They were on their way to a cardiologist conference
If there is any time to have a heart attack, this is the time.
Except for the small inconvenience of being in a metal tube 30,000 ft in the air with limited medical resources
I'm guessing you didn't read the article, because they managed to get IV drips into her arm...not too shabby for a big cigar tube!
Starting an iv is fine, but you really want to start definitive treatment as soon as possible which generally requires placing a stent or giving tpa, neither of which can be done on an airplane.
Nstemi won’t get cathed immediately all the time. Come on Friday with an nstemi, nitro drip and waiting until Monday for a cath.
The cardiologist has golf on Sunday.
Still less golfing than... well, you know.
The one who's name shall not be spoken.
The orthopedic surgeon?
He is not a doctor, I can tell you that much.
Strong as an ox and twice as clever
SHAME! no really.. that was a bad one...
My point was that not all heart attacks get intervention immediately. We sit on MIs all the time.
I'd rather be in the air at 30 000 feet with 15 cardiologists than alone in my apartment...if having a heart attack - I'm not big on flying.
Not sure where you live but I'd rather be somewhere where an ambulance can arrive in less than 10 minutes versus on a plane where advanced medical care is probably over an hour away
Nothing is possible with that attitude!
...Or at that altitude.
Such high altitude attitude you have.
Nothing is possible with that altitude!
Most of us couldn't even afford treatment on the ground.
placing a stent or giving tpa, neither of which can be done on an airplane.
Not in coach, at any rate...
Not with that attitude they can't.
Not with that altitude they can't!
I was certainly not suggesting we replace cath labs or ERs by economy flights!
“She’s fine nurse, she has an IV in her”
“Doctor, she’s bleeding out”
Did the plane just have IV's on board?
Possible one of the doctors carried one for emergencies; more likely it was already on the plane. It's common for aircraft to carry them on board (https://www.usatoday.com/story/travel/columnist/cox/2014/12/21/airplane-flight-first-aid-medical-supplies-oxygen/20637251/) and I suspect transoceanic flights would be even more likely to.
Almost all commerical planes have med kits with basic emergency medications.
Im a paramedic and I did a international flight and a girl on board had a migraine.
I treated her with fluids, anti emetics and analgesia.
Where were you on my flight to Canada!? 6 hours of near-crying, retching, burping, and quietly begging my girlfriend to make it stop
Sorry to hear that.
Big reason of migraines during travel is dehydration. Drink lots of water.
Dont be afraid to ask the crews for help, they may be able to find some one or something to help you.
Thanks my dude. In my case it was stress and tiredness that triggered it. At the time I didn't actually know what was happening because I'd never felt that way before
Cool. But are cardiac monitors, pads, and meds standard equipment on a flight? I have a hard time believing airlines would have an ALS level kit on every flight.
They carry a decent selection of ALS medications and a AED is mandatory but no, they do not carry a true cardiac monitor. Still, you can handle a vast array of problems with what is available, especially since they can divert to a airport generally quickly.
What ALS medication can you give for an unknown cardiac condition without a monitor?
I can take a pulse check for bradycardia and give atropine.
If they are extremely tachy and symptomatic I can give adenosine.
If they have no pulse I can do compressions and alternative EPI and defibs from a AED.
ALS isn't fully reliant on a cardiac monitor. Just good clinical judgment.
In the case above, I imagine the doctors did 4 things, have her chew a asprin, give narcotics(if available) supplemental o2, and start a IV line to get fluids started. All in all, they were limited but there are things to be done (above all they identified that she was having a MI and diverting the plane to get her to the ground quickly which is the number 1 thing she needed, definitive care. )
You cannot differentiate between whether the tachycardia is wide complex or narrow complex on pulse palpation.
You may be able to differentiate regularity but not with certainty.
You could end up pushing adenosine on a patient with WPW in AF and taking away any element of nodal blockade driving the vent rate up and dropping them into VT or VF.
Only someone very foolhardy would push adenosine on a patient based on 'their pulse is a bit quick'. And besides you say 'symptomatic' - if they've got ischemia, features of shock. Etc the treatment is electrical cardioversion not adenosine.
