Seems really straight forward. No aisle seats for children and planes should carry one good stethoscope (they have horrible ones), albuterol inhaler, ibuprofen, benadryl, AED, and possibly an antiseizure med. Or they could just carry a doctor who carries all of those things. I would happily volunteer!
1
How much you wanna bet that the people in the room who decided to only store adult-sized medical equipment on airplanes were all men.
112
@Thomas
I do agree. But I have a differing take. I watched a documentary with American Airlines, have been to their training facility in Dallas a few times (although I was not there for that) and spoke to many differing employess. Airlines are extremely concerned with weight, so each item they approve the weight has to pay for itself and be signed off on. I can see a non emergency medical person allowing items to be cut from EMT kit to conserve weight and it being signed off on by management. Weight really is that big of deal for Airlines.
With that said, and reading through the comments. I am disturbed by the reports of expired medical kits, empty oxygen cannisters, etc. This should be routine mainteance, just as checking their fire suppresion system is.
I also wonder if they are carrying AEDs. I believe they are worth their weight.
20
@it wasn't me
This reminded me of the story of male NASA scientists thinking Sally Ride needed 100 tampons for a week in space!
16
I would rather bet that the people who made that decision were not accustomed to dealing with sick children. It is easy to fall into the trap of blaming behaviours on gender bias when, in fact, the world is changing. Many men take equal responsibility for child care. There are children with two daddies for parents. Doctors, nurses and medics can be men. Some men even read the NYT.
12
We chose to avoid flying with our daughter until she was three and the trip was to Disney. Ideally, infants wouldn't be on a plane but that isn't possible for every family. However, in my opinion, babies should be required to have their own seat for their safety. It would be helpful if airlines could provide car seats so passengers wouldn't have to bring them. It could be an inexpensive courtesy that might encourage more passengers to choose buying a seat for infants.
7
I am incredibly grateful to the physician and paramedic who responded when my daughter suddenly fainted on a nonstop flight from New York to California. She had never fainted before and has no serious illnesses. We were incredibly lucky they were there.
Thank you to all the medical professionals who have responded to the call during flights.
21
A child isn't going to get sick on an airplane, unless it was already sick or ill.
Babies shouldn't be flying anyway. At least not until six months old.
5
@MPA - Maybe not, but sometimes flying with very young babies is unavoidable. Everyone has different circumstances and not everyone can drive across the country with their infant or get a sitter for days on end while they go away out of necessity for a family event, holiday, or an issue requiring air travel.
3
@MPA
Nonsense. Anybody can become ill at any time.
8
@MPA Wrong. My son was moping a little last Sunday afternoon at about 2. He was bored because his brother was on a playdate and the neighborhood friends were not around. I felt his forehead, it was normal. Put him in the car about 3, picked up his brother from the playdate. At about 3.45 on the way to Grandma's, he said, "I don't feel good." Reached back, he was burning up. I sometimes happens that fast.
4
Standard, up to date, inspected medical supplies should be on all flights. Airlines should stop serving nuts if for no other reasons than chips weigh less and everyone please skip bringing nuts onto the plane.
Even if you are selfish enough to believe your snack preferences overrule the safety of others, do you really want to be on a plane when the pilot is trying to see how fast he can get from 35,000 feet to the nearest airport to save a dying passenger?
16
@PS We do not ban otherwise healthful foods because some people are allergic to them. A child with a peanut allergy should not be eating peanuts, but I have yet to see any evidence that the child's life would be in danger because someone else was doing so several rows away.
2
@Joel You haven’t looked very hard then. Plenty of people have reactions to airborne allergens — including peanuts. It’s silly to say you can’t forego a healthy snack for a few hours so others can breathe on the plane.
2
Upon hearing a request for a physician I have volunteered twice while traveling by air. Once it was a young man having an anxiety attack manifesting with shortness of breath. Another was an elderly man suffering from dehydration due to gastrointestinal losses. Each time I was surprised and disappointed by the limited, poor-quality medical tools. Determining a blood pressure in the noisy environment of the cabin was even harder as the stethoscope provided was missing an earpiece. Limited oxygen supplies. An AED I was told could only be used if authorized from the ground. NOT GOOD.
23
I don’t travel a lot and I am not a doctor but a 40 y/o man fainted on a domestic flight. No doctor being on board I got up to say I was a nurse. I can confirm the poor quality of the stethoscope and will carry mine on board next time. Stayed with the guy until we landed and paramedics took over. He ended up being fine.
1
The medical kits on airlines need to be standardized and upgraded significantly. The one I recently had to open on a transatlantic flight was essentially set up for allergic reactions (if I diluted out the epinephrine myself) and not the most recent ACLS course. There was an aspirin 👍🏼The stethoscopes were worthless, but I could at least watch the bouncing of the needle on the blood pressure cuff to determine there was a pressure/ extrapolate a heart rhythm/ determine orthostasis. No narcan, no stop the bleed tourniquets or trauma gauze. Nothing to cover a burn. I imagine the airlines have data about the types of medical emergencies they have, and have medical directors. There is room for improvement here.
40
I always try to travel with an automatic bp cuff that does not rely on my hearing to measure blood pressure, a 325 mg aspirin (for heart attack), and an epi pen if I'm traveling with my allergy prone spouse.
