In-flight medical emergencies during commercial travel

Abstract

Abstract Background Growing number of passengers travelling by air is associated with increased in-flight emergency medical events (IEMEs). However, there are scarce data regarding IEMEs during commercial travels. In this study, analysis of IEMEs occurring among adult and paediatric passengers during commercial international and domestic flights of a major airline company was targeted. Methods Data regarding IEMEs recorded in all international and domestic flights of a major airline company between 1 January 2018 and 31 December 2020 were collected. Demographics, adult and paediatric IEMEs, in-flight deaths and aircraft diversions (ADs) were analysed. Results Total number of passengers was 177 400 748 and a number of 22 541 (0.012%) IEMEs occurred. The frequency of IEMEs per 1 million passengers was 127. The number of male patients suffering from IEMEs was 8387 (37.2%), while the number female patients was 10 853 (48.1%). Median age of adult and paediatric patients were 43, [32–57], 4, [2–10], respectively. The most common cause of IEMEs in adult patients was headache (3424 IEMEs, 15.1%) and it was fever in paediatric patients (688 IEMEs, 3.05%). Multiple symptoms were present in 8449 IEMEs (37.4%). On-board doctors managed events in more than half of IEMEs (13 295 IEMEs, 58.9%). AD was required in 255 (1.13%) IEMEs. The most common reason for AD was chest pain (45 IEMEs, 17.6%) in adult patients. The most common reason for AD in paediatric patients was epileptic seizures (nine IEMEs, 3.5%). A total of 46 (0.2%) patients, including 2 (0.008%) paediatric patients, died. Conclusions Majority of IEMEs are not life-threatening conditions, which can be easily managed by cabin crew or on-board doctors without AD. Multiple symptoms can be present in a patient suffering from IEME. Ground-to-air medical assistance may help optimization of diagnosis and decision for AD.