WPW is an anterograde pathway that bypasses the AV node. That’s the hallmark of WPW. You can give adenosine for it and it simply wouldn’t do anything. The reason WPW is so dangerous is because if the pt was to develop AF there’s a pathway to bypass the AV node. In other words, AF becomes VF. By far the most common form of SVT is AVNRT (AV nodal reentrant tachycardia) which usually responds well to adenosine. I do agree with you that you shouldn’t just give it unless you’re completely out of options but keep in mind, most SVT’s (with the exception of WPW) are more annoying than harmful so giving adenosine isn’t really a priority in an emergency on a plane.
this thread of comments is exactly how I imagine this played out on the plane
Agreed for the most part.
AF in WPW however can exist in a stable state. It'll feel to a pulse like SVT.
If you give adenosine to them, they deteriorate. Otherwise it's pretty safe. Aside from the whole 'Impending death' thing.
That's a pretty good breakdown.
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Probably not on all domestic flights but Id imagine most international flights. But Im really kust guessing, if youre that interested itd be best to inquire with the companies.
Were you working for the airline when you treated your migraine patient? I'm just curious because I'm a medic too and haven't heard of this before.
No. They asked if there was anyone with medical experience to come to the back. They got in contact with their on call doc, and he and I formed a treatment plan.
Did they have some kind of phone system to put you on line with a physician? I ask because I’m a paramedic and my wife and I fly quite a bit. I’ve always wondered what resources I would have should an emergency arise.
They could almost certainly radio a doc, airplanes have a few radios and they're not all always being used by the flight deck.
Yeah. I communicated with a physcian via radio.
There's a service a lot of airlines use, Medlink, that connects to a doctor who helps whoever is onboard figure out what can and should be done for the patient. You wouldn't have it all on your shoulders, not to worry.
What type of analgesia? I can't imagine airlines would stock opioids onboard.
I believe they had 20mg morphine and 250 mcg of fentanyl. I cant say for sure though.
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We need a MacGyver on board alongside these doctors
My grandpa died of heart attack while emergency car stuck in a traffic jam. Heart attack in a metal tube with 30 cardiologists seems more lucky from this point of view.
Maybe she should’ve waited until they got to the conference
I work construction, the first job I was on as an apprentice was a hospital. A man died of a heart attack less than 30m from the emergency department because he was working alone and no one was able to simply open a single door to the reception. Moral of the story, don't work alone if possible and always check on your workmates
When I was a kid my best friends father had an aneurysm rupture ten feet away from a brain surgery room in an hospital considered the best of the region for aneurysm treatments. He fell on the ground while working out with brain surgeons and they understood what was happening immediatly. He worked there. He got out alive and well a few days later.
That is AWESOME
What about at the cardiologist conference itself?
My luck I’d be on a flight with a bunch of proctologists.
I'm sure they didn't hesitate to talk about the heart attack on the plane when they arrived at the conference. Like "Doctor Smith , you'll never guess what happened on the way over here"
My foster father had a heart attack in the hospital while he was being treated for a kidney stone. That seems like the best place to me.
I'm not really convinced. There was a study conducted what impact it has when senior physicians are absent in hospitals because they were attending a conference: in this study patients died less often during that time (link to article, I'm too lazy to look or even read the original study).
I read that study, have an upvote.
But recall, it was comparing Jr vs Sr cardiologists. Not 15 Sr cardiologists vs none.
Yeah, because they weren't there to do risky procedures.
There are so many confounding variables that the "study" can't take into account. It's essentially just an "oh look, some interesting numbers that don't actually mean anything."
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/u/WisdomLess had a nice thought in another thread
Be a lot cooler if the Bee Gees were on board and they all gave her CPR to a live rendition of "Staying Alive".
"at first I was afraid, I was petrified..."
Harvest the organs!
And every "ha", they try to restart her heart
Like some a capella group, that would be gold.
I seriously sing this to myself while doing compressions. It’s almost impossible not to.
