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What would happen if someone were to die while in-flight?

Written by Capt Lim, on 01-10-2006

Published in : Flying, Emergencies

Hi Captain Lim,

I'm a paramedic and was asked, what would happen if someone were to die while in-flight? I've done some searches and found that "nobody dies on an airplane" kind of like, "nobody dies in an ambulance" as it creates all kinds of problems. They don't "legally" die anyway, not until on the ground. However, if someone were to die and it went unrecognized for 30 minutes to an hour, starting resuscitation would be pointless, not to mention the borderline abuse of a corpse.

If there is a doctor on board, can they declare someone dead or does it depend on where they*re licensed, where the plane is, etc.?

I know most, if not all airlines, have contracts with online medical control physicians to guide them in the proper procedures, but are there ever cases where resuscitation were not attempted? If so, is the passenger left in their seat or are they moved?

What would be the furthest distance from an airport in the event of a medical emergency, when flying over the Atlantic, Pacific, etc.?

Thanks,

Andrew

P.S. Great site by the way!

Hi Andrew,

It is not true that "nobody dies on an airplane". It has happened to one of my flight on a Boeing 777 from Australia (can't remember which city) to Istanbul, Turkey. I found out later that the passenger was a terminally ill patient and his wish was to be buried in his homeland should he eventually leave this world. Indeed, halfway through the flight, he unexpectedly passed away. When someone dies in flight, there are laid-down procedures to handle such a case.

I believe, as a paramedic, you are probably more concerned about cases where a passenger may suffer, for instance, a heart attack and may require resuscitation to revive him. Well, all flight attendants are trained on CPR (cardiopulmonary resuscitation) procedures and would do the needful immediately. So, there is no question of cases where resuscitations were never attempted. Of course, at the same time, doctors or paramedics, if available in flight, would be paged to come forward to provide more professional assistance.

In fact, on the long-haul Boeing 777, an AED (Automatic External Defibrillator) is carried on board the cabin. This defibrillator has been found to be more effective than the CPR procedures and pursers and in-flight supervisors have been trained on its use on passengers in case of heart attack.

The captain of the flight would be informed of any medical emergencies. He would then make any decision to divert to the nearest airport with the proper medical facilities based on the in-flight doctor's recommendation. However, where some airlines that subscribe to some kind of in-flight medical assistance, such as Medlink, the in-flight crew would be given proper procedures to follow.

In the case of Medlink - this is a direct communication between the flight crew and MedAire, an organization where doctors attached to the emergency room, would study the problems of the in-flight emergencies and then give an instant expert advice. Up-to-date lists of airports suitable for diversions and details of their medical facilities are also available. This facility gives confidence to crew and any on-board doctor. Once MedAire has been contacted, the doctor is relieved of liability. The captain would then make the decision whether to divert or not, and in case of dispute, would follow the MedAire's advice over that of any on-board doctor or nurse.

What would be the furthest distance from an airport when flying over the Atlantic, Pacific, etc, would depend on when the emergency occurs and the location of airports with medical facilities. It can range from a few hundred to a few thousand miles. If the airline is a member of Medlink, then the captain decision is made easier - he merely proceed to the nearest airport on the given list. The commonest reasons for diversion in a recent US study were cardiac incidents.

If someone were to die on board a plane, I believe, any qualified doctor could declare him dead. In such a case, it is no longer an in-flight emergency. The passenger is normally left on his seat with the face covered. A formal report is then duly made when the plane lands at the destination.

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