I would find it terrifying to be confronted with an ill child on an airplane. I don't do critical care and the last time I treated a child I was a medical student.
16
Given how poorly other travelers treat parents whose babies are crying on flights I struggle to imagine what would happen if infants were in car seats instead of held. It’s hard enough traveling with an infant. If that baby or toddler is crying for hours on end which is what many would do in a car seat can you imagine the air rage from other passengers?? The biggest reason for lap kids under 2 is to keep them quiet.
9
I don’t think this is true. The biggest reason for lap infants is that it saves the cost of a ticket. My kids have all slept for long stretches in car seats on flights. Their car seats are familiar, probably more comfortable than a lap on a tiny airplane seat for any baby bigger than about four months, and protect them from lost of stimulation. The one flight I took with a lap infant was terribly turbulent, and the captain announced several times that everyone holding a baby should hold onto them very tightly, and it terrified me out of ever flying that way again.
39
I don’t think this is true. The biggest reason for lap infants is that it saves the cost of a ticket. My kids have all slept for long stretches in car seats on flights. Their car seats are familiar, probably more comfortable than a lap on a tiny airplane seat for any baby bigger than about four months, and protect them from lots of stimulation. The one flight I took with a lap infant was terribly turbulent, and the captain announced several times that everyone holding a baby should hold onto them very tightly, and it terrified me out of ever flying that way again.
4
@Sara McAlister
Hi Sara - I agree with you. An infant should travel in a car seat. Window seat to avoid having hot liquids passed to passengers over the infant. Not doing that is a recipe for disaster. As is having the child on your lap. I’d rather have a healthy happy baby that’s not injured, versus the cost of the seat.
We just flew to and from Oahu from Los Angeles. My daughter, being a first time mother, considered having my grandchild, 5 months, on her lap. I said no way! Safety first. Baby flew in his car seat, which he knows well and finds comforting provided his favorite toys are at arms reach.
The stewards complimented the parents and the baby was relaxed the whole flight.
Would one travel 2000 miles in a car with an infant on their lap? I would hope not. Flying is no different.
Baby first, $ second.
38
My concern is always some passenger bring peanuts on board which the TSA agents fail to remove or tell the passenger that even peanut dust can cause serious breathing issues for someone allergic to peanuts.
The article says parents need to bring their child's meds with them, yet some TSA agents wont allow liquid meds.
9
@Beth Grant DeRoos
TSA has no authority to remove peanuts from your bag or to prevent you from taking on an aircraft. As to serving/having them on board that is up to each carrier to determine their own policy.
12
My daughter has liquid medications in one pint bottles. Always require a letter from her physician when we fly.
1
I am tired of seeing lap infants on airplanes. They can become projectiles in turbulence. It is the same annoyance when I see adults who refuse to use their seat belts at all times when they are seated.
We keep reading about injuries from sudden turbulence but some people never learn. I know travel is expensive but all passengers should be restrained in their own seat. I am selfish. Your taking the risk of having a lap child could injure me if your child becomes a flying object.
18
This article brings to mind an incident last year where my friend's 10 year old boy suffered an anaphylactic shock from eating a nut that was served on board. The parents did not know he had an allergy. Thankfully, a nurse and passenger helped him. The passenger had a pen and the nurse was able to give him a shot, otherwise, it's very likely he would have died 33,000 feet in the sky onboard a plane. He was invited to lobby in Washington DC by telling his story and the family was contacted by major news networks and interviewed them for TV news.
13
Airlines should be required to have Epipens available on all flights, especially if they serve peanuts. Such a no-brainer! If you think this isn’t a real medical emergency, you’ve never witnessed or experienced anaphylactic reactions, which are sudden, dramatic, and life-threatening.
1
Children and infants should have their own assigned seats period. In any serious emergency landing, that unstrapped baby is potentially a tiny missile threatening everyone else on board. And having 4 people in a row with only 3 oxygen masks presents its own threat. If parents chose to endanger their infants, that's their problem. They shouldn't make it everyone else's.
14
@Ladyrantsalot
I’m sorry that’s all you took form this article. It was more about the safety of infants, and not about how they could possible injure an adult.
SMH
5
Each row has an extra oxygen mask. You don’t need to worry that a lap infant will be using yours. This is why only 1 lap infant is allowed per row.
5
@Ladyrantsalot
Actually, each row has an extra oxygen mask to accommodate lap infants.
3
Better yet: Keep your babies at home.
9
@Elmo Harris
Commercial flights are for everyone. Perhaps we should keep cranky adults at home...?
29
I've never fathomed the whole "lap infant" phenomenon on planes - it's just obviously, blatantly unsafe.... for all the reasons delineated in this article. You wouldn't hold an infant on your lap in the front seat of a car, would you? Stop trying to save a buck: purchase your child an actual, individual airplane ticket/ seat, and place them in that seat - nestled inside their carrier, just like you would in a motor vehicle.
34
@GBR It's very common for public transport such as buses not to have seat belts. I see people holding and wearing babies on busses all the time.
1
@GBR - statistically flying as a “lap baby” is much safer than traveling comparable distance by car. The FAA recognizes that requiring families to purchase seats for children under 2 will tip the decision to car travel in many instances. Most families with young children are in a dissaving phase of their life cycle. So they look to save money.
