have to be prepared to defend our actions in a Coroner's Court if the worst happens.
2. What about rights of passenger - unwell pax who is semi conscious and hears a doctor nearby offer her/his services only to be told not needed. Said ill pax wants doctor involved and says so. No way for crew to defend in courts ignoring pax and sending doctor away.
Once again all have to be prepared to defend our actions in a Coroner's Court and blindly obeying company policy wil only get you so far if pax DIES

[slim_slag]

The above two posts are very good. I'm surprised a member of cabin crew should introduce the level of medical training they receive, one has always thought their expertise lies elsewhere. http://www.britishairwaysjobs.com/baweb1/?newms=info57The training covers everything from safety and equipment procedures on board to product knowledge, delivering excellent customer service, cultural awareness and assertiveness training. At the end of the five weeks, .... Nothing to do with medical training, but assertiveness is important enough to get a mention :)

You need to ask how you would like your mother treated if they were to collapse on the way to the toilet. I would expect, require even, a member of cabin crew to facilitate the provision of immediate care by anybody who claims they are able to provide it. Most cabin crew posting on here appear to have the right idea but it only takes one to really mess things up. What does worry me is the 'jobsworth' attitude that it's all due to legalities, and the suggestion that airline procedures are more important than the immediate provision of medical care. If a US firefighter EMT offered to treat an unconscious US citizen on a flight to the US, and the firefighter got turned away, I expect the lawyers would have a field day.

[flybywire]

Slim Slag, one clarification: Do not worry no cabin crew will insert a catheter as this is something that only a doctor/nurse can do as per our procedures.

I actually agree with your advice to the would-be-travelling doc, Glamgirl, but it's the rest of your comment that astounds me. Are you saying that if you were dealing with a cardiac problem and had a calm experienced cardiologist next to you, you'd tell him to "sit down and let me follow my procedures"?

Well Glamgirl is absolutely correct, obgraham.
A doctor, even a cardiologist can give support, can help with CPR if they wish (provided they do it correctly as there has been a case in our fleet when a medical person was doing the CPR the very old way and the cabin crew had to gently remind them what the international procedures for CPR were at the time!) but our defibrillator is off-limits for anybody else who is not a DEFIB trained member of the crew.

You might think that a cardiologist might do it better, but once you're on a plane at 33,000ft it's very rare for a cardiac arrest to resolve positively anyway, we try our best and I have talked to people who continued with CPR for much longer than the legal 30minutes because they didn't want to give up, however whether a cardiologist helps or not, believe me in such cases doesn't make a huge difference. It is good for the crew to know they have good support though.

As for the original question, I am always happy to know that there's a doctor on board so if I am on your flight do not hesitate to tell me. It definitely would have helped me to deal with a mid-atlantic premature birth which resulted in a stillbirth in 2003 when I would have paid to have had a professional midwife next to me, however even if a doctor doesn't introduce themselves upon boarding, it would be great if they offered their help when it's needed.
In fact I was talking to a man who in fact is a doctor and he was saying that he never responds to calls on board because he's scared of being sued by the passenger (or relatives) if something goes wrong. :uhoh: :{

[flybywire]

If a Doctor happens to be around then you say 'thank god' and let him get on with it. Cabin crew should do the same.

SXB to make things clear there are only 3 occasions when our company procedures require us to make a PA to request help from a doctor/nurse/paramedic and these are:

- IMMEDIATE life threatening situation like a suspected anaphylactic shock.

- IMPOSSIBILITY to contact MEDLINK (sometimes they are very busy and it might take them some time to answer our call).

- MEDLINK has received all the details for the case (we have a VERY extensive form where we record symptoms, history, observations etc) and ADVISES us to do so.

I have to admit I have called for a doctor in the past for some advice, as I cannot make a prognosis, and I have to say that the two people concerned offered help without trying to take over, which is the whole point, really.

Our procedures are aimed at keeping the casualty as comfortable and as safe as possible, solving immediate problems while our colleagues in the F/D get the aeroplane down as soon as possible.
As glamgirl and paddy have already explained we have some equipment that only medical personnel can use on the casualty but even then it should be done after a consultation with MedLink. It's not unusual for MedLink to ask to speak with the doctor on board if the situation requires and to agree on a course of action together. One exception is the AED which can only be used by trained company cabin crew.

As for how well trained the cabin crew are, well after 3 airlines I can say it depends who they work for. My 1st airline had excellent medical training (so much that myself and another 2 girls could deliver this teeny tiny baby on our own and prevented the mum from dying of blood loss) and my current airline has a very good training as well. My previous one....well it had good theory training but I won't comment on the practical aspect of it. All of them considered "legal" by the CAA but if (god forbid) I have to be ill on a plane I know which airline I hope I will be flying with at the time!!!;)

Take care and relax, you're in good hands :ok: and if anybody thinks that the procedures are not "good enough" please feel free to contact the airline to air your concerns.

