IMPORTANCE OF FIRST-AID IN AVIATION

  • by. PRM. DAĞHAN AYLANÇ

It’s known that approximately 3 billion people used air travel in 2015 as their preferred method of transportation amid the ever-expanding world of aviation. It’s not a surprise to say that air travel is our number one method of moving about between cities and countries even though alternatives exist. Out of all the options available, air transportation enables fast, safe, and timely efficient means of reaching our loved ones, our homes, and our business links.

We live through the burden of check-in, immigration and multiple numbers of security checks before we are finally allowed on board the aircraft. As we board the aircraft, we witness the warm welcome of cabin crew members who then take care of us for the duration of the entire journey. As an introvert, anxious, or conversely the lively character a passenger can be, they all get a smile as they make their way into the pressurized hull.

Soon after take-off, we begin to enjoy the beautiful scenery through our windows. Just as the aircraft rides the troposphere, out of the blue, you hear the following announcement made either by the cockpit or the cabin crews; ‘’Attention please ladies and gentlemen, if there is a doctor or a medical staff on board, could you please make yourself known to the cabin crew? Inevitably this announcement leads to a nervy next few minutes in the cabin. Combination of fear and anxiety can be sensed amongst the passengers. If luckily, a medically qualified professional happens to be on board, all eyes will turn in that direction and the remaining passengers will watch the series of critical events and actions unfold in awe and wonder from then on.

Know-how of First-Aid can become necessary in passenger aircraft just like it would do in our daily lives, and those who would employ the techniques of First-Aid ought to have some solid initial training to help them carry out the critical steps involved. In actual fact, you will need to be qualified.

The rise in the number of medical emergencies on board aircraft is clearly showing an upward trend because of higher passenger numbers and longer flights. The number of commercial jetliners is soaring simply because more efficient aircraft are now affordable for the airlines, helping them to expand in an unprecedented manner. Inevitably, airborne cases of medical incidents are now more common to come across in the media.

As of 2018, there were no real time global statistics of onboard medical emergencies since it’s not compulsory to report such incidents to a central regulatory organization, or a watchdog. However, it is estimated that there is one incident for every 500-600 flights worldwide that need some form of a medical attention. Based on statistics gathered by Turkish Airlines, around 49 million passengers were transported in 2013, out of which 11,654 medical incidents were reported. This equates to 1 in every 4,204 flights. A total of 71 emergency landings had to be made as a result of these medical occurrences. Six fatalities were noted for 2013, the main contributory factor being cardiac arrest.

Cabin attendants receive first aid training whenever they start professional work to ensure that they are prepared for such a situation by continuing hands-on training for all medical emergencies on board. Legislations relating to the training given to cabin and flight crew are constantly being reviewed each and every year. Training includes at least Basic Life Support, Advanced Life Support, Trauma, Bleeding, Birth, Hypoxia, and Oxygen Therapy, Defibrillation (Automatic External Defibrillator) use.

If conditions arise beyond which First-Aid won’t suffice to keep the patient conscious and well, the Commander of the flight will most of the time decide to divert to a nearby airport where full medical support can be obtained. Most authorities normally require such diversions to be reported by filling in a Medical Incident Report.

We can divide the emergency situations that occur during and after a flight into two main groups;

Non-traumatic injuries (emergencies);

-    Sudden death,

-    Shortness of breath, frequent breathing,

-    A feeling of swelling in the body,

-    Earache,

-    A toothache,

-    Chest pain, heart attack,

-    Stroke, stroke,

-    Intermittent Consciousness, coma,

-    Fainting, frowning,

-    Psychiatric emergency tables

 

Traumatic injuries (emergencies);

-    Injury to the Head or the Limbs

-    Plane crashes

 

Post-flight, there are two other events which we can anticipate that can possibly make life difficult for us; "Blood clot" and "jet lag" (flight fatigue). Blood clots can form in our foot vessels due to immobility for long-lasting periods. The clot can lead to serious tabulations in our organs such as the heart, the brain and the lungs (pulmonary embolism, stroke, heart attack etc). Therefore, it’s highly recommended for passengers with a similar diagnosis to consult their doctors before setting off for long flights.

Typical symptoms of jetlag are tiredness, lightheadedness, insomnia and so on. This should not be mixed with the tiredness we feel after short flights due to pressure variations our body is exposed to.

Impact related wounds: Just like we typically encourage the widespread use of seat-belts on cars, we take a similar approach towards flying passengers and go as far as asking passengers to remain buckled up whenever they are seated regardless of the status of the seat belt signs. It’s not uncommon to experience unexpected clear air turbulence during the cruise portion of the flight where passengers are most relaxed and complacent. The aircraft may be tossed around in the atmosphere due to temperature and pressure variations, or clear air turbulence due to powerful jetstreams in the higher parts of the atmosphere. Although your aircraft is designed to ride the waves, the consequence of such encounters together with the unfastened seatbelts scenario is obvious head or neck injuries as a result of impact with the cabin roof, window, or seats. 

 

With due respect to all the eventualities described above, there may be times when no medically qualified passenger will be on board to support the cabin crew treating the sick or the injured passenger. In light of this reality, cabin crews must be trained to a minimum level of first aid knowledge and implementation should a requirement arise mid-flight. Remaining calm and focused are essential characteristics the cabin crew shall display when applying the principle knowledge of first-aid training that they have received.

There are many different types of medical equipment available onboard passenger aircraft, but of the many, the two most important equipment are the First-Aid Kit and the Emergency Medical Kit. The First-Aid Kit can be opened by the cabin crew and contains supplies to treat bleeding, burns, measurement of blood pressure etc.

The Emergency Medical Kit is prepared and sealed by medically qualified individuals. Its use is only restricted to doctors and/or paramedics. The contents are recorded and must meet the minimum requirements or standards outlined by international regulations.

Deontological ethics dictates that doctors shall provide support to those in need of first-aid or medical attention (on ground or air). The World Physicians Union and the Medical Ethical Regulations enforce doctors to exercise the privileges of their profession due to moral values whenever such a situation is brought to their attention, or whenever they witness a medical event unfold which requires immediate medical attention.

Last but not least, let’s not forget that no one can predict the nature of a medical emergency and how it will evolve, and whom it will affect. There is no room for discrimination when making use of our First-Aid skills for people of different beliefs and ethnic backgrounds.

PRM. DAĞHAN AYLANÇ


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