my discussion with a flight attendant

[Just Plain Ruff]

Ruff, I spoke with a commercial pilot that is personal friends of mine and also an EMT. He said their company policy was to have proof of the persons credentials before unlocking the medcial kit.

Is it possible this is an airline by airline policy as opposed to FAA policy?

Yes it is airline by airline but can you imagine the news story that would come out

paramedic on board airplane but was not allowed to use the medical kit. Child dies.

[brentoli]

True dat.

My friend, hopefully, is smart enough espically knowing a paramedic's scope of practice to allow it.

[Dustdevil]

Yeah, but the other story is just as scary, and just as appealing to the media:

• And then there is a whole laundry list of people who are well "qualified," but not necessarily carrying a licence. Retired physicians and nurses. Military medical personnel. What to do about them? And, of course, aircrew personnel are probably no more familiar with what a paramedic licence looks like than we are with what a pilot's licence looks like, so that puts them in a hard spot to really verify authenticity. And do any of them really have a clue as to the difference between an EMT and a Paramedic? And what about all those EMTs out there who have a whole 3 years experience on an NJ volly squad, plus they took an ACLS class, so now they think they are qualified to practise cardiology? I can tell the difference in a nanosecond, but darn few pilots or flight attendants could.

It's a tough position for the aircrew. I think what they usually do is just take your word for it, and hope for the best. And really, that is probably the best option available.

[Doczilla]

There was a review of this topic on EM:RAP a couple of years ago which was excellent. Medical equipment carried varies by airline. Some are very comprehensive, while others meet the minimum standards. The airlines tend to guard this information for security or other reasons. As several physicians pointed out, they may or may not be asked to show credentials (another reason the state medical board issues wallet-size cards, and I always carry mine), again varying by airline policy. In the absence of credentials you can give them your identifying information and the state licensing agency. The pilot has control of all decisions regarding aircraft control, whether or not they land or divert the aircraft for the medical emergency. The best thing that you can do (other than snatch the passenger from the hungry jaws of death) is advise them whether or not to divert or land early.

The ground-based medical control doc has control over what medical care is provided in the air, and they can and will tell the flight attendants to tell you to piss off if you're obviously clueless. These are usually aerospace medicine or emergency medicine trained physicians who are contracted by the airlines for this service. They will also provide advice to the pilot on whether or not to land or divert. No matter who you are, they will be talking to this physician, so deal with it and talk to them over the radio. Likely your assessment will be better than the one provided by the flight attendant or non-medically trained passenger and will be helpful to the medical control physician. You do not necessarily need an active license to perform interventions under direction of this physician.

Diverting an aircraft or landing early presents significant challenges. Airplanes are always full; if they don't have a full complement of passengers, they make up for it in cargo. The landing gear are generally not designed to land with a full plane and a full fuel tank. If you divert, you have to burn off that fuel or dump it. The first takes time, the second, well, sucks for the environment. It therefore would behoove you to make this decision wisely. Keep in mind that once the pilot gets clearance to land, burns off the fuel, makes approach, etc, you may not be saving much time with most domestic flights.

You can't really pronounce a patient in the air, because the coroner that has jurisdiction is the one for the county you are flying over at that point. There is nothing to say you can't discontinue futile resuscitation efforts (or not initiate resusc on someone who is obviously dead), but the patient will not be declared dead until landing. In this case, it would be advisable not to divert the plane, since doing so would not help anyone.

On the oxygen issue, there is a specific FAA guideline on permitting transport of medical oxygen cylinders. You can't SHIP them by air, but they may be carried for emergency or routine passenger use.

'zilla

[pacman]

And what about all those EMTs out there who have a whole 3 years experience on an NJ volly squad, plus they took an ACLS class, so now they think they are qualified to practise cardiology? I can tell the difference in a nanosecond, but darn few pilots or flight attendants could.

You're dead on there Dust. There are a many scary ones here!

[firedoc5]

Many of the Airlines have gone to this "TYPE" of kit:

http://www.statkit.com/index.cfm?fuseactio...amp;itemnum=700

Its not like your on a bus or something, one really can't get off at the next stop .... ok just the way I read this tickled me funny bone is all.

Ok a story: I am sitting in the back of a continental jet, getting the safety briefing ... like I haven't done them myself ... so the attendent after the seat belt demonstration : this slays me in itself, like who does not know how to operate a seat belt these days ? Anyway the attendent says : "In the event of sudden loss of cabin pressure" part ... and not ONE person is listening, well accept for me. She states: WHEN THE SCREAMING STOPS pull the mask sharply towards yourself .... well you get the point ! So now I am laughing so hard all of the passengers are looking at ME!

The attendant and I got along great after that, she gave me free drinks for the next 3 hours ... telling the other passengers that I was the only one that answered the skill testing question....dang good flight.

cheers

Are you sure you just weren't trying to get into the "mile high club"?

[tniuqs]

[

Are you sure you just weren't trying to get into the "mile high club"?

Ok I like the way you think, but .. um ... let me think NO! In a public washroom the size of a NYC locker in Grand Central station .... eeeuuuwww.

I WAS trying to TRIPLE my Airmiles ! :oops:

[firedoc5]

Ok I like the way you think, but .. um ... let me think NO! In a public washroom the size of a NYC locker in Grand Central station .... eeeuuuwww.

I WAS trying to TRIPLE my Airmiles ! :oops:

I can relate.

On a flight back from Dallas, a VERY early flight after a Cowboy's game :sleepy2: , my seat just happened to be in the very back where the attendant sat. I had a patch with a star of life or something on it on my carry on and she asked me if I was a medic. I told her I was. She said that at one time there was a state that proposed that if someone had medical training that they had to inform someone on the flight crew. I don't know what state, I think it might have been TX. But that was years ago.

[asrnj77]

The card issue is irrelevant. As mentioned before, they have ground medical control. So you put the little headset on and speak with the md on the ground. They can't see what your little card says and the situation now calls for somebody to do what they are able to. If you tell the doctor that you are an EMT-B and don't know how to start a line but you think this person is having a stroke, then the doctor will authorize you to perform whatever they are comfortable with on their medical license. This may be 02 by non-rebreather and monitor. You can't expect a flight attendant to say "oh I see that you are a wilderness emt from Pennsylvania and since we are currently over some wilderness you can now go crazy with the furosemide and 16 gauge iv"

Hopefully the most qualified person or group of people will volunteer and explain their level of ability to the medical control and they will take it from there.

[CBEMT]

Unfortunately, my state doesn't issue wallet cards, we're given an 8.5"x11" piece of paper. Not exactly portable. I've taken the step of making a photocopy, folding it up 5 or 6 times, and carrying that.

One guy on my POC department had a copy of his shrunken down to wallet card size, and laminated it.