Cpr can not and does not save lives, it preserves the body while the heart malfunctions and is waiting for something to restart its rhythm (usually defib) when I was being trained my instructor told me to never be scared doing cpr because you can’t mess up and kill a dead body
Literally lol'd. Thank you.
Yeah but imagine getting 15 specialists' bills.
Now that's a life debt.
More, did you spay? Ohhh, meesa gonna be sick.
I bet she wishes the heart attack succeeded.
I'd just die tbh
They were all presumably from the UK, given they were flying to a conference from Manchester.
So here's an exact copy of the bill:
£8.60 - prescription for all required medicines
Not true at all - you don't need a prescription for all medicines, and definitely not ones used during emergency care. They're for things like non-emergency antibiotics, or epi-pens you carry as a precaution - not for all the drugs they use while directly treating your heart attack!
If you go in to casualty (ER) in the UK, whether you walk in yourslef or use an ambulance, are given 1 drug or 100, it doesn't cost you a penny.
Yeah but they'll usually leave you with a prescription for whatever is required for post-op
Correct, but that's still not bill. She'd have walked out of the hospital having not spent a thing for the care those doctors provided.
Sure you pay for prescriptions, but you're comparing two different things.
If you want to be pedantic, sure. I was just highlighting the fact that even the medicine is trivially priced
Fair enough. Sorry, your comment came across to me as by one of those 'actually it technically isn't free' types who tend to pop up every time universal healthcare is mentioned.
She's from the UK so it wouldn't be that bad for her
Holy shit, thank god I live in Canada.
Found the American.
To be clear, the 15 cardiologists were also on the flight.
I choose to believe that there is a troop of high altitude sky diving cardiologists just waiting for the right moment to shine.
There has to be an anime about something ridiculous like that. If there isn't, there should be.
Is there a rule for anime similar to R34? If it exists, there is an anime about it?
Like Bane's henchmen in Dark Knight Rises.
This man is dying! Is there anyone here trained to shove a fist in his ass?
If it was me I would have gotten 15 proctologists.
Well, if anyone could save your ass, it’d be them
Ha! Good one.
Yeah, the strangest things happen. A greataunt of mine went swimming in Lake Tahoe and got run over by a motorboat many years ago. The propeller hit her so hard in the head that brains were leaking out. Normally she would have died in the hospital but guess what was taking place in the city on that very day - a brain surgeon congress.
So she made it?
Nah she fucking died. But at least there was a nice conference going on.
You made my day
Yep, she did.
a brain surgeon congress.
I wonder what it looks like when they all take off together.
And the one amateur cardiologist mixed drinks.
The American Heart Association (AHA) president, who is a cardiologist, had a minor heart attack while at the AHA meeting last November. It was the day after he gave remarks on his family history of heart disease. Surrounded by a lot of cardiologists, though. He ended up getting a Stent.
"The president of the American Heart Association, Dr. John Warner, had a minor heart attack Monday during the organization's scientific conference taking place in Anaheim, California" http://www.cnn.com/2017/11/16/health/aha-president-heart-attack/index.html
Unbelievable luck. I wonder if they fought over who got to treat him!
No. I'll treat him
No I will
Fuck off. I will
Unless there was a Cath Lab built into the conference hall, they can't have done much besides call 911.
Something like this happened to our Boy Scout troop a while ago.
Hiking the Kalalau trail on Kauai. These two brothers brought in a drone to take some camera footage using their phone as the remote, but because no service they couldn't use it. On the way out, the older brother carried the drone and the younger brother carried the water. Their plan was to meet up occasionally for water.
Near the end, older brother collapsed from heat exhaustion by himself (he had other go ahead since he didn't want to slow us down). There happened to be about 5 doctors overall helping him out of there, rehydrating him and such.
Too bad they spent the whole time arguing about who is right.
I got hit by an ambulance but it was full!
They appeared. What, like magic?
No, like a random encounter.
A wild Cardiologist appeared!
I cast magic missle!
Your saving throw against balloon catheterization failed.
A fifteen-creature random encounter? They must have really low individual CR
Regular human is what cr 1/3
15 expert cardiologists ... as opposed to 15 non-expert cardiologists. I'm glad she got the good ones.
