Over 700 million people travel for wellness or medical reasons. That equates to almost 10% of the world’s population that are flying on planes and staying in hotels with health and wellness as one of their primary focuses.
With an ageing global population, the continuing increase of chronic disease and the increasingly mobile and cashed up ‘Millennial’ generation, the amount of people traveling for medical or wellness reasons will only continue to grow.
Current estimates are that upwards of 4 billion people traveled on commercial airlines in 2017. With these large and increasing numbers of passengers combined with the fact that the number of Wellness & Medi-Travelers is also on the rise it is interesting to look at inflight medical emergencies : how often do they happen, who bears the cost and how well prepared are the airlines to handle them?
How often does an Inflight Medical Emergency Occur – and who pays?
It is actually very hard to get reliable numbers on the amount of global inflight medical emergencies. This is mostly because not all airlines are required to report them. Figures range from 1 medical emergency in every 604 flights globally (a 2013 study by the University of Pittsburgh Medical Centre) to as few as 1 inflight medical event per 14 000 passengers (British Air Transportation Association 2017).
If you are ever unlucky enough to be the cause of an inflight medical emergency, then perhaps things other than your health will also start to occupy your mind, especially if you haven’t been honest and upfront about an existing medical condition.
The largest airline by international traffic (Emirates) says that a single flight diversion can cost anything from US$50,000 to over US$600,000 depending on the nature of the diversion. These flight diversion fees can include; fuel, flight catering, landing and ground handling fees, air navigation cost, passenger rebooking costs with onward connections, as well as other associated costs to care for crew and the other passengers.
Usually, airlines will be super nice and pick up the cost of an inflight medical emergency and any subsequent diversion – but – just make sure that you have disclosed any pre-existing medical conditions and have also sought clearance to fly if it is required by the airline. Pre-existing conditions may include a recent surgery that you may have had as well as other conditions. Each airline is different with regard to timeframes and requirements, so make sure you check out the Resources section of our website to check the requirements of your chosen airline.
A rise in passenger traffic is just one of the reasons why the incidence of in-flight medical emergencies will not be decreasing anytime soon. It is noteworthy that an increasing amount of passengers are over 60 (this is a dramatically increasing demographic) and also that increasing numbers of passengers may be returning home with post-surgery complications.
Other important causal factors include longer flight durations. Longer flights subject passengers to increasing physiological stressors. These stressors include relative hypoxia (insufficient oxygen) and lower relative humidity. Again, these factors may have greater effect on the increasing proportion of older passengers and those flying with pre-existing medical conditions. Some airlines even warn about the dangers of Cosmic Radiation for frequent travelers!
What is most likely to cause in inflight medical emergency?
The top five causes of in-flight medical emergencies are:
- Syncope/presyncope : 37.4% (Syncope is the temporary loss of consciousness caused by a fall in blood pressure)
- Respiratory symptoms : 12.1%
- Nausea or vomiting : 9.5% (Includes obstruction of airways)
- Cardiac symptoms : 7.7%
- Seizures : 5.8%
Are Airlines and Crews Prepared for In-Flight Emergencies?
In major international and domestic airlines, flight crews receive continued training in the treatment of in-flight medical emergencies. Compared of course to health care professionals (i.e. doctors and nurses) they receive very minimal training indeed. Of course most airlines do ensure that flight attendants are:
- Trained in first aid (different levels airline dependent).
- CPR and AED (automated external defibrillator) proficient.
- Able to manage both the aircraft and the airlines emergency procedures along with the flight crew (pilots)
- Able to facilitate communication with ground-based telemedicine support
- Trained to resource the emergency with the on-board medical kit, AED and supplemental O2 (oxygen) via secure on-board supplies.
Operationally, medically trained passengers will probably be unaware of the medical equipment on board a particular aircraft and also unaware of the challenges of treating patients on an aircraft.
Generally, any commercial aircraft with at least 100 passenger seats is legally required to carry a medical kit (in addition to the usual standard firstaid kit). Commercial aircraft with fewer than 100 seats are required to carry only a standard first aid kit.
The individual airline outlines the minimal requirements the medical kits must contain. Airlines do have the flexibility to enhance the contents and conduct their own preparations and set up as they see fit and most do so using the guidelines from the International Civil Aviation Organization.
Statistically, Who Usually Responds to an Inflight Medical Emergency?
Optimally, the best approach to any in-flight medical emergency will be a mixed team of medical professionals and flight crew (flight attendants and pilots).
Available research on in-flight medical emergencies shows primary responders to be:
- 40-50% doctors
- 5-25% nurses and paramedics
- 45% flight crew
For example, in 45% of cases, it is the flight crew as primary responders only. In 40-50% of cases, doctors are involved while in 5-25% of cases, nurses and paramedics are the primary care providers. Of course flight crew will be involved with 100% of the cases in some form.
Specifically, an Air Canada report identified that 47% of in-flight emergencies were handled by Flight Crew alone while 53% involved a mix of doctors, nurses or paramedics with the flight crew.
The Bottom Line
At Ticadoc, we feel that it is extremely important to be aware of all of the details involved in your Medi-Travel journey so that you, and everyone else involved in your journey is safer and more secure.
When you are travelling with a pre-existing condition or even after a surgical procedure of some sort, check out the Resources section of our website for Travel Checklists, Tips and Airline clearance forms and requirements.
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