Nic Hamilton: Death from above

It's a very rare occurrence to have someone have a cardiac arrest on a plane, but it does happen. Illustration / Daloui

An in-flight medical emergency, with no doctors on board, is a terrifying experience writes Nic Hamilton.

"Is there a doctor on board?"

There I was, sipping a tomato juice and eating salty snacks. Just quietly enjoying the view from 35,000ft, when the voice of a person trying not to sound panicked asks if there is someone on board who wouldn't mind helping out with a bit of CPR on the gentleman in the front row whose heart has stopped beating.

My heart started beating faster. And then, among the silence a collective feeling of dread, because no one stood up. Surely not I thought, there has got to be someone on this plane who has watched Shortland Street.

The air crew were frantically trying a few of the more well known medical procedures like ensuring the air vent above him was flowing correctly.

The call went out again and this time the pretence of not being panicked had disappeared: "Please, is there a doctor on board?!"

There wasn't. And so there we were at 35,000ft above France with a man who had just died, and no one knew what to do except the pilot who diverted to Lyon.

Worldwide, 2.75 billion passengers fly annually on commercial airlines so stories like these are becoming more common. But let's be clear - despite recent news events - the airline industry is at its safest since the dawn of the jet age and the stats show it's a very rare occurrence to have someone have a cardiac arrest on a plane.

It was particularly unlucky for the chap in the front row not to have a medical practitioner on board. However, airlines often call on professionals to assist, which is partly why some airlines provide preferential seating at check-in if medical professionals offer to be "on call" during their flight.

Doctors who step in to help on a flight are putting themselves into a situation that might not be part of their medical specialty. A cardiologist could probably deliver your premature baby but imagine grappling with a diabetic when you're an ear, nose and throat specialist.

Under Good Samaritan laws, doctors have an ethical and moral responsibility to offer assistance.

Legal liability on a doctor's in-flight care has never been tested in law in New Zealand, but it can be a concern when asked to respond in a situation where availability of medical equipment, oxygen and drugs can be limited. It's like a mechanic responding to a call for help, but turning up with a wrong-sized spanner and a can of CRC.

The sense of isolation when a medical emergency takes place on a plane becomes an agoraphobics' nightmare. If you're halfway over the Pacific, there aren't many options available to the air crew except to ask passengers for help.

So what is a traveller to do to help prevent a fellow flier croaking?

Airlines publish plenty of information about how to ensure you don't cause them a major headache by having a stroke. Not drinking too much alcohol is an obvious one.

Airline travel can be stressful at the best of times. You rush to the airport, park the car at exorbitant prices, wrestle over-packed suitcases onto the check-in scales praying that you're not going to be charged excess baggage, take your shoes and belt off at security, so you can spend hours in a small pressurised tube. It's a wonder more of us don't require medical assistance.

Although no one would expect aircrew to perform like A&E doctors in an emergency, commercial operators have a duty to train staff to know how to respond in an emergency. Air New Zealand carries defibrillators on all flights and crew are trained to use them.

Heartening news. But if it's your time it's your time.

Whether you're mid-Pacific or standing outside your local hospital is irrelevant if your heart doesn't want to play anymore.

Dying on a plane just means you get an audience.