Emergency(Medical) & First aid kit

[Lolegas]

Ladies and Gentelmens ! How do you think , what things and medicaments should be (or must be) inside in First aid and Emergency kits? Maybe somebody have some examples of that kit's complectation? Or some idea?

Thanks for everybody!

My E- mail:[email protected] ::rolleyes: :confused:

[QDMQDMQDM]

Depends entirely what it's for, lolegas. Can you give us some idea?

QDM

[Lolegas]

For the charter plane carryng up to120 passengers , flt time about 4-5 hours.:p

[takenthe5thamendment]

I did a quick search and found that BA use this kit (http://www.britishairways.com/health/docs/during/Aircraft_Medical_Kit.pdf) which seems extremely good and able to cater for a multitude of medical emergencies........ only problem is - it doesn't come with a Doctor or Nurse.
But, if the price is right, I COULD oblige :)

[QDMQDMQDM]

Good kit. Very comprehensive.

A friend of mine had to suggest to the captain to divert a BA flight from Singapore to London into Bahrain when an elderly passenger started fitting over the Gulf. He had one fit and they thought they could carry on, but then he had another and another and so on. Expensive business for the airline.

QDM

[Lost_luggage34]

I just hope to God that the CAA minimum medical kit requirements have been beefed up on what was required some years back.

My father, as a Doctor, has had to deal with several medical emergencies on flights over the years. He was particularly distressed about one particular incident because it resulted in a fatality. It can't be proved, but it is likely that this was down to lack of suction equipment in the medical kit. The kit was within CAA requirements.

He made noises to all the relevant authorities at the time and was thanked for his contribution. What came of it I know not. He was lined up for a piece on GMTV. However, as they put it - 'it was too much of a hot potato'. I am sure in these days of sensationlist journalism they would make a meal out of such a matter today.

I was able to provide details of the BA kit at the time, which did carry such a device, above and beyond the CAA requirements. I am sure this is the case for other carriers too.

[gingernut]

Lolegas, you may find that a call of "is there a doctor on board" may fall on deaf ears, as no organisation appears to offer to indemnify health professionals acting on board aircraft.

A sad fact of the times I'm afraid, but we all think of the adverts with the smarmy guy claiming "where there's blame there's a claim !!"

Our professional bodies are (unofficially) advising us to keep quiet in the event of an incident mid flight, although we may be guided by our moral fibre (I can't spell consciounsse), to act otherwise !

Sad but true.

[takenthe5thamendment]

As a nurse, our governing body state, within our Code Of Conduct, that:

In an emergency, in or outside the work setting, you have a professional duty to provide care.
The care provided would be judged against what could reasonably be expected from someone with your knowledge, skills and abilities when placed in those particular circumstances.

And morally, never mind professionally, surely we HAVE to provide help, sure as eggs are eggs, I certainly couldn’t sit back and keep quiet if someone needed medical assistance.

So the answer is...............call for a nurse:p

[gingernut]

So the NMC will indemnify you ?

I don't think so.

The RCN ? I don't think so.

Your employers ? I don't think so.

Wake up girl !

The airlines ? ha ha ha !

[Remmington]

Nice to know that any potential hi-jacker need not bother to risk capture bringing his own "weapons" on board with all that he needs is in the BA kit, no doubt stored with big "find me here" sticker.

[DX Wombat]

Gingernut, as you well know that is a directive from the UKCC (can't remember at the moment what the new name is) that we have a duty to help even when off duty. It is called being stuck between a rock and a hard place. You may be damned if you do help and most certainly will be if you don't and it is dicovered that you were present at the incident. The airlines need to think hard about covering those who do give help. There is a very good In Flight Nursing course available but it is expensive (just about a month's salary when travel and accommodation is taken into account) and my employer is insisting that I do it in my own time and at my own expense. I am prepared to do it as I travel in the region of 48 - 72,000 miles a year and want to be as fully up to date as possible both for my own sake and that of anyone I may need to help. I agree with 5th, we have to help to the best of our ability.