All commercial aircraft have to comply with minimum safety equipment by law
This includes first aid kits for short-haul flights, and comprehensive first aid kits, specially designed for long-haul flights
Aircraft operating long-haul flights are supplied with additional oxygen bottles, enough for the mission
All the safety equipment is checked, every day, by the airline’s maintenance staff
The cabin crew check that all the equipment is OK before the passengers board the plane
All wide-body planes are equipped with baby cradles, that are attached to the bulkhead, to be used during the flight
5
Only tangentially mentioned here, but why are drinks (and soups etc) only provided in open containers? Planes shake, and people err. Is this anachronism required by the FAA for some reason, and if so, why? It would seem far safer for drinks--especially hot ones--to be in containers with lids. And even cold liquids can ruin a computer, or stain a shirt. I can think of no reason why they insist on serving everything open.
16
Dear M.,
They insist on serving things open because many containers, such as cans and glass bottles, can be used as weapons with very little modification. Even a full plastic bottle makes a decent thrown distraction.
1
Dear M., again,
But sorry, that was too dismissive. They can't give us a can or bottle, but they could at least have a plastic lid on the coffee cups, and the only reason I can think of them not doing that is to save money. The lids would take up storage, and so on.
12
@Dan Stackhouse I've found that flight attendants will give a can upon request, but they have to open it. Ditto for bottles. They take the caps. I always assumed it had something to do with alcohol rules, to prevent people from taking anything with them from the plane. But if that's the origin, it's a very onerous and cumbersome solution to a petty and unimportant problem.
5
The best thing for babies is never to take them on a plane. Sheesh people have some mercy on the rest of us, babies despise air pressure variation and all other aspects of being on a plane, just don't take them. No baby needs to be flown off to some destination wedding, they seriously don't care about any weddings at that point. The grandparents can go to them. They can take trains reasonably well. But children who are too young to sit quietly for several hours should never be put on a plane at all.
33
Whaaaaaat. You’re assuming that parents with babies have a strong support structure (grandparents may not even want to watch a baby) and that they will be mentally healthy having no life - sitting at home and watching their baby for protection.
It’s about finding balance for mental sanity. Taking a baby to a wedding is not for the baby - it’s for the parents to enjoy themselves while continuing to cate for their baby.
19
@Dan Stackhouse
Well, there's a new low in tolerance, right there.
29
@Dan Stackhouse
It’s crazy when people act like infants are no different from a dog that can be left at a kennel. He/she are part of the family and so attend family events.
16
I've responded several times, mostly on international flights. There's a big variety in the on-board kits. Generally they tend to have a lot of equipment in one area (say 5 different sizes of IV needle) but to lack others. It would be great if all airplanes had a pulse oximeter and an AED. Agree with other comments that the stethoscopes are useless in the aircraft environment. Most recently I had to ask the pilot to land because a passenger had low blood oxygen due to heart failure. He was OK on oxygen but the supply was not enough to complete the whole flight. We diverted to another airport, then were stuck there about 6 hours because they had to resupply the oxygen! I got a few wry looks from the other passengers after that one.
20
@JA Pulse Oximeters are not typically helpful in-flight as oxygen saturation levels are always lower, even for healthy individuals, while at cruising altitudes or higher (average 02 sat of 93% at cruising altitude). In a hospital, a sat of 93% or less would indicate the need for supplemental oxygen, so for most people, a normal mid-flight sat could easily prompt fear and unnecessary application of supplemental oxygen by an unknowing medical professional.
2
@Rachel M
I would still find a pulse oximeter useful. An O2 sat of 88% would still merit supplemental oxygen, even if the O2 sat would be higher on the ground.
7
I have been involved in two airplane emergencies. They both involved younger women who seemed to be dehydrated from long travels, stress, lack of eating, etc. and were otherwise healthy. So increasing fluids and monitoring them was enough. Both times, I and the few other medical people on board (as a young doc, I was fortunate to have 2+decades EMT with me in one case) were asked whether we needed to land and we agreed there was no need.
Those incidents both happened more than a decade ago and back then, my thought was that the planes were not well equipped. Simple things like the blood pressure cuff was broken. I've heard that things on planes have been upgraded since then, including AEDs now. Fortunately, I have not encountered incidents since then.
6
I was recently on a plane and answered a call to help. I was disappointed to discover that the emergency medical kit had no monitoring equipment, only a manual blood pressure cuff and stethoscope (very hard to hear on a plane) and an AED. A pulse oximeter costs less than $10 these days. I agree that basic medications (Benadryl and epi) would be immensely useful. The flight attendants were wonderful. It sounds like these kits, and the protocols that accompany them, could use some updates.
22
The emergency equipment aboard American airplanes leaves much to be desired. No epi-pens, for instance, which a doctor discovered when he tried to help me for anaphylaxis caused by the shrimps served on an overseas Delta flight.
13
In the 1950s my parents travelled, with four children under the age of 5, on trains from New Orleans to Tacoma, Washington, where my father had a new work assignment. My father told me years later that we four children became ill on the train; the youngest was only 6 weeks old. I'm glad I don't remember that experience! I'm sure that the train staff never forgot us.
