I am sure many doctors who travel by air have over the course of their careers responded to a plea by cabin staff on an airplane to help with a health problem in a fellow traveler. This happened to me on a Lufthansa flight I just deplaned from. I was flying from Delhi to Boston connecting in Munich.
When I responded to staff that I am a doctor I was led to a galley near the rear of the plane where a fellow passenger was lying unresponsive with a group of people around him. I soon discovered that along with me, a German psychiatrist, an Indian-American pathologist, and an Indian-American pediatric oncologist plus a German health care worker had also just reached the scene.
The man was German, heavy set, and in his 50's. He was breathing, not sweaty, but also not responding. We quickly started evaluating the man. He was breathing at a normal rate, his carotid pulse was strong and he was not tachycardic. His systolic blood pressure was in the 90s.
The pursar came put to us to ask to seek guidance on what he should advise the captain - land the plane or continue onto Munich one-hour fifty minutes away? Since the man seemed hemodynamically stable we decided we needed more information. In the mean-time we laid him on his side and administered oxygen. We asked cabin staff to seek out fellow passengers to see if he had been complaining prior to passing out; we asked them to look into his hand baggage for clues on his medical history and his medications.
He was traveling alone. He seemed to be behaving a bit oddly one passenger told us. No-one told us that he had complained of chest pain or headache or weakness. There didn't seem to be a history of excessive alcohol intake.
The man himself suddenly arched his back and became stiff. It looked like a seizure. The cabin staff came back with a pouch in with there was an international epilepsy certification. We had the diagnosis - a tonic clonic seizure. We looked through the emergency equipment and located the intubation bag just in case and we identified diazepam and a syringe and needle to administer it.
Remarkably, after 10 minutes of observing him he came around. He was able to talk in slow broken sentences and told us that he had taken his epilepsy medication - which appeared to be phenytoin - and that unmarked pill bottle in his pocket contained one days dose. We administered his oral phenytoin with some water and recommended that to the Lufthansa cabin staff that they move him upto business class in the seat next to me so that I could keep an eye on him. The rest of the flight was uneventful and the man disembarked uneventfully.
The Lufthansa cabin staff were superb - calm, prepared and very cooperative. But the bottom-line was that a motley group of doctors - a psychiatrist, a nephrologist, a pediatric oncologist and a pathologist with a health worker combined in a team effort to stabilize this man.
Isn't that what doctoring is all about? Working as a team?
When I responded to staff that I am a doctor I was led to a galley near the rear of the plane where a fellow passenger was lying unresponsive with a group of people around him. I soon discovered that along with me, a German psychiatrist, an Indian-American pathologist, and an Indian-American pediatric oncologist plus a German health care worker had also just reached the scene.
The man was German, heavy set, and in his 50's. He was breathing, not sweaty, but also not responding. We quickly started evaluating the man. He was breathing at a normal rate, his carotid pulse was strong and he was not tachycardic. His systolic blood pressure was in the 90s.
The pursar came put to us to ask to seek guidance on what he should advise the captain - land the plane or continue onto Munich one-hour fifty minutes away? Since the man seemed hemodynamically stable we decided we needed more information. In the mean-time we laid him on his side and administered oxygen. We asked cabin staff to seek out fellow passengers to see if he had been complaining prior to passing out; we asked them to look into his hand baggage for clues on his medical history and his medications.
He was traveling alone. He seemed to be behaving a bit oddly one passenger told us. No-one told us that he had complained of chest pain or headache or weakness. There didn't seem to be a history of excessive alcohol intake.
The man himself suddenly arched his back and became stiff. It looked like a seizure. The cabin staff came back with a pouch in with there was an international epilepsy certification. We had the diagnosis - a tonic clonic seizure. We looked through the emergency equipment and located the intubation bag just in case and we identified diazepam and a syringe and needle to administer it.
Remarkably, after 10 minutes of observing him he came around. He was able to talk in slow broken sentences and told us that he had taken his epilepsy medication - which appeared to be phenytoin - and that unmarked pill bottle in his pocket contained one days dose. We administered his oral phenytoin with some water and recommended that to the Lufthansa cabin staff that they move him upto business class in the seat next to me so that I could keep an eye on him. The rest of the flight was uneventful and the man disembarked uneventfully.
The Lufthansa cabin staff were superb - calm, prepared and very cooperative. But the bottom-line was that a motley group of doctors - a psychiatrist, a nephrologist, a pediatric oncologist and a pathologist with a health worker combined in a team effort to stabilize this man.
Isn't that what doctoring is all about? Working as a team?
