- If a passenger experiences a medical emergency, the flight crew will measure vitals, assess the likelihood of causes of chest pain and contact ground-based medical support for guidance.
- The flight crew, medical volunteers, and medical ground support can offer recommendations, but ultimately the decision to divert is made by the pilot and flight dispatcher.
- The decision to divert the aircraft to land at a different destination due to a medical emergency may be appropriate for specific medical emergencies, but many other factors need to be considered.
In the hit HBO series, “Succession” fans are reeling after the latest episode (spoiler alert!).
One of the main characters, Logan Roy, played by actor Brian Cox, had a heart attack while on an airplane, which ultimately led to his death. This shocking plot twist has many people questioning what actually happens when you have a medical emergency on an airplane.
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If a passenger develops chest pain, the flight crew will respond, measure vitals, and assess the likelihood of causes of chest pain, Eric Stahl, MD, Non-Invasive Cardiologist at Staten Island University Hospital, explained.
The risk of thromboembolism (deep vein thrombosis or pulmonary embolism) is increased, particularly for long-duration flights. Differentiating between a heart attack or pulmonary embolism mid-flight may be difficult, but both require more specialized therapy at a medical center.
“I have not encountered a heart attack on a flight but I’ve been in several other situations, which included a cardiac arrest requiring CPR,” Dr. Heba Wassif, a cardiologist at Cleveland Clinic, told Healthline. “However, the goal in that situation is to have the patient directed to PCI available facility ASAP. Provide ASA which is available on flight. Nitroglycerin if available. Each airline has different drug kits. I was on an overseas flight where IV drugs were available which is not the case on American Airlines.”
If a medical emergency occurs, the flight crew notifies ground-based medical support for guidance.
“The flight crew members are trained in cardiopulmonary resuscitation (CPR) and are able to administer lifesaving medications and equipment available in the emergency kits,” said Stahl. “The flight crew may also seek assistance from other passengers who are trained medical professionals. The Aviation Medical Assistance Act (also known as a “Good Samaritan” shield) protects these passengers from liability.”
The Federal Aviation Administration (FAA) requires that emergency kits aboard US airlines contain specific equipment and medications.
“If a passenger develops chest pain and a heart attack is suspected, aspirin is available and should be given. Kits often include other medications that treat the pain associated with a heart attack,” Stahl stated. “If needed, medications to raise blood pressure, equipment for intravenous administration, and supplemental oxygen are also available.”
The decision to divert the aircraft to land at a different destination due to a medical emergency may be appropriate for specific medical emergencies, but many other factors need to be considered.
The flight crew, medical volunteers, and medical ground support can offer recommendations, but ultimately the decision to divert is made by the pilot and flight dispatcher, Stahl explained.
It may require 30 minutes to land from cruising altitude. Timely decisions and transport to a percutaneous coronary intervention (PCI)-capable hospital is important to avoid complications from myocardial infarction.
For those with chronic cardiovascular conditions, they should discuss travel with their doctor and take their medications regularly.
If they are at risk for low oxygen levels, supplemental oxygen may be needed to fly. Lastly, for long-duration flights, in-seat calf muscle exercises or walking down the aisle is recommended to avoid deep vein thrombosis, Stahl stated.
“If you are suffering from heart conditions, need to discuss with your cardiologist how safe is it to fly,” Wassif stated. “Make sure you have all your medications with you.”
In addition, “the change in oxygen can negatively impact patients with COPD, congestive heart failure, arrhythmias,” said Dr. Aseem Desai, a cardiologist at Providence Mission Hospital. “Usually, a heart attack is not caused by the flight. A patient usually has an existing blockage or clot they may be unaware of. Any stress could trigger a heart attack.”
In the instance a passenger has a heart problem, the flight crew will take vitals, examine chest pain and contact ground-based medical support for next steps.
The flight crew, medical volunteers, and medical ground support can offer suggestions, but ultimately the decision to divert is made by the pilot and flight dispatcher.
Diverting the aircraft due to a medical emergency may be appropriate for specific medical emergencies, but many other factors need to be considered.
For those cardiovascular complications, talking about travel and medication with their doctor is essential.
