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In-flight first aid a cost of business

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By Milwaukee Journal Sentinel
Saturday, Nov. 23, 2013, 9:00 p.m.

Inside a pressurized metal tube traveling at 500 miles per hour seven miles above the earth is not the best place to get sick.

But it happens.

An estimated 44,000 in-flight medical emergencies occur worldwide each year, and once such a situation occurs, it starts a complex, orchestrated and often expensive response that airlines train constantly to handle.

For frequent business travelers, if you haven't already been on a flight where a medical emergency has been declared, chances are you will at some point.

“If somebody has to absolutely get on the ground ASAP to the nearest ambulance, we do what we have to do,” said Capt. Michael Sharpe, a pilot and flight instructor for Southwest Airlines.

There are no exact figures on how much it costs to divert an aircraft from its planned route, but it's thousands of dollars. A Boeing 737-700, for example, holds 6,875 gallons of jet fuel. At $3 a gallon, that's nearly $21,000 to fill the tank. Once a plane is diverted and lands, it almost always has to be refueled.

‘Major expense'

“It is a major expense to the airline, but we just look at it as a cost of doing business,” said Sharpe, who has been with Southwest 30 years.

“It's not that person's fault” they became ill, he said. “Some people have health conditions they are not even aware of.”

Once a medical emergency is declared, landing becomes the priority. Landing, though, takes time.

“Even if you have someone who needs absolute, immediate medical attention, you can't just push the ‘down' button like you're on an elevator,” Sharpe said.

It takes at least 25 minutes to get from altitude to the ground. “You have to plan your descent (so) that you don't get down too early — that burns a lot of fuel — and that you don't get down too late — you'll overfly the airport,” Sharpe said.

UPMC plays role

At 35,000 feet, the first responders in the cabin are the flight attendants. By law, they are trained to deliver basic first aid as well as begin the process for getting a sick person help.

Say someone collapses while a plane is airborne.

Flight attendants notify the cockpit crew that there is a medical emergency in the cabin. The cockpit crew then establishes a communication link with doctors such as Christian Martin-Gill, assistant professor of emergency medicine at the University of Pittsburgh Medical Center, which operates the STAT-MD Communications Center and provides emergency medical guidance to 17 commercial airlines.

Martin-Gill is one of the authors of a New England Journal of Medicine study this year that looked at 34 months of in-flight medical emergency data, numbering nearly 12,000.

In about three-fourths of those cases, a medical professional such as a doctor, nurse or paramedic was aboard.

“That's a big reason we wanted to publish this — to provide some guidance to health care providers who might find themselves in that kind of situation,” Martin-Gill said.

“The key piece is, it doesn't matter if you are a cardiologist or an orthopedist or a pediatrician,” he said.

“Often what is necessary is being some eyes and ears, and being able to provide a medical assessment or just the administration of some medications.”

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