Health: Airlines see on-board medical care as key issue

By BIRGIT HEITFIELD

A passenger in row 16 turns pale and struggles for breath before slumping into his seat unconscious. The cabin crew must go into action immediately ...

On-board medical care is being recognised as one of the most important problems facing modern airlines.

A rise in passenger numbers has seen a proportionate rise in the size of high-risk passenger groups, which include babies, the elderly and those in poor health.

Serious medical problems during a flight often spell an emergency landing and the additional costs this entails. Landing fees, hotel accommodation and replacement tickets leave airlines with huge bills.

Britain's Civil Aviation Authority is likely to demand changes too after the recent death of a young woman from a blood clot following a flight to London from Sydney, and a parliamentary committee will urge airlines to give more preventive advice on the condition.

The apparently healthy and active 28-year-old woman died from a deep vein thrombosis, also known as "economy class syndrome." Medical experts say middle-aged or elderly passengers, pregnant women, smokers and those with cardiovascular disease are usually the most at risk from the condition. For disaster to strike, other factors usually come into play, such as dehydration, a fatty meal or oral contraception.

In 1998, the German carrier Lufthansa had to deal with some 50 life-threatening situations caused by poor passenger health. In 37 cases, the aircraft had to make an emergency landing. In the United States, four such emergencies are reported every day.

An effective method of dealing with airborne health crises is telemedicine, which enables doctors to treat patients by means of a videophone. Medical equipment such as ultrasound scanners and biomonitors for monitoring heart and circulatory functions are maintained on board.

"These applications have all been adapted from space travel," says Eduard Mueller, spokesman for the German Aerospace Centre in Cologne.

The centre is working on a new telemedical system in cooperation with Lufthansa. In the event of an emergency, the crew will contact a specialist at a university clinic who will make a diagnosis and give advice.

In 1985, American critical care flight nurse Joan Sullivan Garrett founded MedAire in Arizona. The company provides a 24-hour medical hot-line for airlines.

MedAire's satellite phone technology means pilots can consult a team of doctors drawn from 16 specialist disciplines. Another 50 specialists can be contacted.

The doctors are trained to explain medical procedures in simple terms to laymen on an aircraft.

The firm's control centre keeps a record of some 5000 airports to ensure patients' immediate and effective treatment on the ground should the situation demand an emergency landing.

MedAire also provides training for flight crew. The firm puts the number of trainees at around 25,000 a year.

The course includes instruction on coping with emergencies caused by variations in passengers' oxygen supply - the trigger for the majority of in-flight medical problems.

The air pressure within an aircraft cabin is equivalent to that at the top of a 2500m mountain. The change in pressure can pose a risk to those suffering from chronic respiratory complaints, who may suffer circulatory collapse and heart failure.

Air recycling is seen by travel experts as another potential health problem. Airlines save on fuel costs by mixing fresh with recycled air passed through filters supposed to remove dangerous organisms.

With emergencies in mind, many airlines - including Air New Zealand - carry a defibrillator.

This is a mobile device capable of applying a brief electric shock to restore a patient's normal heart rate and can be operated by the cabin crew.

- NZPA