Medical volunteers in commercial flight medical diversions

Background: In-flight medical emergencies are difficult to manage and medical volunteers can be valuable when these events occur. The study objective was to examine the role of medical volunteers in medical emergencies which resulted in medical flight diversions. Methods: This was a retrospective cohort study of medical diversions in a large Hong Kong commercial airline from December 2003 to November 2008. This study is derived from a database of in-flight medical events which has been previously reported. The presence of medical volunteers, the need for diversion, and the outcome for all in-flight medical events were recorded. The records of the medical diversion incidents were reviewed in detail and symptom-based categorization applied. Results: Medical volunteers were available in 1439 (35.4%) of the 4068 medical events and in 39 (84.8%) of the 46 cases which required medical diversions. Suspected stroke cases, as categorized under the nonspecific category, was the most common, followed by chest pains and deaths. Conclusions: Medical volunteers presented more often for more serious events, and may be due to the airline medical incident policy and medical legal concerns for volunteers. This study identified measures which may reduce medical diversions, including cabin crew training for stroke screening, and promote the use of the Medical Information Form (MEDIF) and indemnity forms. Recommendations for medical diversion may require more specialized training than is currently given in undergraduate medical courses, and may benefit from better communication with ground-based medical advice services