7
As an English physician, I grew weary of this happening on what seemed to be every flight I took. Not only was there not very much I could do apart from words of comfort, the 'first-aid' equipment carried on aircraft - at least in Europe - was laughably inadequate (it has improved considerably in the last 10 years with AEDs, IVs and some useful drugs). On the one occasion that I advised an emergency landing to get the patient to a hospital, the captain reacted with horror and my request was eventually flatly refused - via HF radio - by the airline.
I never, ever, received any formal thanks, or recompense, from the airlines. The sum total of gratitude over a couple of decades was ONE single non-alcoholic complimentary drink.
The issue of medical negligence was never uppermost in my mind - particularly since my British malpractice insurance offered unlimited cover for incidents occurring in the context of 'Good Samaritan' acts performed, unpaid, as a paying passenger on a commercial flight - anywhere in the world. NO MORE! My recent insurance covered me for all such acts provided they occurred OUTSIDE US jurisdiction. The whole world excluding America and US citizens. Not American passengers, not American planes, not American airspace. The result of American obsession with litigation, I'm afraid.
62
@nolongeradoc Extremely interesting comment - yep, litigious is certainly the word for Americans - quite embarassing, TBH.
11
@nolongeradoc
My physician wife had to respond to four different in-flight emergencies over a period of just one year, recently. These included epilepsy, anaphylaxis, heat stroke, and testicular torsion, so serious stuff. On the last flight home from Asia, I finally complained (she never would have) to the flight attendants that she had provided professional services multiple times without even an expression of appreciation. And, one thing I haven't seen mentioned is all the paper work responding Drs. must fill out. They gave her 20,000 miles on the incentive program and a bottle of champagne. You can be sure that if lawyers were the responders, they'd charge their hourly rates.
11
@nolongeradoc:
ridiculous! Should be changed back to what it was.
1
Do the airlines ever share tips with those traveling with young children or infants? They do ask you when booking online you are traveling with an infant. Perhaps at that time they could make several suggestions. Lots of times it’s not just an emergency that tries your patience.
I have been traveling on business many times with a continually crying infant. I recall one fight where a baby was passed around to see if any of us could calm this child. After a while the kid just got wore out being passed among rows of people and - thankfully - fell asleep. There were probably other things that could have been done, either proactively or at the time. Sadly the flight attendants did nothing.
When a person travels with a child, every soul on that flight is traveling with that child. We all need to be prepared for that.
17
@Sheela Todd
Seriously? A crying infant? If you were in an adult space, or a venue where one does not expect to see babies (the theater, for example), I might see your point. But sometimes babies have to travel. On airplanes. Sometimes they cry. Sometimes the crying is incessant. This is part of life and if you complain about this, I can't imagine how you handle a real problem.
26
@maestro:
I don't think she's "complaining", merely commenting about an unpleasant experience.
AND yes, small suggestions of how to deal with young babies, especially on flights and take offs would be helpful !
4
As a follow up to my last posting. We always page for a physician or nurse first. I would say almost 80 percent of incidents (though very few) have been responded to by a doctor or nurse. Naturally we are required to check credentials before allowing them to proceed. We have one flight attendant communicate with the cockpit while others assist or bring medical equipment as needed. If an infant is turning blue or not breathing, while paging for a physician we would begin our infant Heimlich/CPR procedures. We do, however, stand back and allow a physician to examine and request any medicine from the advanced kit. A stethoscope and blood pressure cuff is on the outside of the kit and quickly available.
10
@Wamsutta just curious what type of credentials are you looking for? I don’t have or travel with a card stating I’m an md!
3
@Wamsutta
“Naturally we are required to check credentials before allowing them to proceed.” Remember the trouble poor Delta crew got in by following that reasonable check, when the volunteer doctor claimed the check was only because of her race.
6
I am an RN and the only time I responded on a domestic flight, we had WiFi and I found my license information online. Will carry copy of my license with me now and bring my own stethoscope!
As another flight attendant, here's what we are trained on: infant CPR and infant Heimlich. We have 2 different types of medical kits on board, one that may only be used by a physician, nurse or EMT. We also have a physician on call that we can contact from the airplane and they can authorize use of items from the advanced medical kit. There is no such thing as an infant oxygen mask (at least at my airlines). In case of a decompression, adults need to put theirs on first and then put those on children/infants who are unable to put them on themselves. You aren't going to do them any good if you lose consciousness first. An infant in a car seat must go at a window seat in order to not impede others in an evacuation. P.S. That's why we irritate you about seatbacks forward (to allow the row behind you to have plenty of room to evacuate) and tray tables up for the same reason. We all have CPR masks and knowledge of the differences in using it on an infant as opposed to an adult. The same goes for the Heimlich.
19
I'm curious what percentage of in-flight medical problems for children, especially those under 5, are choking related. I can just imagine toddlers snacking, hitting a bit of turbulence, and inhaling something. At home you could quickly pick the kid up and commence with a Heimlich maneuver, but this could be really tricky on a tightly packed, bumpy plane. The better part of valor would be to have FDA-approved de-choking devices (and Epi-Pens, while I'm at it) in infant, child and adult sizes on all planes.
8
This article is extremely interesting and important for everyone, not just children. My husband and I are fortunate to be healthy seniors. We do not travel on airplanes very frequently. When we do, I make sure that we have some basic OTC medication (tylenol, ibuprofen, topical antibacterials), plastic bandages, towellettes and water bottles with us as we board. We can't control everything, but better safe than sorry over the smaller stuff. Really.
