A few months ago, Adventure Medic asked Nicole Chastain, an experienced flight attendant with a major US Airline, what went into an airliner’s emergency medical kit. Unfortunately, due to anti-terrorism restrictions, she couldn’t tell us! So instead, here’s her insider’s account of what happens when something goes awry in the air.
Fasten your seatbelt, turn off your cellphone, raise your seatback and tray table, stow your bag all the way under your seat.
These are the things you may not like, but expect to hear from your flight crew when you board a flight. An important part of our job is to give you information that the government has determined is necessary, and can possibly save your life. How would they know? Because even though accidents are rare, following every incident, a group of governmental agencies gather information regarding what went wrong, and what might prevent accidents or loss of lives in the future. Even though some of the flight attendant’s requests might seem pedantic or irritating, they really are there to help you.
A flight attendant’s primary responsibility on an aircraft is passenger safety. We are fully certified in first aid, CPR and use of AED’s (Automatic External Defibrillators). In fact, we are trained in provision of certain medical care (including delivering babies), evacuating planes, fighting fire, providing on-board security, not to mention providing in-flight service to keep customers comfortable during the flight. Additionally, we are required to recertify once a year to keep our skills updated. We do not claim to be doctors, however flight attendants are a valuable resource to have on-board should a passenger become unwell.
Incidents in flight
In the event of an in-flight medical incident, the flight attendants will retrieve the appropriate on-board medical equipment (First Aid or Emergency Medical Kit +/- oxygen). We operate as a team, with one of us attending to the passenger, and one contacting the Captain to notify him and to request a radio patch through to a medical service. Ultimately, it is the Captain’s decision whether to divert and land the plane early, determined by the assessment made by on-board staff, healthcare professionals if available on the flight and/or as advised by medical services on the ground.
This in-flight medical service provides support in the event that we are unable to locate medical personnel on-board. However, once medical personnel have been identified, or the link to the medical service on the ground is established, the flight attendant will communicate their initial patient assessment to the healthcare professional. If passengers do happen to be in a position to help with this medical assessment and treatment, they should be covered legally in the USA by the ‘Good Samaritan Law’.
In the event that no medical personnel are on-board or a radio link to ground support is not possible, we are, however, prepared to act on our own. Most medical incidents on-board tend to be minor and easily resolved using our first aid kit. However, occasionally, a passenger will experience more serious conditions such as seizure, heart attack or stroke. In any event, we are prepared to stabilize the passenger until we land and are able to have EMT’s (Emergency Medical Technicians) take over and transport to a medical facility.
You act faster than you can think
It’s important to think through how our training might impact on the management of major disasters too. On one flight, this was brought home to me after I spoke with an elderly passenger who had survived the American Airlines Flight 1420 crash in Little Rock in 1999, which had killed the captain and ten passengers. He had formerly been a medic in the military, and his training had clearly come in useful. He told me that after the aircraft came to a stop he immediately unfastened his seatbelt, and yelled at the young man next to him to do the same and follow him out. He set up a triage, sorting passengers’ injuries by severity and helping to keep people calm as they waited for rescue personnel. Tragically, the young man made the decision to go back inside the burning wreckage to try to save others, and perished. I questioned what I would do in a worst-case scenario like that but his answer, based upon our established training, was simple: “Don’t worry, it comes automatically. You act faster than you can think”.
With nearly 14 years of professional experience, I have had my fair share of medical emergencies while on duty. These have occurred in the terminal while the aircraft was still at the gate, during flight and upon de-planing. I’ve even had several incidents occur on the same flight, the other worst-case scenario! I have learned to spot potentially ill passengers during boarding and by intervening and asking some questions and contacting EMT’s at the gate, it is sometimes possible to prevent a potential medical emergency in flight.
Medical emergencies on-board can be stressful both for those involved and also for other passengers witnessing them, but having highly trained flight crew to attend to emergencies can make the difference between life and death. It is our job and our primary responsibility. We hope that each day we step on an aircraft that we will have uneventful flight and safely deliver everyone on-board from A to B. But, when things go wrong, we are well trained to do all we can to ensure a positive outcome.
So, next time you board a flight, say ‘hello’ to your flight attendant, because you never know, they might just save your life.
