We all know those announcements, if not from our own travels then at least from movies and TV shows.
“Is there a doctor onboard?”
And the thing is, the answer is pretty much always yes.
A doctor may not always be seated in the cabin on your flight, but most commercial airlines are aware that inflight medical emergencies can happen (I’ve written about one or two such instances myself in my time at USA TODAY) and most carriers contract with on-the-ground experts in emergency medicine at altitude.
In addition to onboard medical kits, services like MedAire and STAT-MD provide flight crews with physicians to guide them in evaluating and stabilizing passengers who are having medical episodes onboard or even on the ground before a flight.
“It’s an invaluable tool to be able to assess and treat passengers,” Seth Heiple, an air safety, health and security representative at the Association of Flight Attendants and a crewmember at a major U.S. airline, told USA TODAY.
How do air-to-ground medical hotlines work?
According to TJ Doyle, medical director of STAT-MD, every airline has slightly different procedures around inflight medical emergencies but the basics on every call are the same, whether they, whether take place through an air-to-ground radio patch via the airline’s dispatch center or a satellite phone link or internet app. Usually the first step is a doctor familiar with aviation medicine conducting an evaluation.
“We get information on passenger demographics, age, sex and what the symptoms are, any other circumstances that occurred, any history that’s available, anything that’s already been done for the passenger, and then the physician will make a recommendation on a further course of action,” Doyle said.
Heiple said MedAire, the provider his airline contracts with, is rolling out a diagnostic app that can help flight crews begin the process of evaluating the passenger and send information to the doctors on the ground more quickly.
“The technology is making things even easier,” he said, especially as high-speed satellite internet becomes available on more flights.
Doyle added that in many cases, doctors on the ground will have a sample of the medical kit available onboard, which he said can be especially important when volunteer doctors on the flight become involved in treatment.
“We can say ‘oh the medication we’re recommending is in the orange pouch of the kit and it’s in a silver foil packaging,’ ” he said.
Volunteers who are qualified and do offer to assist during an in-flight emergency are protected from liability under Good Samaritan laws.
Doyle emphasized that STAT-MD and other ground-based medical providers can only offer recommendations about treatment or flight plans. It’s ultimately up to the captain, air traffic controllers and flight crews to decide if their suggestions are feasible.
“All I can do is make a recommendation,” he said. “If I recommend that they continue on but the captain wants to divert, then they divert because it’s the captain’s call.”
Heiple, however said flight crews typically listen to the doctors’ advice.
“If MedAir makes a recommendation it’s generally followed,” he said. “As soon as we start the process of contacting MedAir we notify the pilots. They’ll immediately start looking for diversion options.”
What are the most common medical conditions that occur in flight?
Doyle said STAT-MD received around 15,000 emergency calls from airlines in 2022, and that the most common issues are fainting, respiratory symptoms and nausea or vomiting.
“There’s a passenger, they get on the plane, maybe they’re rushing through the airport, maybe they didn’t have anything to eat or drink before, or they had a few glasses of wine and they’re vasodilated and they get up to use the bathroom and then they pass out, that’s one of the most common issues we get,” he said.
Do these services provide pre-flight screening as well?
Companies like MedAire and STAT-MD can also advise flight crews if a passenger is fit to travel before they even board – all it takes is a call from an airline employee at the gate.
“Do we think this person is safe to travel based on what happened to them?” Doyle said. “That can get nuanced because you can have the same situation but based on the flight there might be different recommendations.”
For example, he said, a person with some mild symptoms may be cleared to take a short domestic flight but could be advised against traveling on a longer international service, especially one that flies over the oceans or the poles.
“It’s inconvenient for the passenger, but it’s really for the safety of other passengers and us, and it reduces diversions, which are inconvenient for everybody. They’re safer to be on the ground,” Heiple said.
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What do passengers need to know?
Although airlines have medical resources available, Doyle said it’s better if passengers don’t travel with the mindset of relying on them.
“If you’re a passenger traveling, there’s no medical condition that gets better at altitude. If you’re not doing well on the ground, you’re probably going to do at least as bad or worse in the air,” Doyle said. “You’re getting onboard a commercial airliner, you’re not getting onboard an air ambulance. Even though there are some resources available, they might be limited.”
Zach Wichter is a travel reporter for USA TODAY based in New York. You can reach him at zwichter@usatoday.com