29
Since I usually upgrade to extra legroom, I’m always one of the last people to board the plane, so the flight attendants insist that I check my carry-on luggage—which has my medications—because the overhead luggage compartments are already full.Then I have to get into an argument with them, even after showing them a doctor’s note saying I must have a carry-on bag with me on the plane.
I have to go through this every time I fly. It’s extremely stressful to me to know that I have to have an argument every time I get on a plane about caring on my essential medications that I must have with me.
19
@Sarah
You are always allowed one carryon bag and one personal bag - briefcase, purse, etc.
You don't mention how large the bag is that causes the arguments, but unless it's a roller bag you should be able to carry it on instead of your personal item. I've never seen anyone forced to gate check their personal item, but then I don't fly the cut-rate airlines so maybe they are more strict.
Not to be a complete critic, but if those meds are so important then book the extra legroom and pay for it. You won't have to argue and the flight crew won't have to deal with a cranky passenger holding up the loading.
17
@Sarah - I could easily care a week's worth of meds in the pocket of a blazer. Even a full month from the pharmacist fits in the small pouch of my daypack. Are you really carrying that much medication with you that you can't put a single day's worth in the coin pocket of any bag?
9
@Sarah
This doesn’t make sense. Medications - even 30 bottles worth of different ones - can fit in a small personal bag. One is _ never_ required to check such a bag ( which can fit under the seat in front of you. )
11
Having brought my then-recently-adopted children home on transoceanic flights, and having seen an infant become so sick that the plane made an emergency landing, I'm well aware of the need to be prepared. Really, you can't prepare too much. It dismays me to see that airplanes' medical equipment and supplies are often less than adequate, and that could be easily fixed with some investment. But one thing occurred to me as I was reading this article: How are parents supposed to bring pediatric medications on the plane? Most OTC meds are liquids, in bottles that hold more than 3 ounces. Do these parents need to carry an MD note in order to satisfy TSA regulations?
17
@B Exactly. As we went through Heathrow this summer, we watched a couple wrangling with airport officials over children's meds. A young child obviously had at least a cold. They were well-prepared with OTC meds, but the official rejected them. They even had to throw away sealed bottles taken out of unopened boxes. They were reduced to a few ounces of meds for a lengthy flight. I felt badly for them and grateful we were not seated near them.
25
@B
Open the meds and split them into 3 ounce bottles that will fit into the requisite quart bag. Carefully label EACH bottle and either peel off the label and put it in the bag or take a photo of it so that you have all the information about the product.
This may mean that the adults have to put their cosmetics and other liquids in their checked bags, but what's more important - hand lotion or cough medicine?
As a herbalist, I often fly with liquid extracts and this process works very well. I can get an entire 8 ounce bottle of liquid into the quart bag this way with full TSA approval.
Most druggists will have small bottles for purchase in the case illness happens away from home, by the way.
11
They were poorly prepared. The rules are clear. Just put 3 oz of Tylenol in a small container in case of a high fever. I am a nurse and most OTC are useless. Hydration and sleep fix most problems and real emergencies requires real meds.
1
I work for the airlines, so as a family we traveled a lot. My son is allergic to EVERY nut. I always brought his own food and I carried an epipen. Luckily he never had a nut at 35,000 feet. He could go into an anaphylactic shock within 20 minutes of eating a peanut or any other nut.
I asked a couple of very senior pilots the other day if they ever had had anyone go into anaphylactic shock in the air, and it surprised me that the answer was "no". Maybe parents are more diligent about making sure their children are not around nuts during the flight.
The new rule about allowing passengers to preboard if they are allergic to nuts to give the parents time to wipe down their seating area is an excellent new rule. I just wish more parents knew that this is their right, that they can make sure the area is free from anything that could make their children have an anaphylactic shock in the air.
32
Planes should be equipped with amplified stethoscopes. The additional expense is nothing when considering the health consequences for the patient and consequences of decisions made regarding emergency landings, etc. I know a hospitalist PA who was on a long flight and the only responder to a call for medical assistance. As a former EMT, he is comfortable stepping into various situations and doing his best. He is also an accomplished musician, which seems to enhance his ability to listen and discern what he hears with a stethoscope. However, the stethoscope that was provided for his use by the flight attendant was extremely inferior in quality thus making assessing a critical situation quite difficult. Planes in flight can certainly be noisy. He was however able to determine the reason for her cardiac issue, and she seemed stable upon landing.
16
@Elizabeth I completely agree with you. I have been involved in assisting a passenger during a medical emergency (all ended well) but the other provider and I had a terrible time using the provided stethoscope with all the ambient noise in the aircraft. Thank goodness the patient was lucid, breathing, and able to communicate how she felt.