[takenthe5thamendment]

gingernut -

Further to your remarks I contacted the Nursing and Midwifery Council to ask the question ‘ If I was on board an aircraft and someone was taken ill, what would my role be regarding ‘Duty of Care?’
Their reply is as follows

‘There may be issues around whose soil one is on at the time but as this would be deemed to be an emergency the following should assist you.

Clause 8.5 NMC Code of professional conduct (April 2002)

8 As a registered nurse or midwife, you must act to identify and minimise the risk to patients and clients

8.5 In an emergency, in or outside the work setting, you have a professional duty to provide care. The care provided would be judged against what could reasonably be expected from someone with your knowledge, skills and abilities when placed in those particular circumstances.

Many registrants have expressed concern regarding this clause and consider that it is something new. This is not the case, the UKCC Code of professional conduct (June 1992) made the implicit statement, within the overarching tenets of the code, that:

Each registered nurse, midwife and health visitor shall act, at all times, in such a manner as to:

safeguard and promote the interests of individual patients and clients;

serve the interests of society;

justify public trust and confidence and

uphold and enhance the good standing and reputation of the professions.

The updated version, in response to many requests for clarity on the matter from registrants has made the statement explicit. What this means for you is that in a situation where a registrant perhaps comes upon an accident in the street at any time, the registrant does not have a legal duty to stop and care for the injured person. But if she/he does, she/he then takes on a legal duty to care for the person properly. In these circumstances, it is reasonable to expect her/him to care for the person to the best of her/his skill and knowledge.
Although the registrant has no legal duty to stop and give care in this example, they do have a professional duty.
The Code of Professional Conduct places a professional duty upon her/him at all times.
However, in this situation it could be reasonable to expect the nurse to do no more than comfort and support the injured person and ensure that relevantly qualified and competent professionals are called to deal properly with the situation in hand.

It is most unlikely that any registrant who can justify that they have acted in the best interest of the patient and client and within the limitations of their skills and knowledge, even if that meant that no action was taken, would be called to answer for their actions by the NMC.

Registrants are accountable not only for their actions but equally importantly for their omissions.
Whatever the registrant chose to do she/he would have to be able to justify why they took, or indeed didn't take, should they be called to answer for them.

Registrants must also be aware that personal acts undertaken outside of the workplace and off duty time can have an impact upon that registrant's ability to practice. For example all criminal convictions are reported directly by the courts to the NMC Professional Conduct Div. A decision is made from there as to whether this would have the potential for removal from the Register in that an act undertaken by a registrant is not in line with public protection and does not uphold the good standing and reputation of the professions.’’

So, as you can see, we, as nurses DO HAVE a professional responsibility at all times….and doctors don’t??

It’s a sad state of affairs if a doctor will sit there and do nothing when someone needs medical assistance because they fear litigation – I wonder what advice the MDU actually gives their members in this matter…….. Our professional bodies are (unofficially) advising us to keep quiet in the event of an incident mid flight,

I'm not talking about indemnity here - I'm talking about acting in a responsible professional manner.
The reason I joined the profession is because I care about others, as I’m sure you did – so can I ask you - Is it really ok to do nothing thereby NOT acting in the interest of the patient and NOT 'upholding the good standing and reputation' of one's profession?

[gingernut]

Dx and takethe5th, thank you for enlightning me with your informative reply.

Dx, as far as I know, the UKCC has been disbanded, and the public is now protected by the new Nursing & Midwifery Council.

You may recall that the UKCC was charged with protecting the public interests, although it did seem to lose quite a bit of credibility in the early and mid nineties. Didn't they let a rapist back on the register ? Hadn't the guy been convicted of raping several patients with mental health problems ? I think that he was reinstated as being fit to practice after a couple of years.

So the UKCC changed its name to the NMC. (Like Windscale did. -same s"*t, different hat).

Takethe5th, thank you for reminding me about my duty of care. As you rightly state, nurses have a duty of care at all times, and, as you point out, it is a sad day when doctors (?and nurses), are prevented from acting as they feel they should, because of the fear of litigation.

Unfortunately, your reply does not really answer my original point. It is all very well the NMC stating that they won't hold be professionally culprible, but they won't be the ones suing me.

