Inflight Medical Care: An Update

A major concern in aviation medicine is the cabin inflight emergency that may result in the diversion of a flight. At the present time there is no convenient way to monitor the incidence of inflight medical emergencies because airline companies are not regularly required to report medical emergencies or resulting diversions. A survey of one major US airline revealed that one out of every one million passengers may be deplaned by an unscheduled landing because of a life-threatening medical emergency. During a two-year FAA survey of US domestic flights there were 2,322 inflight medical emergencies, averaging approximately three per day, which resulted in an annual diversion rate of approximately 9%. In a 1989 study, inflight emergencies among arriving passengers at the Los Angeles International airport were analyzed. During the six-month period of the investigation 0.003% of 8.5 million passengers developed symptoms in flight that required follow-up assistance on the ground, and 10% of these passengers required hospitalization. A survey of the status of inflight medical care aboard domestic US air carriers was undertaken to determine the impact of current changes in the airline industry. Information for the years 1990 to 1993 was obtained from two airlines and two inflight medical care delivery companies, representing a total of nine major US Part 121 air carriers. This sample accounted for approximately 65% of US domestic air carrier activity for the period 1990 to 1993. The information was reviewed to determine which category of inflight medical emergency occurred most frequently and which category accounted for the greatest number of diversions. The trend in the frequency of diversions for medical reasons was also assessed. The impact of inflight medical advice was then evaluated by comparing the number of diversions that resulted in hospitalizations to the numb