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BACKGROUND: In-flight medical emergency (IFE) impose considerable challenges on healthcare workers (HCWs) because of limited resources, constrained environment, and medico-legal issues. This study assessed HCWs knowledge, willingness, and confidence in addressing in-flight medical emergencies. MATERIALS AND METHODS: A cross-sectional study was conducted between June and August 2023 among nurses and physicians working in primary healthcare centers and governmental hospitals in Bahrain. Subjects were selected using stratified random sampling; a self-administered online questionnaire of high reliability (Cronbach alpha = 0.914) was used to collect the data. Logistic regression analysis were performed to determine association of knowledge, willingness, and confidence in dealing with in-flight emergencies with various characteristics of HCWs. RESULTS: The study included 805 HCWs with mean age of 35.5 years (SD=9.2). The findings indicated deficiency in training, with

Introduction: Emergency medical kits (EMK) are provided to clinicians who volunteer on commercial aircraft during a medical emergency. The contents of the EMKs are mandated by the Federal Aviation Administration in the United States and, internationally, by the International Civil Aviation Organization and the country of airline origin. The mandatory contents of the kits have not been updated by the Federal Aviation Administration since 2006, and the EMKs continue to lack key equipment such as automated blood pressure cuffs, glucometers, pulse oximeters, and epinephrine autoinjectors. Of further concern is a lack of standardized and centralized reporting for in-flight medical events that, if it existed, could better inform the contents of the kits. This commentary is intended to advocate for an update to the EMKs in the United States given the authors' experiences with in-flight medical events. Rajagopal AB, Pissaris A, Clark K, Merrill A, Glatter R, Ho A, Towle DC, Yanuck J, Lahham S, Ulin L, Fischetti C, Apisa L. Recommendations for updates to emergency medical kits for commercial aviation. Aerosp Med Hum Perform. 2024; 95(10):794-796.

Background: In-flight medical emergency (IFE) impose considerable challenges on healthcare workers (HCWs) because of limited resources, constrained environment, and medico-legal issues. This study assessed HCWs knowledge, willingness, and confidence in addressing in-flight medical emergencies., Materials and Methods: A cross-sectional study was conducted between June and August 2023 among nurses and physicians working in primary healthcare centers and governmental hospitals in Bahrain. Subjects were selected using stratified random sampling; a self-administered online questionnaire of high reliability (Cronbach alpha = 0.914) was used to collect the data. Logistic regression analysis were performed to determine association of knowledge, willingness, and confidence in dealing with in-flight emergencies with various characteristics of HCWs., Results: The study included 805 HCWs with mean age of 35.5 years (SD=9.2). The findings indicated deficiency in training, with <10% of participants trained on IFE. A considerable proportion of participants exhibited low levels of knowledge (88.3%) and confidence (75.9%) with IFE. Nonetheless, more than half of the participants expressed the willingness to assist in IFE (59.1%). Non-Bahraini healthcare professionals (odds ratio [OR] = 2.901, P < 0.001) had higher knowledge of IFE. Nurses (OR = 1.642, P = 0.047) and participants with longer work experience had higher willingness to assist in IFE. In addition, professionals who were non-Bahraini (OR = 3.249, P < 0.001), working in secondary care (OR = 1.619, 95% confidence interval P = 0.021), had had training on IFE (OR = 2.247, P = 0.004), and had encountered IFE before (OR = 1.974, P = 0.006) had greater self-confidence levels., Conclusion: Considering the low levels of knowledge and confidence healthcare professionals in Bahrain had with regard to IFE, targeted training initiatives and educational programs are necessary to improve HCW's confidence and preparedness to deal with such emergencies., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Family and Community Medicine.)

INTRODUCTION: In-flight medical emergencies require healthcare providers to operate in confined spaces with limited resources and delayed access to definitive care.These emergencies are common, with an estimated frequency of 1 per 100 to 1000 flights. Despite this, training for medical response in these environments is limited. We hypothesize that integrating such education into a pre-existing medical student elective course would improve knowledge and ability to respond appropriately to in-flight medical emergencies. METHODS: The available literature surrounding in-flight medical emergencies was reviewed. Syncope, respiratory distress, allergic reaction, and cardiac arrest were identified as common and potentially life-threatening complaints. Simulation cases were designed for each of these complaints and a simulation room was modified to mimic an airplane cabin. These simulation cases and accompanying relevant didactic lectures were incorporated into an existing wilderness and extreme environmental medicine course, with multiple-choice tests completed by the students at the beginning and end of the 2-wk course. RESULTS: Participating in this study were 18 students. The pretest average was 76%, which improved to 87% on the posttest. Qualitative feedback regarding this type of training was overwhelmingly positive. DISCUSSION: Simulation-based training for in-flight medical emergencies can significantly improve medical students'knowledge. This training was very well received by the students. Opportunities for training to manage in-flight medical emergencies remain limited; incorporating such training into existing curricula could provide a means by which to improve provider knowledge. Such a curriculum could be adapted for use by flight crews and other populations. [ABSTRACT FROM AUTHOR]