[flybywire]

Nothing to do with medical training, but assertiveness is important enough to get a mention
You need to ask how you would like your mother treated if they were to collapse on the way to the toilet. I would expect, require even, a member of cabin crew to facilitate the provision of immediate care by anybody who claims they are able to provide it.

I can imagine that situation (and my mum did have a problem on board, and thank god she was flying with a very good airline, the crew were superb on that occasion.)

Assertiveness is needed in any situation on board an aircraft. Our medical training is very intense and covers a whole week of those 5+weeks.
Not enough to get you a degree in medicine, but if you're brightand not an airhead it is enough to teach you what the most common illnesses that happen on board are, what they involve, how to recognise them, what to do and what not to do. It gives you the tools to face at least those situation and makes you alert if something that you didn't expect actually happens. That, together with empathy, a caring approach and of course assertiveness and good organizational skills can save your bum in many situations.

I might not be a doctor, but I was there when a woman was going through the worst experience of her life and I was there to comfort and reassure her as well as try to do my best to deal with the case. Cabin crew (at least the crew that I know) have this attitude, and when things turn for the worse those are things that are equally important to make the passenger feel better.

Lately I have had a couple of bad experiences (issues about my health) where doctors were very knowledgeable but were so cold and detatched that I left the hospital in tears. I am not saying that all doctors are like that, far from the truth, I am only saying that where our medical knowledge finishes there are other qualities that complement it and as for all what I have seen and heard (many, many episodes in my airline in the last 2 years:rolleyes: ) no one so far has been disappointed/angry/has taken the airline to court.

Sorry it is a long post once again but this is something that involves me so personally that I couldn't stop myself from posting my thoughts.

FBW.

[Glamgirl]

Thank you FBW for managing to put into words what I tried to say. I didn't seem to get my point across, but your posts are excellent, thank you.

[obgraham]

I must say, FBW, that it is your attitude that still concerns me. You are convinced that company policies and procedures are what matters, come hell or high water.

What a professional should do, in an unexpected and unplanned situation, is to try and come up with the best plan for all concerned, using the resources at hand. Slavishly "following the book" may get you plenty of brownie points and even a promotion, but is it the right thing to do?

I picked the cardiology example because it is more common. Any doc worth his/her salt would pitch in, use what was needed, including the kit, the equipment, and the medlink folks, then work as a team to make the best of it. Who cares who straps on the AED, as long as it is done.
In my case, as an ob doc, I've responded to 2 inflite requests regarding pregnant passengers, neither was of consequence, but everyone was relieved by what I could tell them, including the patient herself (who conveniently seems left out of this thread!). Perhaps I could have helped you out in your situation. Perhaps you would not have allowed it.

I'm distressed by your attitude, but I'm not surprised.

I contrast that with the recent Continental case of the fatal incident for the pilot. The copilot moved to the left seat, flew the plane, engaged the help of a PPL onboard to help him with the checklists, and professionally handled the situation. I doubt whether everything he did was in the SOP.

[flybywire]

Obgraham, with due respect, in any organization you DO need policies and regulations. Can you only imagine what would happen if everybody did whatever they fancied or felt appropriate anytime, all the time?!

This is a job where, if you consider that we never work with the same people twice in a row, we need set guidelines to follow so that we can easily work with whoever happens to be on our flight that day! Regulations make this possible, as we all know what to do, when to do it and we know we can count on our colleague as they have been trained the exact same way! Teamwork is the answer to many questions in this job and that would be impossible to achieve without set guidelines.

Of course there are situations when your own initiative is essential, but it's impossible to think of doing this job with no guidelines, and just follow "the passenger's desires".

Besides, if the passenger is well enough to tell me what he/she needs I am there to listen and do my best, but if for example I think that they are clearly showing signs of hyperglicaemia and are refusing a glass of water be sure I will do my utmost to convince them to have a few sips as I know that THAT is the best thing to do at that time and place before things take a turn for the worst.

Also remember that we have a duty of care not only for the person involved but for the rest of the passengers too, and our point of view as crew member can be slightly different from the one of a passenger.

Having said that, I am sorry you do not like my attitude (which as I have said before saved a woman's life while flying over the ocean) or the attitude of the other crew who have more or less said the same things as me. So please feel free to contact my airline to air your concerns.
You might have the answer for a new method which might save many more lives, why not.

[flybywire]

Perhaps I could have helped you out in your situation. Perhaps you would not have allowed it.

If you re-read my post I said I would have paid to have had a midwife with me that day. However there were no doctors or midwives on board and the result wouldn't have changed anyway, as at 24weeks gestation you need special equipment to keep a baby alive, and an aeroplane just isn't equipped (just like many hospitals in this part of the world!).

