Is there a doctor on the plane? The distinctive conditions of cardiopulmonary resuscitation on commercial flights

Even today, when over 3.5 billion passengers travel on commercial flights each year, there is confusion about the duties and role of doctors and other licensed medical professionals volunteering to provide assistance to a passenger whose life is in jeopardy, especially when it comes to measures of cardiopulmonary resuscitation in the distinctive conditions of an airborne commercial aircraft. There are still no international, standardized guidelines, rulebooks, or instructions applying to all airlines when it comes to training and organizing the cabin crew, equipping emergency medical kits and covering the role of medical professionals volunteering their services in medical emergency situations. The aim of this work was to attempt to solve a common quandary among medical professionals when it comes to airplane travel. Based on the available literature, national and regional guidelines and rulebooks of airlines, in accordance with the ethical and legal principles binding medical professionals, we have attempted to answer the major questions related to cardiopulmonary resuscitation on commercial flights. All aspects are covered – from a doctor volunteering to provide emergency medical care, through the marshalling of the cabin attendants, the availability of equipment, interaction with the flight captain and the captain’s decision whether to perform an emergency landing, to the possibility of obtaining additional information from medical call centers on the ground and calling medical crews to the nearest airport