medical equipment

sofie · Post by **sofie** » 03 Apr 2007, 17:02

Hi,
I’m following a training to become a CCM. So, if everything goes well, I’ll be flying this summer.
When we learned about the safety equipment in the B737, I was very surprised there is no Medical-oxygen available. You can only give first aid oxygen (2 or 4l/min.) but you can’t use it for a resuscitation because there is no 15 l/min outlet and there is no equipment like a bag-mask for ventilation. Is this correct? It seems to me not very logical. I know in some cases, it can be dangerous to give 100% oxygen but it can be very helpful for CPR. Why is it they don’t have this equipment or are there other companies who do have this stuff on board?
Thanks for answering my questions…
Greetz
Sofie

TCAS_climb · Post by **TCAS_climb** » 04 Apr 2007, 10:20

It's not only a question of space available onboard, or regulatory requirement, but also of liability.

Let's take the example of defibrilators. They've become very cheap and easy to use, and they can bring a people back to life without much difficulty or safety risk to the aircraft or the people onboard. Almost every supermarket has at least one within reach ! However it's not required by JAR-OPS to carry one on every commercial flight. The next regulations, known as EASA Part OPS (coming up in about 18-24 months), may change that, but at this time it's not a regulatory requirement over here.

Here's what the regulations say about Emergency Medical Kits:

"AMC OPS 1.755
Emergency Medical Kit
See JAR-OPS 1.755
The following should be included in the emergency medical kit carried in the aeroplane:

Sphygmomanometer – non mercury
Stethoscope
Syringes and needles
Oropharyngeal airways (2 sizes)
Tourniquet
Coronary vasodilator e.g. nitro-glycerine
Anti-spasmodic e.g. hyoscine
Epinephrine 1:1 000
Adrenocortical steroid e.g. hydrocortisone
Major analgesic e.g. nalbuphine
Diuretic e.g. furosemide
Antihistamine e.g. diphenhydramine hydrochloride
Sedative/anticonvulsant e.g. diazepam
Medication for Hypoglycaemia hypertonic glucose and/or glucagon
Antiemetic e.g. metoclopramide
Atropine
Digoxin
Disposable Gloves
Bronchial Dilator – injectable and inhaled form
Needle Disposal Box
Catheter

A list of contents in at least 2 languages (English and one other). This should include information on the effects and side effects of drugs carried."

Impressive list, and it's obvious that only doctors could put all that to good use in a medical emergency situation.

Having said that, you need to realize that providing medical assistance to a person is a highly risky business. If it goes wrong, who says the relatives of the dead pax will not sue you and the airline for negligence? You tried to help and you messed up, but that doesn't matter. You're responsible. It has already happened that a real doctor (with a real diploma, etc.) got sued by the people he helped during a flight!!! Amazing, isn't it ?

Airlines are not very keen on giving lots of medical equipment to the crew. Coming back to the example of defibrilators, I know one company where there is one onboard, but it is not mentioned in the Operations Manuals or anywhere in the aircraft (i.e. on the location chart of the emergency equipment). Only the crew knows there's one, and if they're not comfortable with the idea of using it in a medical emergency, they're not forced to use it! If they decide to use it anyway, it's on their own responsibility, not the company's responsibility. If a pax dies of a heart attack in flight because the crew didn't use the defibrilator, the company is "protected": the pax do not know that there was one, the regulations do not require one and the chances of a lawsuit are close to zero.

A more clever approach is to subscribe to a service where you can call a doctor from the cockpit (either by sat phone or radio).

regi · Post by **regi** » 04 Apr 2007, 14:58

Can you use a Tazer to restart the heartbeat?

kozmopolitenka · Post by **kozmopolitenka** » 04 Apr 2007, 15:46

TCAS_climb: "Only the crew knows there's one, and if they're not comfortable with the idea of using it in a medical emergency, they're not forced to use it! If they decide to use it anyway, it's on their own responsibility, not the company's responsibility. If a pax dies of a heart attack in flight because the crew didn't use the defibrilator, the company is "protected": the pax do not know that there was one, the regulations do not require one and the chances of a lawsuit are close to zero."

I just can not admit the fact that crew wolud not even try to help as a last choice /defribrilator/,hm,cowardliness

744rules · Post by **744rules** » 04 Apr 2007, 16:55

I wouldn't call the crew cowards if they don't use it.

There is also something as a diagnosis. So,if this is wrong, the remedy might cause more harm then good. Remember, the crew get's a first aid course, that's not the same as a medical study.

kozmopolitenka · Post by **kozmopolitenka** » 04 Apr 2007, 17:25

certain subjects from aviation medicine should be highly required in crew-trainig,course is not enough,or,as a second,even better option, one preson graduated in aviation medicine should be required on each flight

sofie · Post by **sofie** » 04 Apr 2007, 19:30

With the automatic external defibrilators they provide on the aircraft there are not a lot of things you can do wrong.
Lay rescuers can be trained to use it. The AED analyses the cardiac rhythm by itselfs and you can only deliver a shock when a ventricular fibrillation is present. The only thing you have to do is make sure the pads or on the correct place (this is indicated on the pads), not on a pace-make... And that everyone stays clear of the victim the moment the shock is given.
In fact in case of a ventricular fibrillation, giving a shock can rescue a life!

Aviation medicine? I've never heard about that.. I tried to find some articles on that subject but I can't get acces. I'm very interested in that kind of stuff!

Paramedic · Post by **Paramedic** » 01 May 2007, 23:20

Hi, Im a first aid paramedic from Holland, I am writing a trainingsesion for other paramedics. so I was looking for emergency equipment of aircrafts.

I wonder if the emergency equipments includes also: Intubation materials, a neck splint, medical O2 bottle??

And also I wonder why there is only 2 of 4 l/min flow and not 15 l/min?

I read in the list of JAR OPS 1.755 that the first aid set includes some medicines, and I read in a reply that cabincrew has only a first aid course. I dont know which knowledge and skils cabincrew will learn at this course.

but I think a first aid course is not enough to decide to give a patient drugs, or other medicines. because I m also a first aid medic.

But if there is a paramedic, or doctor onboard he/she could use the medicines. and that is better I think.

I will give you 1 hints:
1 if you think a patient has somthing wrong with his heart you think (cardiac arrest pain on his chest) even the patient is not uncousiuosness, get the pads on of the AED on the patient, and start the AED, and keep talking with the patient.