Doctors often on board airplanes to help sick fliers, study says

Is there a doctor on board? Surprisingly often, there is — in half of in-flight medical emergencies — and sick airline passengers almost always survive, a new study finds.

The research is the largest look yet at what happens to people who develop a medical problem on a commercial flight — about 44,000 of the 2.75 billion passengers worldwide each year, researchers estimate.

Most cases don’t require diverting a plane as the study’s leader, Dr. Christian MartinGill, advised a pilot to do two years. He works for MD-STAT, a service at the University of Pittsburgh Medical Center that advises about 20 major airlines on how to handle in-flight emergencies. Another large service is based in Phoenix.

Martin-Gill handled a call when a passenger seemed to be having a heart attack on a flight from Europe to the U.S. The man’s implanted defibrillator had shocked his heart five times to try to restore normal rhythm.

“The aircraft was in the middle of its destination, flying over the Atlantic,” so he recommended landing at Newfoundland off the Canadian coast to get the man to the nearest hospital, Martin-Gill said.

The federally funded study reviewed about 12,000 cases handled by the Pittsburgh center over nearly three years. Results are in Thursday’s New England Journal of Medicine. Researchers found:

» The odds of a medical emergency are 1 in 604 flights, or 16 per 1 million passengers.

» Planes had to be diverted for emergency help in only 7 percent of cases.

» Doctors were on board and volunteered to help in 48 percent of cases; nurses and other health workers were available in an additional 28 percent. Only one-third of cases had to be handled by flight attendants alone.

» The most common problems: Dizziness or passing out (37 percent of cases); trouble breathing (12 percent) and nausea or vomiting (10 percent).

» About one-fourth of passengers were evaluated at a hospital after landing and 9 percent were admitted, usually with stroke, respiratory or car- diac symptoms.

» Out of nearly 12,000 cases, a defibrillator was applied 137 times, including in 24 cases of cardiac arrest, where the heart had stopped. (Sometimes defibrillators are used to analyze an irregular heart rhythm to help doctors figure out what to do, not necessarily to deliver a shock.)

» Of the cases in this study, only 36 deaths occurred, 30 of them during the flight and the others after landing.

» Pregnancy-related problems were generally rare — 61 cases, in this study.