7
Last month I fell terribly ill on a flight from Seattle to Philadelphia. It was gastrointestinal so i was vomiting for hours. I was switching between being in my aisle seat and the lavatory. Those poor passengers around me. When I could no longer stand either place, I stumbled to the back of the plane and laid myself over the flight attendant’s jump seat and continued to heave into the garbage bag they provided for me. By the last hour of the flight I was dangerously dehydrated and had low blood pressure. I am deeply grateful to the two doctors who responded to the flight attendants’ calls: one was a nurse practitioner and one was an anesthesiologist. the anesthesiologist was trying to get a line in me for an IV but could not because I was so dehydrated and also because of the turbulence. I was bleeding from the attempted draws but no bandaids in the first aid kit. I think the flight attendants were at a loss as to what to do with me. They did their very best but I don’t think their training covered what to do with a passenger in my state. They did their best tho and they were kind and took control. I ended up in the back row of seats, head in my husbands lap while they reseated some folks. They called for medics who took me off the plane and to an ambulance and to the hospital. If the doctors and flight attendants from that flight are reading this, THANK YOU.
95
I am only a nurse but for that type of situation, IV fluid and maybe Zofran for the nausea and vomiting. It might have been very difficult to start an IV with someone as dehydrated as you were.
1
When I've flown with an infant, whether or not they have their own seat, the flight attendants say that they will give me an infant oxygen mask if needed. That has always made me nervous because it would be difficult to remember in an actual emergency and do they have enough masks for all the infants on board? Any flight attendants out there know what the actual procedure is?
2
@CHL
I don’t believe there are infant face masks. The standard emergency (drop down) masks are soft and very flexible, and could be held in place over a child’s mouth/nose, which is also how adults are supposed to wear them.
The flight attendants CAN prove an infant life vest, however, hitch are carried on board and an adult vest cannot be made to safely fit and infant.
2
@George S:
Yes, infant face masks exist. (as do face masks for cats and dogs which firemen now have).
1
Emergencies happen, and I am grateful to the professionals who responded, but I also think that many need to rethink the idea of flying with small children. Plan a vacation closer to home. My son had ear problems, and we did not put him on a plane until he was 10 or so, and his health improved. He had so much fun on his first flight, and so did we.
28
@Barbara A lot of times people traveling with infants aren't traveling for fun. My boyfriend's family immigrated when he was young, and had to move very long distances several times for his father's job.
27
@Barbara I traveled A LOT with an infant. Some of it could have been considered "a vacation" but I wouldn't count seeing elderly family who can't travel as a vacation. We also traveled for deciding where to move and the move itself. I'm just throwing this out, because I ran into the opinion of don't vacation with an infant aka why are you on this plane a lot - but the world's a different place these days. Families are spread and travel is just more common.
17
@Barbara
I think this is ridiculous. Reminds me of my mother-in-law who thought taking the kids to the petting zoo was too dangerous. E-coli, don't ya know!
My kids traveled from three months on, as did my siblings and I. No accidents or illnesses mid-flight ever. Yes, it can happen, but so can getting hit by a car crossing the street. The risk is negligible.
7
I am a pediatric critical care doctor, and I have answered the overhead call for a physician. I was on my way to a conference with several of my nurses, and I'm not sure that I would have answered the call so confidently if I didn't know that my amazing co-workers were there to back me up!
The patient was an adult who had suffered a seizure and was unresponsive in first class. There were 2 other physicians (adult ER and Gyn Onc), and with their help and my 3 nurses we were able to maintain the patients airway (without support she was slumping over and going apneic). She was otherwise stable. The captain asked if we needed to land. There was no question of connecting flights, we were asked to consider the patient's condition only. So we landed. It only added about an hour to our flight.
What the regular public doesn't realize is that physicians and nurses on planes are often well outside their normal scope of practice. The plane has very little equipment on board, and in my case the entire medical kit was about 18 months expired. My nurses put in an IV just in case, but we didn't use any of the IV fluids as we thought they were an infection risk they were so outdated. There was no oxygen (empty tank), and the BVM had no mask. We rarely receive recognition or even thanks for our help. I got a cookie and many rude comments from other passengers for making the plane land.
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@Christine
I'm so sorry you were treated badly by the other passengers. People can be so selfish these days that it's horrifying. I'm sure if any of those people had been the one who was ill, they would have wanted and expected the same treatment.
And your story reminds me that my primacy care doc once gave me a new med to take occasionally for migraines jright before I was leaving for Europe. She asked to please not take it the first time on a plane. Not just for me, in case I had an unexpected reaction to it, but she said that almost every time she herself got on a plane for a trip, she ended up having to deal with a medical issue for a passenger!
So, folks, another tip is for both adults and kids to avoid taking any new meds either just before or during a plane flight.
38
@Christine Just want to thank you and all other medical personnel who respond to those in-air emergencies. And I hope airlines are taking note of this egregious lack of basic medical emergency supplies.
47
@Christine Let me just say... Thank you.
My son is a paramedic and I have a fair understanding of the wish to help on the part of people like you and him. You did the best you could with what you had and I suspect you'd do it again if asked. So again... thank you.
9
Thank you for this article. I am a Flight Attendant for a major carrier on long haul flights. I was not aware of the fact that infants have died co-sleeping with parents on planes. Important information and I will pass it along to my colleagues. We do, however, make announcements asking passengers to keep aisles and exits clear during the flight. We say it for a reason, we say everything for a reason.
