Washington, February 27: Physicians have developed recommendations for managing in-flight medical emergencies. In an answer to the call "Is there a doctor on board?", the researchers have formed a guide for managing such medical emergencies while onboard an airplane. Physicians at St. Michael's Hospital have developed practical recommendations for in-flight medical emergencies for healthcare professionals.

More and more people are travelling by plane each year, with approximately 2.75 billion passengers flying on commercial airlines annually, according to the authors. In Canada, there were 133.4 million airline passengers in 2015, a 27 percent increase from 2009, they said. This increase in patient traffic, along with longer flights that increase the stress of flying on the body and a greater proportion of older passengers and those with pre-existing medical conditions, have led to an increase in in-flight medical emergencies in recent years, according to the authors.

"Every health-care professional is likely to hear this call at some point while flying, but for most of us, treating patients on a plane is a completely unfamiliar scenario," said senior author Alun Ackery. "We wanted to provide a better understanding of what to expect and how to respond if you're called to assist in one of these emergencies."

The recommendations, developed in collaboration with Air Canada and WestJet, provided an overview of the available medical equipment, the environmental challenges of treating patients on a plane, the airlines' policies and procedures as well as the legal and ethical duties of physicians to respond to a call for assistance.

Every plane with at least 100 passenger seats is legally required to carry a medical kit, according to Transport Canada. Although Transport Canada also outlines the minimal requirements the medical kit must contain, individual airlines have the flexibility to enhance the contents as they see fit, the authors said.

"Each airline's kit is going to look different, and the contents aren't always going to be familiar, which adds another layer of complexity to an already stressful situation," said Dr. David Kodama, lead author of the recommendations.

In Canada, Quebec is the only province that imposes a legal duty on physicians to come to the assistance of a person in a life-threatening emergency, the authors said. All jurisdictions, however, have legislation that protects physicians who voluntarily provide emergency medical assistance at the scene of an accident or in an emergency.

The Canadian Medical Association and the Canadian Medical Protective Association both suggest physicians have an ethical obligation to provide their best assistance during an emergency, according to the authors.

"We recognize that hearing the call go out for a physician on board a flight can be unexpected, but we do have an obligation to respond," said Dr. Ackery. "We hope these recommendations will provide healthcare professionals with enough knowledge to make that call a little bit less anxiety-provoking in the future." The findings from the study are published online in the journal CMAJ.