More people are travelling by air and in-flight medical emergencies are becoming more common. Some in-flight emergencies require assistance from passenger doctors who act as good Samaritans in the sky. Their liability and the associated medico-legal issues of providing assistance in mid-flight emergencies are unknown. Although provisions exist in theory about good Samaritans on the ground, it is unclear to what extent these doctrines are applicable to good Samaritans in the sky. This article examines the obligations, liability and legal protection of doctors when acting as good Samaritans in mid-flight emergencies, regardless of their nationalities. It examines the jurisdiction, existing legislations, case law in the United Kingdom and compares with their equivalence in the United States and to some extent, with the legal provisions in France. In addition to in-flight emergencies, this article reviews airlines’ liability for injuries sustained by passengers during flight. It is concluded that doctors’ liability is unclear and uncertain, their legal protection is inadequate and inconsistent; airlines’ liability is restricted by the courts. Reforms proposed include legislative enactment and extension of commercial airliners’ insurance to accord the deficient legal protection. [ABSTRACT FROM AUTHOR]

Introduction: In-flight medical emergencies occur in an estimated one out of 604 flights. Responding in this environment poses a unique set of challenges unfamiliar to most emergency medicine (EM) providers, including physical space and resource limitations. We developed a novel high-fidelity in-situ training curriculum focused on frequent or high-risk in-flight medical scenarios while replicating this austere environment., Methods: Our residency program coordinated with our local airport's chief of security and an airline-specific station manager to arrange the use of a grounded Boeing 737 commercial airliner during late evening/early morning hours. Eight stations reviewing in-flight medical emergency topics were reviewed, five of which were simulation scenarios. We created medical and first-aid kits that reflect equipment used by commercial airlines. Residents' self-assessed competency and medical knowledge were assessed both initially and post-curriculum using a standardized questionnaire., Results: Forty residents attended the educational event as learners. Self-assessed competency and medical knowledge increased after curriculum participation. All tested aspects of self-assessed competency had a statistically significant increase from a mean of 15.04 to 29.20 out of a maximum score of forty. The mean medical knowledge score increased from 4.65 to 6.93 out of 10 maximum points., Conclusion: A five-hour in-situ curriculum for reviewing in-flight medical emergencies increased self-assessed competency and medical knowledge for EM and EM-internal medicine residents. The curriculum was overwhelmingly well-received by learners., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Kommor et al.)

Fire on board an aircraft is one of the most serious incidents that may occur during operation. Ever since military jet combat aircraft were equipped with fire protection systems, flight manuals have included instructions to eliminate fire on board as part of the instructions for in-flight emergencies. Emergency abandonment thus was no longer the only and inevitable solution to the occurred situation. Over the sixty years of operation of military combat aircraft equipped with fire protection systems in Czechoslovakia and the Czech Republic, there has been a clearly discernible evolution also in instructing pilots in in-flight fire emergencies. These instructions reflect very well not only the progressive technical development of aircraft, but also the overall concept of safety in military aviation. This article presents a unique comprehensive overview of such emergency procedures, common features, differences and developments in Czechoslovak and Czech Republic military jet combat aircraft since 1951. [ABSTRACT FROM AUTHOR]

Medical emergencies frequently occur in commercial airline flights, but valid data on causes and consequences are rare. Therefore, optimal extent of onboard emergency medical equipment remains largely unknown. Whereas a minimum standard is defined in regulations, additional material is not standardized and may vary significantly between airlines. European airlines operating aircrafts with at least 30 seats were selected and interviewed with a 5-page written questionnaire including 81 items. Besides pre-packed and required emergency medical material, drugs, medical devices, and equipment lists were queried. If no reply was received, airlines were contacted up to three times by email and/or phone. Descriptive analysis was used for data interpretation. From a total of 305 European airlines, 253 were excluded from analysis (e.g., no passenger transport). 52 airlines were contacted and data of 22 airlines were available for analysis (one airline was excluded due to insufficient data). A first aid kit is available on all airlines. 82% of airlines (18/22) reported to have a "doctor's kit" (DK) or an "Emergency Medical Kit" (EMK) onboard. 86% of airlines (19/22) provide identical equipment in all aircraft of the fleet, and 65% (14/22) airlines provide an automated external defibrillator. Whereas minimal required material according to European aviation regulations is provided by all airlines for medical emergencies, there are significant differences in availability of the additional material. The equipment of most airlines is not sufficient for treatment of specific emergencies according to published in-flight medical guidelines (e.g., for CPR or acute myocardial infarction). [ABSTRACT FROM AUTHOR]