'and 15 amateur cardiologists appeared. She died.'
Like magically appeared? She has connections.
What could a bunch of cardiologists even do without equipment?
Argue about who is going to be in charge.
EAT SOME BREAD
Give asprin, nitroglycerin, maybe IV fluids. Airlines have some basic equipment and meds for these situations.
My thoughts, based on the title:
I'm imagining all 15 doctors crowding around, offering conflicting medical advice. Surely 1 good doctor is better than 15 good doctors.
Imagine the balls on doctor #15. "Excuse me, ladies and gentlemen, I think I have something to contribute here."
Imagine 15 doctor bills showing up in the mail for services rendered.
I'm assuming some sort of ticket reimbursement exists if you treat someone on a plane, to entice medical professionals to fly with you.
God damn I've become cynical.
"Folks, we're about to experience some turbulence."
"Tower, this is flight TK421, we're going to need medical assistance upon landing for 16 people...Yes, there are medical professionals onboard.."
I think you missed one:
If I was on board, this article would have said "...saved by 15 cardiologists and 1 passenger" because I've been practicing my insult game an have the House, MD theme song on my phone.
Up voting for your reference. 😃
Expert cardiologists? As opposed to amateur cardiologists??
Probably all attendings as compared to residents? Idk though
I didn't really want to get into semantics, but expert cardiologist is redundant. If you have the title of cardiologist, you're past residency. Otherwise, you're a cardiology resident.
maybe they meant like someone who's been a cardiologist for 20 years as opposed to 1 year?
Yea, it doesn't really matter
Amateur doesn't really mean a skill level, just means they're not getting paid.
I'm very surprised. Generally speaking your odds are much better with one or 2 experts. Put 15 experts to deal with an emergency situation you get at least 3-4 different opinions and a lot confusion...
With very little room on an airplane, I imagine the closest doctors had much more say in the treatment. It's not like every one of them are aching for glory either; professionals should know how to work together on it.
It's also not an episode of House with a mystery illness; they probably felt almost unanimous on how to proceed.
actually this WAS an episode of House
But since 15 expert cardiologists took vacations at the same time, hundreds of other people died.....
They were likely heading to the same conference and the hospitals got someone else to cover their shifts.
Source: Grey's Anatomy
I wish my hospital would get people to hover my shifts
Yeah, that would be nice!
"Finally, this is my chance....fuck..."
When I worked in Mexico for a few months, one week the hotel was filled with firemen from all over Mexico in town for a conference. I figured I was safe from fire for at least that week. Plus they all brought their chefs so every morning we had awesome food.
15 expert cardiologists appeared, saving her life.
This is phrased like they appeared out of thin air.
(pun slightly intended)
I'm a career FF so deal with unknown med emergencies every day I work. This summer I was on an international flight and it was in the middle of the night and lights were off (opted for first class with lie down seats) and a page came over that if there's a doctor to please come back because there was a medical emergency. They specifically asked for a doctor so I was like whatever, I waited a few minutes and no one got up or anything so I went back and asked if I could help and the flight attendant asked if I was a doctor and I said "no but I'm a" and cut me off. I was like that's fine and went back to my seat. I did see a girl unconscious with people standing around her not doing anything. Hope the girl was fine, I did see chest rise so that was good. However, this is stuff I go on at work all the time, was very frustrating because to think a doctor is always going to help is kind of silly. What if they got a Pediatrist or an Otho? Sure they might be able to help but it wouldn't be directly related to their specialty.
What is an FF? What is it that your do!
Oh fire fighter, huh. I'm dumb.
Firefighter yah, we go on med calls for 80% of the total runs so I've seen a lot, not everything though haha.
They are likely trained (like lifeguards or other first aid providers) to not yield care unless somebody with a professional certification arrives. For liability reasons, it is unwise to let someone help unless they are a physician or EMS provider.
