An Expanding Horizon

An Expanding Horizon MedAire's business grows as airlines realize the advantages of inflight medical emergency support BY Monica L. Rausch, Associate Editor July 1999 PHOENIX, AZ — A woman, 38 years old, is six months pregnant...

While convincing doctors and customers of the need, Garrett also built a foundation of information on airports, hospitals, and the specialties of those hospitals. "I recognized that by handling the call in flight, that was only a piece of the puzzle ...You could do a great job of saving their life in the plane, but they could die from the airport to the hospital."

Software was a huge investment for the company, says Garrett. MedAire is now in its fourth rendition of customized software, with some five years put into the most recent design.

Getting A Quick Response
Garrett's company is built around the three factors she believes it takes to handle a medical emergency aloft:

• Training "by people who understand that environment, the constraints of the environment, and all the variables associated with it," says Garrett.

"If you look at the criteria written by the FAA, for example, in terms of training flight attendants, Éit's not realistic. It's text book."

Training should be simple enough to remember, hit the basics of life support, and center around the most frequently occurring medical emergencies, she adds. MedAire has found that 14 percent of all calls to its service are cardiac related. "That means that every one of those has a chance of becoming a CPR victim...The focus should be the one thing that's not even required (by FAA): to be trained on CPR, " says Garrett.

MedAire offers the Medical Inflight Illness and Injury course which incorporates CPR training and training on automatic electronic defibrillators (AED), tools used to resuscitate cardiac arrest victims. Courses are usually held on customers' aircraft so that crews can see how to treat and maneuver a sick or injured passenger in a small area. "The idea is to be in the aircraft with them and help them design a plan," says Garrett.

• Tools: MedAire stocks its medical kits with the tools to treat medical emergencies the company has found most common among its customers. Tim Singleton, a MedLink communications specialist and instructor, recommends three staples: epinephrine for allergic reactions; glucose gel for diabetics experiencing low blood sugar; and nitro glycerine for heart patients.

AEDs are also distributed by MedAire. Garrett is a strong supporter of having them on board all flights. Passengers in cardiac arrest need help within minutes, she says; even diverting may take too long.

• Medical assistance on the ground: "Even as a flight nurseÉI always had my medical control to call when I got into trouble," says Garrett. This is where the MedLink service comes in, she says, especially since crews can rely less and less on assistance from medically trained volunteers on board. According to calls received by MedLink, from 1996 to 1997 medically trained passengers responded to 65 percent of inflight emergencies; in 1998 that number dropped to 56 percent. And, on smaller aircraft typically used in business aviation, it is less likely a medical physician is on board; help from the ground could be invaluable. Currently 15 carriers are signed up with MedAire, but MedAire's mainstay is still business aviation, says Garrett.

Passengers at risk
Now, with some 13 years experience in handling calls, MedAire is able to build statistics to estimate future trends. Looking at the number of patches they receive, Garrett reports that inflight medical emergencies are on the rise among clients, up 25 percent in 1998 over 1997. (This figure takes into account business growth.)

She believes this rise in the number of inflight emergencies mirrors a growth in the number of "at-risk" passengers. Airlines are altering policies and procedures to better accommodate the disabled, and the aging of the American population means more elderly passengers will be on board more flights in the future. Garrett adds that there is a need for medically prescreening individuals at the gate to safely accommodate special medical requirements of passengers.

"We always had the hypothesis that people who traveled with existing past medical illness in their history, that they had a more difficult time in flight...And what we've seen is that that hypothesis has been borne out and the fact that inflight medical emergencies are on the rise because there are more and more infirm or chronically ill people traveling," says Garrett. "There's no doubt in our mind that this is going to continue and with much greater frequency."

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