Ask Captain Lim

Dear Capt Lim,

Haven't received the FAQ updates from you for a while now but I still managed to read some of the FAQ from your Webblog. I hope everything is going well with you.

With the recent report of the British Airways dead passenger, I can't help but wonder how crews react in/to the situation and what decisions are made. Though it's a rare case but there surely are other unexpected incidents occurring. There's not much update on on-board handling of medical issues (correct me if I'm wrong). Hence I*m triggered by it to ask more.

I believe both cabin crews and probably flight crews too will have to undergo First Aid and CPR course as part of their training.

a. Were they taught the basic cardiac life support as well?

b. What other training is required?

c. When encountering medical emergencies onboard, what skill or knowledge is required of the crews? How are they trained to react to that?

d. I believe First Aid kits are made available on all flights. What about defibrillators, stretchers or other equipments? If yes, is it available on bigger aircraft only?

e. When confronted with emergency situation, are Captains given the discretion to divert the flight?

f. Will the passengers be consulted for diversion? Can diversion be aborted even if passengers are put at risk, due to operating costs?

Kindly enlighten me. I know it*s quite a list of questions from me.

Thank you in advance ;)

Den.

Hi Den,

I hope you have received my latest updates.

Thank you, I am feeling fine. I have stated the reasons in my last Newsletter as to why I was not as active as before. Well, it is basically the pressure of work and personal chores; further, when I am off, I wish to spend more time with my family too (especially my wife and granddaughter!)

a. Yes, both cabin crews and the flight crews have to undergo First Aid and CPR course as part of their training. They are taught the basic cardiac life support and the use of the defibrillators too.

b. Some of the initial courses last between 2 to 5 days and are followed by a practical and a multiple choice written examination. It covers all aspects of first aid which occur in the aircraft as well as the occupational health, manual handling, altitude physiology and details of medical equipment carried on board. In addition to the initial courses, the flight and cabin crew return for their annual refresher course and cardiopulmonary resuscitation practice that lasts a day, followed by an examination.

c. Remember, the flight crews are trained on basic first aid and the use of the life supporting equipment. For more serious medical emergencies, they would have to rely on the professionals. Hence the announcement "Is there a doctor on board?" is often heard over the public announcement.

In the United Kingdom, there is no legal duty for a doctor to offer assistance in an emergency although the General Medical Council considers that such a duty exists. The question of legal liability for medical emergencies on board aircraft is confusing because the law varies from country to country. Several major airlines have now taken out insurance policies indemnifying doctors who come forward to help.

d. First Aid Kits are mandatory equipment on board all commercial aircraft but the contents may differ from airlines to airlines. Virgin Atlantic was the first airline to carry automatic external defibrillators (AED). Provision of AED on board aircraft was controversial until the old unsuccessful and expensive procedure of cardiopulmonary resuscitation and diversion was challenged. Recent litigation has helped to increase their popularity. Now most major long haul carriers have obtained them and are training cabin staff in their use. And that means, AEDs are mainly carried on bigger planes.

e. Yes, all aircraft commanders have the discretion to make a diversion on medical emergencies based on the severity of the case. Of course, they would consult all parties - doctors in the air or from the ground and the airlines before coming to a decision. (Most airlines have their own medical departments with doctors on call to advise about any clinical emergencies.)

f. Normally the affected passengers are too seriously ill or unconscious to be consulted and if the commander's decision is to divert, he does so because a life is at stake. In my opinion, an airline*s reputation would be affected if it were found that it aborted a medical diversion and lost a life just to save cost!