I'm heartened that you can find it so easy to seperate professional responsibility from professional indemnity, but unfortunately living and working and flying in the real world (I left the cosy world of secondary care several years ago), makes it difficult for me to seperate the two.

So my question still stands, who would indemnify me if an airliner passenger suffered resultant damage because of my negligent actions ?






PS would I perform first aid if needed.....of course I would, but I'd let some other fool come rushing forward shouting "Its ok I'm a nurse !"

[QDMQDMQDM]

I just phoned the Medical Defence Union which insures me. Members (i.e. doctors) are covered for good samaritan acts worldwide (even the USA!), even if their membership is temporarily dormant.

QDM

[Circuit Basher]

QDM cubed - so does that mean I'm safe to fly commerical again??!! ;) :D

[Lolegas]

Thanks for all of your! You are really fantastic and helpful person!

[gingernut]

Just a post script re. the position of the MDU/RCN.

They offer worldwide protection, on a discretionary basis for acts of negligence by their members when acting as good samaritans.

The discretionary cover is indeed worldwide, but is depends on approval by the management board.

I'm not sure how this works in practice, and the risk management dept. were unable to discuss individual cases.

Interestingly, worldwide discretionary cover is only extended to individual paying members, and individuals who are part of a "group" scheme, eg practice nurses, are not covered for good samaritan acts, outside of work.

The RCN claim to extend their cover to good samaritan acts performed outside of work.

I can't be right all the time !

[takenthe5thamendment]

That's good news gingernut.
Thanks for the info.

Pleased to have been of assistance Lolegas,
Best wishes to you :)

[Sick Squid]

The BA Medical kit mentioned earlier (formerly, and still known to crew as the M5 kit) has an indemnity form within it. BA will indemnify any medical professional who acts on board their aircraft.. can't speak for other airlines, which obviously doesn't mean to imply no-one else does. I think you will find amongst the larger carriers this is the norm. If I'd thought, I could have looked for the form, as had the kit open last trip (buccastem).. will make a point next time.

Also several major airlines have contracts with medical advice agencies (Medlink in Phoenix being the one I am familiar with.) Contact can be made by Satellite phone if fitted, HF radio, or ACARS (SMS-type datalink.) Have used this service in anger twice and found it invaluable where there was no on the spot medical personnel. Crew are trained to note basic signs and symptoms, and guided by the use of a pro-forma; information is then passed to the Doctors who are aware of aircraft position, route and destination as well as the nature of any specialist hospital units along the intended route.

Indeed, the value can come not only in advising of the best diversion options, and urgency of the situation, but also in sometimes preventing an unnescessary diversion where we as flight crew may have been inclined to err too conservatively based on lack of relevant information.

[Dangerous_Dave]

In my experience of flying (cabin crew for 15 years) the help that we ever got from doctors was pitiful. Most of the medication that is needed routinely on a flight is able to be administered by the cabin crew. If there is something more immediate then we used the radio to contact Medlink, and they advised us whether we needed to have a doctor or not. Usually they are not needed.

Now I work in the medical field (as a paramedic) the medical training that the cabin crew receives is of a high standard, and if the cabin crew are confident, you highly paid, arrogant doctors are not really needed.

Also British Airways carries a Samaritans Indemnity for the very rare occasion that someone does help.

[flapsforty]

DD, not to pick a fight, but to balance the view a bit.
I've been an FA for longer than I care to admit, and my experience with MDs is not like yours.

In the medical emergencies I have been involved in on board, medical personel has invariably shown a willingness to help that was above and beyond.
And in most of the serious cases, the outcome for the passenger involved could have been very different with only FAs to provide the care.

You know what p!sses me off most about getting doctors to attend on board?
The way they are subsequently treated by my company! Maybe other companies have a good system for it, but with us it's a thousand thank yous from the CC, a bottle of bubbly and bye bye. :(
Highly embarassing that, and it's the only thing that sometimes makes me hesitate to make that PA call.

I'm deeply grateful to all doctors who are willing to step up to the plate when they are not on duty. And impressed by their ability to improvise.
Dave, have you ever considered that arrogance can be a lot like beauty?
Mainly in the eye of the beholder? ;)

[slim_slag]

Flaps, methinks you have hit the nail on the head. Doctors know enough about things to improvise.

