The lack of a central registry of in-flight medical emergencies makes it difficult to conduct epidemiological studies that would improve the care of passengers who become ill while flying, writes Dr Keith Ruskin in a commentary for Critical Care. The commentary accompanies a recent research article from Sand et al. in which the authors studied data collected from two European airlines over 5 years. The research also featured recently on BBC News.

Commentary   
In-flight medical emergencies: time for a registry?
Keith J Ruskin
Critical Care 2009, 13:121 (25 February 2009)
[Abstract] [Full text] [PDF]

Research
   
Surgical and medical emergencies on board European aircraft: a retrospective study of 10189 cases
Michael Sand, Falk-Georges Bechara, Daniel Sand, Benno Mann
Critical Care 2009, 13:R3 (20 January 2009)
[Abstract] [Full text] [PDF]

Of the 32 airlines approached to take part in the study, 27 did not have the data available, one had unsuitable data and two refused to take part due to company policy. The study found fainting to be the most frequently occurring medical condition, followed by stomach upsets and heart conditions; however the lack of data means it is difficult to make strong recommendations based on the findings.

As medical emergencies on board flights are usually dealt with by volunteer medical personnel Dr Ruskin highlights the importance that physicians understand the physiological changes that occur during flight and adjust their care accordingly. Epidemiological studies will also help to identify patients who are most likely to become ill and therefore enable the development of training materials for physicians, guidelines for emergency medical kit provision and aid ‘fitness to fly’ evaluations.

An observation noted by Sand et al. was that not all airlines carried defibrillators as part of their medical kit, despite cardiac conditions being the third most commonly occurring emergency in their study. Dr Ruskin comments that regulations governing the provision of medical kit onboard aircraft vary outside the USA, and equipment may be sparse, particularly on low-cost ‘no-frills’ airlines.

All research published in Critical Care is open access. Commentaries require a subscription for access, but if you do not currently have a subscription to the journal, you can register for a free 30-day trial.

Philippa Locke
Assistant Editor – Critical Care