Aren't I an EMS provider? Even though I'm an EMT I'm probably far more qualified in an emergency event rather than the flight attendants...or even some (not all) doctors that don't do anything for emergencies (osteo, foot, pathology, etc) - they don't provide patient care that would be necessary in a situation like this. Not saying EMTs are more qualified than doctor's, but in some situations doctor's might not be proficient on CPR and even taking a BP, etc. I was trying to be a helping hand if need be, I can start CPR, set up appropriate o2, airway and breathing control, etc.
If there was a doctor or nurse or para there I'd definitely let them have control and see what I can do for them. EMTs are essentially first responders to start appropriate action on what needs to be done but definitely can't push drugs, intubate with ET tubes, etc.
Sure, I agree, but the flight attendants when trained were likely told "don't cede care unless they are a doctor" and likely discouraged from thinking independently beyond that simple rule. I'm a doctor, and I'd rather have you than a flight attendant or radiologist, but most people aren't smart enough to know the difference.
Right, I wasn't going to argue with them at all. They asked for a doctor and I'm sure they got one eventually.
They were alllllll time travelers. Twelve monkeys.
Dr. Mantis Tobaggan
Good thing there were 15, and not just 5 or 6.
Must’ve missed this episode of Grey’s Anatomy
So much for "too many cooks spoil the broth".
a wild cardiologist appears
Expert Cardiologists, they’re like cockroaches man, they’re everywhere.
I work for a non-profit that often has cardiologists on site for meetings and I have to say that it’s comforting to think they can save me as I bite into my seventh slice of deep dish pizza.
Was getting a stroke part of your plan?
Oh sure.. but ask if anyone knows how to fly a plane and everyone panics.
This woman's having an heart attack! Is anyone a doctor?!
Me! Me too! I am! Over here!
Did some say doctor! What's the issue?!
You need a doctor! I got this! Right here!
On my way! *Tardis appears*
You called?! I talk to animals but I'll help!
delorean appears Yaaaaassss!
I’d get 15 shrinks and it still wouldn't make a difference.
Sound like an episode of Grey's anatomy IRL.
Believe it or not, stories like these are relatively common since there are so many medical conferences all over the country at all times of the year.
Is there such thing as a non-expert cardiologist?
There was 15 Redditors on that plane? Incredible.
More debate here in this thread than among the cardiologits on that plane.
Wait... which one of you take XXXX insurance?
🎶Too many cooks, too many cooks!🎶
I sort of like the idea that there’s a fully kitted outfit of world-class surgeons flying around all the time, just waiting for a situation like this so they can spring into action.
A wild expert cardiologist appeared. Woman uses heart attack. Its not very effective...
The bill killed her husband.
My aunt had a stroke on a long flight and a haematologist was luckily onboard. She has had blood clotting issues since adolescence and flew across continents for her job, pretty much every three months.
It was so lucky for her that there a specialist doctor that ONE flight and he saved her life.
There must have been 15 redditors on the flight.
Forgot about the vegan dude who also responded.
Doctors. What a nerd. /s
I'd ask if this was on an a380, but it was 2003. Was this going to a city that was hosting a cardiologist convention?
Well you're a regular Sherlock Holmes aren't you.
what a shitty clickbait title
I wish this could have happened when Carrie Fisher had her heart attack.
I like how OP said "appeared". Like they just magically appeared out of thin air.
Nice story. But pretty much bullshit. First off, without a 12 lead EKG there's no way to diagnose or treat a STEMI ( heart attack). And second, even if one cardiologist just so happened to have a monitor with them in their carry on, where would they get the controlled medication, syringes, IV tubing, and fluids to do anything. I'm a paramedic and don't just randomly travel with an ambulance worth of equipment. Sounds to me like they gathered, all agreed that the woman was indeed having some sort of chest pain, found some aspirin which is a standard med given for cardiac or presumably cardiac emergencies, and hung around the lady until they landed.
That's what the guess is, though it's worth noting that some of those medications are available in the emergency kits on airplanes.
"They carry a decent selection of ALS medications and a AED is mandatory but no, they do not carry a true cardiac monitor. Still, you can handle a vast array of problems with what is available, especially since they can divert to a airport generally quickly."
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