For Physicians. By Physicians.™
For Physicians. By Physicians.™
Airline travel is governed by a plethora of federal laws which are overseen by the Federal Aviation Administration (FAA). In most cases, aviation federal law will override state laws. An in-flight medical emergency, sparking the overhead announcement asking if a medical doctor is on board, is estimated to occur in about 1 of every 600 flights. The FAA mandates that U.S.–based airlines have first-aid kits with bandages and splints, at least one automated external defibrillator (AED), and at least one kit containing (among other things) a stethoscope, blood pressure meter, gloves, airway and breathing apparatus, intravenous access tools, and medications such as aspirin, bronchodilator inhaler, and epinephrine. The full kit contents do not cover pediatric nor obstetric emergencies.
United States healthcare providers traveling on registered U.S. airlines have no legal obligation to assist in the event of a medical emergency. Canada and the United Kingdom also do not require that a provider assist. However, providers may feel an ethical obligation to help. Australia and some countries in the European Union do impose a legal duty on physicians to act.
In 1998, Congress passed the Aviation Medical Assistance Act (AMAA) to protect medical providers who respond to in-flight medical emergencies from liability, thereby encouraging medical professionals to assist in emergencies. The care provided must be for a “medical emergency”, not routine care. The law is also limited to claims arising from domestic flights and most claims arising from international flights involving U.S. carriers or residents. International flights using international carriers may operate under other laws, thus making the requirement to render aid unclear.
When is a healthcare provider potentially at legal risk under the AMAA? A provider can be found liable for injury under this law if the patient can establish that the provider was “grossly negligent” or intentionally caused the alleged harm. The volunteer provider must be medically qualified and must not receive monetary compensation for services rendered. In addition, the provider is bound by HIPAA privacy rules, but airline personnel are not.
Note that the airline pilot is not obligated to divert the plane to a closer airport even if the medical provider recommends it – the decision to divert belongs solely to the pilot. For example, there may be other considerations, such as the plane’s maximum landing weight. If the plane still has a relatively full, heavy fuel tank following take-off, a landing may be potentially dangerous. Rather, the provider should offer a medical opinion and clearly communicate the urgency of the situation.
In-Flight Medical Emergencies during Commercial Travel
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Lessons Learned During an In‐Flight Medical Emergency: Case Report and Discussion
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In-Flight Medical Emergencies – A Review
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