My dangerous friend, I see you are from Brighton. You will no doubt have heard of the great Douglas Chamberlain. He was basically the first arrogant doctor in the UK to stick his neck out (and he was not very popular at the time for doing so) and let paramedics like you run around in your green uniforms saving lives which would otherwise have been lost. Of course they were still just ambulance drivers then, but a good bunch, and very keen to expand their skills. Dr Chamberlain even let - nay encouraged, or required - you to come on our business wardrounds, and you learned how to do as you were told and follow procedures, for that was basically all you were qualified to do.

Every now and then the paramedic would cock up because he failed to follow procedures set out by the arrogant ones. I remember one lad in particular. This paramedic had noticed that if you give atropine, the heart speeds up. If you give diamorph, the heart slows down. He probably didn't know why, but he knew it happened all the same. So one day he failed to follow the procedures set out by some arrogant doctor and stuck somebody with atropine who didn't really need it. Heart rate went through the roof. What's a boy to do? Well, boy wonder decided he would squirt a large bolus of diamorph in, and slow the heart down it did. Quite a lot in fact, and the respiratory rate too.

Fortunately the paramedic got the patient to A&E in time, and the arrogant doc who had heard of naloxone saved the day. The paramedic didn't even know what naloxone was, and why should he? He was only supposed to follow procedures, which he spectacularly failed to do.

Anyway, we all had a laugh about it later, but that paramedic was never to be seen on the coronary care unit again. He is probably still bussing old dears to their day care centre.

Great people paramedics, the do a lot of good, but if you are going to think out of the box, you really need to apply to med school first. One is starting up in Brighton I hear, and it's not as hard as most people think :)

I was on a flight the other week where some old guy collapsed on the way to the toilet. The cabin crew were quite frankly useless, I was amazed. But like most people, he got better on his own. That's probably why doctors are not needed on flights. But when somebody is truly ill, you unfortunately really need a doctor or nurse to make that kind of evaluation.

Flaps, the previous time to that when I got up to help, the CC took one look at me and told me to sit down! Too much booze in the lounge had left me the worse for wear, I was sicker than the patient :D

[Dangerous_Dave]

I am not here to enter into a discussion of paramedics vrs. hospital staff. This is not the place, or the time, Slim. A doctor has at least 5 years of medical school, where as paramedics have 6 months classroom training over 3 years. Your story, Slim while making interesting reading, is not entirely true. Yes the paramedic did make a lot of mistakes, but there again all of us have done at some time in our lives. The person in question was sacked. I realise that people only think that we are glorified white van drivers, but actually had to also attend 1 month of advanced driving instruction. Actually even the smallest, most petite female ambulance staff would be a safer/faster driver than 99% of men who haven't gone through the training. It is worth doing.

Everyone has anecdotes, and stories that will back up their own point of view. As you can see in almost every thread that there is anecdote, after anecdote. If you want, I could reel off a list of anecdotes about how come I feel doctors are overpaid, and arrogant. I am sure that people might of had different experiences than mine.

I will just rely one such anecdote. While flying for Rod Eddington,one of my crew came to me and told me about a pax who was in a lot of distress. After hearing the crew, talking to the pax and his family, and also speaking to Medlink on the radio, it was requested that we PA for a Doctor, in order to administer drugs from the M5 medical kit that are IV only. After the call went out, I got a call from my purser in Club World saying that there was a doctor in her cabin, but the doctor said something to the effect that he would go and look at the pax in distress but only after he had finished his lunch. (The end result was there was another MD on board, and after seeing the pax we were diverted for a medical emergency, and the pax was in an ambulance on the ground almost before the other doctor would have finished his steak, and cheeseboard.)

The whole point of what I was trying to say was that the training that cabin crew get (at the airlines I worked for at least) is a high standard. The crew only need a little confidence and they would then be able to handle a whole range of situations with ease. It is only because the medical situations do not happen often and the crew do not get much practice.

I don't mean to upset anyone, and yes I do know Mr. Chamberlain, and consider him a friend.