In this experience we look at what happens when there is a medical emergency in flight. The incident that will often cause the classic announcement over the public address system: "Ladies and gentlemen, if there are any qualified medical personnel on board please indicate by hitting your flight attendant call button." It's just for doctors who assist with medical emergencies. Nurses and paramedics are other examples of professions that assist with medical emergencies. And it's not always the dire situations like you see in TV and movies. Usually it starts with someone stating they don't feel well, a travel partner or a fellow traveller noticing that a passenger does not appear to be well. Flight attendants look for signs of illness – in some cases it might be something as simple as dehydration. Of course the flight attendant has no idea what the passenger's day was like before the flight, how many flights a passenger may have done in the day, or what the passenger's medical history is. It could be an acute issue, but sometimes it could escalate. The goal of the crew is to make the passenger comfortable and determine what's going on. A crew member will not be doing any of this alone, someone always be assisting the first crew member who responded. And if it gets to be a big enough situation, the captain has to know. At that point you'll hear the ding. Who gets involved? Sometimes there are cultural or liability concerns in some countries which may cause some people to avoid assisting. Crews deal with medical support on the ground by calling with a satellite phone or through the flight deck. This ground-based medical support maintains control and decision making. Airlines have a well stocked medical kit – even doctors usually don't know the specific contents of an airline's kit – they're not able to open it without guidance from the ground. Crews are not allowed to administer medication. A crew member is involved with the note taking and paperwork along with the medical responder. What do crew do with the passenger who had the medical emergency? It may also be a case of a passenger needing oxygen. Vinod shares a memory of an unintended handful when providing oxygen on the way to Maui. Remember, not all medical cases are physical. They could also be emotional. Meanwhile...the crew cannot forget about the rest of the service on the flight. What happens when the plane is flying over isolated locations without medical facilities or runway service? Vinod shares a story of a British Airways Los Angeles to Heathrow diversion that arrived at Calgary. Often it also means an affected passenger's bags will have to be pulled off the flight. We share Vinod's classic experience in Denver once again. Vinod shares a story of an intense CPR experience when he opened the door of a Martinair 767 flight. Sometimes the airplane will have stretchers built right in. And sometimes it's a challenge for paramedics to get to the back of plane – like Vinod saw in Manchester, UK. Not all passengers involved in a medical incident survive. Vinod shares a particular route that this happens very frequently. What do crew do when it happens? How does crew handle bystanders? If you're called upon to change your seat, please oblige the crew. There may be compensation available to passengers and to medical personnel who respond. Geoff takes a quick look at Lufthansa's "Doctor on Board" program. What happens if the crew get sick, or there is a quarantine situation inside a plane? Vinod shares a story of a returning flight he was waiting for on the ground – and oh did that airplane smell. Finally, there are cases where external police may need to get involved – and Vinod shares a story from before he was working in aviation. The crews go through a lot of training and requalification, and recently many airlines are adding a Chief Medical Officer to their staff. If you're not feeling well, it's okay to ring the bell and let the crew know. News Items: Flyertalk.com article "Maskless Flyer Urinates in Alaska Airlines Cabin, Faces $250,000 Fine." businesstraveller.com article "Singapore Changi launches baggage disinfection service." If you have a story about a medical incident inflight as a passenger or medical responder, a question, or other experience that you would like to share, please email us at stories(at)seat1a.org or find us on Facebook, Twitter, Instagram and Patreon. Show notes are available online at http://podcast.seat1a.org/.

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