Anyone for CPR?
The recent tragedy where a passenger was sucked out of an airplane window raises concerns for Maurice Gueret, who sees off Dr Asperger and his legacy
High Flier
Not being the world’s most comfortable high flier, air accidents always catch my attention. Last month, there was a fatal incident on Southwest Airlines flight 1380 from New York to Dallas. An engine failed. Debris broke a window at 32,000 feet. A seat-belted lady was partially sucked out of the plane, suffering blunt trauma to the head, neck, and chest. There was a lot of blood, and a call went out from a flight attendant: “Does anybody know CPR?”. The lady needed urgent resuscitation. A retired nurse and an emergency medical technician were on board, and they volunteered to help while the plane descended for an emergency landing in Philadelphia. It begs the question — who among airline crews knows cardiopulmonary resuscitation? Surely airlines make enough money to organise advanced training days for their own staff. Passengers already pay for the flight, the suitcases, the seats, the food, the duty-free and the lottery tickets. I’d gladly pay to improve medical facilities aboard airlines, clear a permanent row of seats for a compact treatment area, and for at least one crew member with advanced first-aid skills. It’s common practice for airlines to ask if there is a doctor or nurse aboard. That’s fine. What’s less clear to me now is exactly what first-aid skills cabin crews have, and whether at least one member of each crew has advanced ones. There must be many flights with no docs or nurses aboard. Here’s hoping our pilot readership can reassure me.
Ditching Helmets
Mandatory wearing of helmets with faceguards was introduced for all hurlers and camogie players in 2010. A paper in the current Irish
Medical Journal looks at why players modify these helmets, and how they risk injury. Three hundred sliotar-hitters, male and female, were given an online questionnaire about the topic. The research team at DCU and Athlone IT found that helmets were chosen by appearance for over 40pc of respondents, and by price for 20pc. Less than 2pc cited safety as the main reason for their choice of helmet. Almost one in 10 helmets was already modified before purchase, and a further 30pc of players made further modifications, usually removing bars or switching faceguards. The authors worry that helmet modification, often done to improve vision, may be increasing injury risks to the eye and face. Leave well alone.
Dr Asperger
The naming of new conditions can come back to haunt doctors. Hans Asperger, pictured above, was an Austrian paediatrician who worked principally on mental disorders among children. As a child he was quite solitary, and when we were in medical college we were led to believe he had a touch of the little professor himself at school. Asperger later wrote papers on what he called autistic psychopathy. Psychiatrists later coined the even worse term, ‘schizoid disorder of childhood’ for it. None of his work made an impression when he was alive, but in the 1980s and 1990s, his surname was attributed to a newfangled pattern of signs and symptoms labelled as Asperger’s syndrome. Now it transpires, after some careful historical work that should have been done earlier, that Hans Asperger assisted the Nazi euthanasia of many disabled children. He referred them to a notorious clinic in Vienna where hundreds died. Consensus in the medical profession about Asperger syndrome and what exactly it is has never been clear. But I expect a new consensus soon that will banish the name from medical diagnosis forever.
Disease Number 11
The World Health Organisation is now taking more seriously how doctors describe and name diseases. They have issued a guidance paper suggesting that we stop naming them after people, places, jobs, animals or foodstuffs. People in Japan with the common surname of Noro weren’t too enamoured with the Norovirus that was causing diarrhoea and vomiting in hospitals. House prices in the Brisbane suburb of Hendra took a dip when the name of their area was given to a horsekilling bug that was carried by fruit bats up the coast of Queensland. The Ebola virus was named after the local river, rather than the town in which it arose. But tourism in all the towns it passes through isn’t exactly booming. A suggestion has been made that in future, all diseases should be given a number rather than a name. Dublin’s next disease outbreak could be a wan and wan.