76
Smartphone-based stethoscopes that visualize heart sounds may be a simple, inexpensive tech solutions to this problem, described in the article: "he couldn’t hear anything through his stethoscope because of the white noise, and couldn’t feel the baby’s pulses because of the vibration of the airplane"
12
Years ago my husband and I were traveling with our children and an infant on the train from Seattle to Chicago. We were in a sleeping car and sometime in the night when the train was in the middle of nowhere there was banging on our door. There was a doctor and a porter asking if we had infant acetaminophen because there was an extremely ill child who had a high fever and was experiencing febrile seizures and it was a still a very long way to the next real town. We gave him the medicine and I followed him down the corridor and saw a very young couple (they looked like kids) with an extremely ill infant. I remember seeing the baby earlier and he/she smiling and seeming perfectly fine. It is frightening how quickly a child that age can go from looking fine to very ill and so people shouldn’t judge traveling parents and parents should always be prepared.
101
It is so encouraging to see responsible professional adults respond to an issue in a mature cooperative manner, especially when our government is failing us dramatically.
32
After reading this article I feel like my kids are survivors. Living in Europe with my American husband I did a lot of transatlantic flights with them. The year my father in law got cancer I flew six times to the US with a two year old. I was prepared, I brought games, books etc ... but I quickly learned that there is no way a two year old will stay in a seat for eight hours. So I ended up letting him wonder around the plane. To people in the comments comparing it with buckling up a child in a car seat I have to say that I would never drive for eight hours straight and that once the kid is buckled up in a car, everybody in that car will be sitting whereas on a plane a child can see adults walking around. There is theory and then there is reality. As for medicine, yes, definitely take with you at least what you would need to take fever down.
49
I am a pediatrician. On a cross-country flight, I hesitated but responded to the 2nd call. Passenger was unresponsive and blue. Staff provided a full medical kit with meds and IV. Even with a stethoscope I could not hear respirations or heartbeat or feel carotid pulse. I thumped on the chest and she woke up. “Dead faint“. She was stressed, skipped breakfast, no coffee. A Coke helped revive her. I was so relieved I did not have to give CPR. Believe me, I would’ve preferred and deferred to any other health provider with experience with adults, particularly acute care. Over the years I have responded to two other cases of adults with acute illness. Fortunately, no catastrophes. Believe me, I pray I don’t have to respond again.
Note: both of my children as parents have traveled overseas with pairs of children as young as two and four, reserving seats and using car seats. These helped comfort the children in their familiar seats for the long flights and entertain themselves the whole way, including sleeping overnight. Children fared better than parents.
Yes, basic medications such as ibuprofen, acetaminophen, and diphenhydramine would be easy and appropriate for healthy children, and specialized medications for children with known-existing conditions. But you would take them on an extended trip anyway, wouldn’t you? In an emergency, responding medical personnel would have to break down adult medications in the emergency kit.
46
And most of all, if ur child seems a little sick before the flight, don't go. If you have kids and want to travel, pay for cancellation insurance which will fully cover you if you get a doctor's note that the child should not fly with the condition that was suspected. You can go to an urgent care center, explain your concern and the doctor/NP will write you the note.
I realize no one wants to cancel a family vacation but no one want to witness a sick child that may need medical care get worse on an airplane either.
60
I am an adult critical care doctor and responded to a request for an adult that I firmly believe was having a myocardial infarction. He had every symptom and I treated him with what was available. I was on the phone with the doctor on the ground and the recommendation he made was to continue the flight for another 3 hours. I told the captain that I completely disagreed and that the gentleman needed to get to a hospital immediately. Thankfully the captain took my advice and we were on the ground in 15 minutes. I followed up with the patient the next day. He did have a massive heart attack and was recovering after stent placement in the ICU. If the captain had listened to the doctor on the phone this man would have died.
This incident made me wonder if the doctors on the ground are working for the patients or for the airlines. Later I was told that the plane I was on had 35 passengers that would miss their overseas connection if we landed for this patient. It made me wonder if the suggestion to go on for 3 more hours was based on this instead of the clinical information.
Thankfully it all ended well for the patient and the airline held the other flight so the other passengers ultimately got to where they were going too.
189
@Karen
I was a passenger on a flight that had an emergency landing due to a passenger's critical illness. I could not believe the amount of people griping about the inconvenience of it. How can you be so lacking in empathy? Imagine the sick passenger, or his friends and family. How terrifying for them!
I had a similar situation on the subway this summer when we were diverted to an alternate line because someone had jumped in front of the train. "When you want to commit suicide, don't do it at rush hour and mess up everyone's commute," someone kept complaining loudly. Where is the humanity?
30
@buttercup-Especially for the subway driver. I was on MUNI (which is like the subway ) when someone jumped. It was extremely distressing for the drivers and all of us passengers. About 12 of us patted his shoulder and offered to serve as witnesses if the suicide investigation required it. Very disturbing and sad.
8
As a mom, flight attendant and coffee addict, I wholeheartedly agree with the advice not to pass hot drinks over children. I understand the need for caffeine as a parent, but at 35,000 feet with a possibility of clear air turbulence, please think twice before ordering coffee or tea for your beverage if traveling with young children.
31
@Eliza
It’s not just the passing...people set the hot beverage on the wobbly tray table where it can be easily spilled.
5
It is past time for the FAA/NTSB to require all passengers, including small children, to have their own seats. Their rationale for continuing to allow lap children is that if they make air travel more expensive by requiring tickets for those kids, people will drive instead, and on a per mile basis, flying is far safer.