Baby was delivered and while my colleague cleared baby's airways, tried to keep baby warm and make her breathe I was looking after the mum who was losing lots of blood. Thank god we were carrying some specific drugs to stop post-partum hemorrage. We did our best while our colleagues at the front got the aircraft on the ground as quickly as possible (we were operating an ETOPS flight).
If you had been on board, you would have been of great support for me but I doubt you would have saved that baby's life anyway, simply because the aircaft is not the best place to have a baby at 24 weeks!!

Please do not misunderstand me, I do appreciate what knowledge it takes to be a good medical professional (3 in my family are paediatricians and gynaecologists/obstetricians and I have seen how hard they studied to get there) however the training myself and my other colleagues went through was good enough to help us in such a dramatic situation, which we never thought we would face in our lives.

I will always ask for help if I need it and even if the passenger feels better doing it, but I know what I can do and what I cannot do. I know what I must do and what I shouldn't. In my previous airline I was allowed to insert an Airway, now, despite I know how to do it, I wouldn't do it as in this airline is something I am not allowed to do.
You might not like this way of thinking, but I do believe that it wasn't an idiot who came up with our medical guidelines (which by the way keep evolving) and I am sure they were and are thought with our passenger's best interets at heart.

In my case, as an ob doc, I've responded to 2 inflite requests regarding pregnant passengers, neither was of consequence, but everyone was relieved by what I could tell them, including the patient herself

As a 1st timer and 8 months along myself I am not surprised at all! Pregnant ladies tend to panic about anything (well, at least that is me) and a reassuring word from an obstetrician who knows what they're talking about is always welcome. This pregnancy thing is such a miracle and a mystery that even the most rational of people can find it difficult to keep totally "sane" for 9 months ;) :E

Have a good evening

FBW:)

[slim_slag]

In my previous airline I was allowed to insert an Airway, now, despite I know how to do it, I wouldn't do it as in this airline is something I am not allowed to do.Securing the airway is the first thing you should be doing. Refusing to do so because of airline rules when you claim you know how to is absolutely appalling.

[Glamgirl]

Slim, we are NOT allowed to insert an "airway". This is in case it goes wrong and we get our behinds sued. If you know anything about first aid at all, you'll know that you do not need to insert an "airway" to keep the airway open/clear. Now will you please stop saying our attitudes are apalling, that we don't know what we're talking about and that pretty much anyone but cabin crew know how to deal with a medical incident better. I wonder if you could enlighten me as to what you do for a living?

[obgraham]

Guidelines and procedures are fine, and indeed, necessary. What I, and I think Slim are pointing out, is that there comes a time to throw the guideline out and do what needs to be done.

And with that, I think I'm done here.

[wiggy]

...no you're not done yet, FWIW, drifting back to your comments about the Continental fatality ( Flight Deck )and your comment about there not being an SOP for it - in most airlines there is an SOP for exactly that sort of incident.

Back to the medical issue...I think you've got the impression that the "Rules of Engagement", are completly inflexible - they are not - Cabin Crew are not expected to act beyond the limits of their training, and if time permits they should, if necessary, contact the Company's Medical advisors by satcom. However they are allowed to call for onboard assistance ( " anybody here ....") if there is a " a life-threatening emergency, when immediate help is needed (my italics)", when contact with the medical advisors on the ground cannot be made or if the medical outfit themselves suggest finding a Doctor.

So you see, we have a SOP...and it's flexible. Does that reassure you?

[6chimes]

At the airline i work for we have a neat piece of kit called tempus, its a portable box that takes blood pressure, pulse, O2 saturation, body temp, breathing rate, and even ECG. It has a camera for taking pics of the patient and it all gets downloaded live to medlink. There is an earpiece and mic so we talk live to a doctor. I have used it several times with pax and never needed to call for a medic on those occasions. Its the best piece of equipment i have ever used on an a/c.

6

[Skunkie]

As Revmen2 correctly said, a doctor usually introduces him/herself on boarding.
In 15 years of flying as purser, when I needed a medic, no one answered....two deads on board :suspect:
Usually medics fly with their ID to avoid suspects from cabin crew in the unluckily case they are needed.
Not all planes in the world have the defibrillator, and too many cabin crews are not so well trained on how to use them, so I'd prefer the advices and assistance of a medic -at least he/she knows something about anatomy and passenger's reaction ;)
Expecially on long flights!
Don't know much about their deontolagical codes, so be sure of what really you can do (i.e. cabin crews are not allowed to give some medications that could save a life or stabilize the injured up to the first stopover or diversion.
I don't mean that all docs must act as heros, if they don't feel like, but they could be of great help.

Skunkie

[flybywire]

Securing the airway is the first thing you should be doing. Refusing to do so because of airline rules when you claim you know how to is absolutely appalling.

Slim slag, after this comment I think that you do not know what an Airway (capital A, piece of equipment) in fact is and what inserting it involves. I would research my facts before accusing people. Glamgirl explained things better than me.

[slim_slag]

I fail to see how you draw that conclusion from my post, but if you say so, flybywire, if you say so.