This reasoning ignores the reality of flights on routes where driving is not a viable alternative, e.g. flying in and out of my state and the rest of the US or most of the world except for parts of NW Canada. Plus all transoceanic flights.
Not only are lap children at huge risk of injury or death during emergency landings, but they present a risk to those seated nearby, too. Physics makes it difficult or impossible to safely restrain a lap child without a child safety seat. Putting the adult seat belt over the child will crush it, while keeping a on the child's body may not be possible. Thus the child becomes a projectile. Passengers are not allowed to have unsecured cabin luggage during emergency landings. An unsecured 15-20 lb child is also a hazard, both to itself and to others, when the aricraft is pulling Gs. Anyone with a grasp of physics understands this, but plenty of parents seem to think it's OK to get away with saving money even if it puts their child and other pax at risk. Pay for a seat, use an approved safety seat for your kid, or leave the child at home, please.
128
@Humanist I'm not sure which world you live in or if you have ever had to fly long distance with a small child, but there are good ideas and there is reality.
When I had to fly from Auckland, New Zealand to Madison, Wis. because my father was dying, it was not possible to leave my 18 month old baby behind. If you think a child of that age will sit quietly buckled into a seat for the 14 hours it takes to cross the Pacific you are clearly delusional or have never had to do this yourself. He was not interested in watching a movie, could not read a book and was so wired he didn't sleep either.
I'm still waiting for practical, helpful ideas, but sometimes you have to do what you have to do, taking account of the inherent risks.
98
Maybe not but when it comes time to sleep the child goes into his own seat.
31
@Robin Having a child seat next to you still offers you the option of keeping him in the seat in the case of take-off, landing, and any emergency situations, even if he is in your lap a large portion of the time.
53
Saying "parents should carry aboard in their carry-on luggage medications in pediatric forumulations" is only helpful if you know your child has a medical condition before you board the flight, and it sounds like in many in-flight emergencies, the kids were healthy when they got on the plane. Add to that the fact that many over-the-counter pediatric medications (analgesics, antihistamines, etc.) are liquids that come in bottles larger than 3 ounces and you're recommending advice that is vague AND nearly impossible to follow.
23
@OCPA I am no big fan of the TSA but the fact is that liquid medications in excess of 3.4 ounces are absolutely allowed in your carryon. Two requirements: 1) the amount you bring in carryons must be reasonable for the amount of time you will spend in transit, and 2) you must declare the liquids during the security screening process.
I bring more than 3.4 ounces of contact lens solutions with me all the time.
34
Actually I find this really varies depending on the TSA agent who happens to be working that day.
28
So basically in a study of 48,924,000 flights (1 in 604 chance of a medical emergency multiplied by 81,000 actual medical emergencies), 4 lap infants died of unknown causes, and therefore no infant should travel as a lap infant and should be buckled into a seat at all times, despite the extra (significant) cost and despite the fact that the infant may sleep better while snuggled?
No, thanks.
My infants are grown now, but I would not have wished to feel pressured to follow this "recommendation."
18
@cls
Dying in a car crash has a pretty low probability. Are you going to stop buckling up?
42
@Luke I don't know, are apples and oranges the same thing? Your comparison doesn't work. Have you ever flown on a plane with an infant? I would guess not.
A lap child can be "buckled" -- if that's what you think my comment was about.
3
Order of magnitude more dangerous than flying
6
This article would be very helpful if it included the most critical items for parents to pack. I'm 10 minutes into Googling and still don't know what I should bring on board in response to the shortcoming...
38
@Ashley I am not a Doctor but have been a parent for several years now. If I was travelling I think I’d pack the following in children’s formulas: Tylenol, Advil, an antihistamine, an anti nausea medication, bandaids and an epipen. I think that would really cover everything until landing.
54
@Ashley: Child formulations of acetaminophen (Tylenol), ibuprofen (Advil), and diphenhydramine (Benadryl), the latter of which is an antihistamine that works both for allergic reactions and motion sickness in children. I don't know how you lay hands on an Epipen if you haven't before experienced anaphylaxis. Commercial airliners should have Epipens on board given the problem with peanut allergies these days. I also carry instant ice packs, which "cure" (via placebo effect) all manner of childhood ailments. I've never had any problem getting liquid OTC medications for children through TSA.
26
@Ashley - As an emergency medicine pediatric pharmacist, instead of diphenhydramine (Benadryl) I would suggest cetirizine (Zyrtec). Both are antihistamines but diphenhydramine causes significant drowsiness, whereas cetirizine does not. Assessing a child can be extremely difficult if they are lethargic from diphenhydramine.
15
There should be a review of current protocol based on these studies and the supply list on board should be updated. I hope someone is on it.
24
I wonder whether there are doctors who would be willing to identify themselves before boarding a flight as individuals ready to be called on if there is an emergency? Also, shouldn't there be a more extensive collection of medical supplies that experience and expertise determines would be to a doctor when that in-flight emergency occurs?
24
@A Goldstein. Many airlines allow to choose how you want to be addressed when booking: Mr/Mrs/Dr. Supposedly, this is what those airlines use. Yes, technically speaking a PhD is a Dr albeit not a medical Dr. It should be easy to filter those out.
4