Commentary: Flying and the pain of dealing with allergies, anxieties and emergencies while up in the air

Commentary: Flying and the pain of dealing with allergies, anxieties and emergencies while up in the air

As people live, work and travel longer, whether on business or holiday, there is a greater likelihood of medical problems in the air, says the Financial Times' Michael Skapinker.

Motion sickness altitude sickness plane travel holiday
(Photo: Unsplash)

LONDON: Regular US television performer Mikhail Varshavski, “Doctor Mike”, voted the “sexiest doctor alive” by People magazine in 2015, added to his fame this year when he administered a life-saving injection to a passenger who had gone into allergy-induced anaphylaxis on a flight from New York to Tel Aviv.

The Delta Air Lines plane had no EpiPen auto-injectors on board, but it did, in accordance with Federal Aviation Administration regulations, have epinephrine and a syringe.

“We needed to do some troubleshooting, adjusting the dosage and working out how to administer the medicine. We were able to work it out and administer it into his leg muscle,” Dr Varshavski told the New York Post.


This and other incidents have prompted Robert Houton, a Washington DC lobbyist, to set up a campaign group called the Coalition for Lifesaving Epinephrine Auto-injector Responsibility (Clear) to press for legislation forcing airlines to carry two EpiPens on board.

Most passengers who know they have a potentially life-threatening allergy carry their own EpiPens, which are easy to use and require no fiddling with vials and syringes.

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But there are other travellers who discover their allergies for the first time on a flight — an increasing concern for airlines, says Robert Quigley, senior vice-president of MedAire, an organisation that provides ground-based medical advice to crews.


It’s not just allergies. As people live, work and travel longer, whether on business or holiday, there is a greater likelihood of medical problems in the air.

Inside a plane
A passenger removes his luggage from an overhead bin on a flight after arriving in New York. (REUTERS/Carlo Allegri)

“What we see terrestrially, we see in-flight,” Dr Quigley told me. MedAire, part of the International SOS travel security company, which, he says, has contracts with “the vast majority” of the world’s airlines, employs emergency-room doctors at its centres in Phoenix and Johannesburg to talk cockpit and cabin crew through medical emergencies.

A concern that might, on the ground, prompt an internet search, an appointment with the doctor or, at worst, a call for an ambulance is a particular worry in the air.

An aircraft is a cramped and uncomfortable space and a hospital might be several hours away.

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How common are in-flight medical emergencies? A 2013 New England Journal of Medicine (NEJM) article, based on a study of five airlines, estimated that for every 604 flights, there was one medical emergency serious enough to warrant contact with doctors on the ground.

The NEJM said that 37.4 per cent of cases involved fainting or feeling faint. Respiratory symptoms made up 12.1 per cent of cases and nausea or vomiting 9.5 per cent.

airline, cabin crew, stewardess, plane
(Photo: Unsplash/Jacky Watt)

Few problems are serious enough to warrant the plane diverting. The NEJM said that, in almost half of cases, a doctor on the plane came forward to offer assistance.

Aircraft had to be diverted in 7.3 per cent of cases. Dr Quigley, who says MedAire gets about 150 calls a day, puts the level of diversion at a far lower 2 per cent.


What new issues worry in-flight medical specialists? Dr Quigley says there is a growing awareness of depression, anxiety and addiction problems, which can affect crew as well as travellers.

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Increasingly in the US, passengers bring animals on board to help them get through the flight. I have yet to see an animal on a plane, but Dr Quigley says it is now a rare flight on which he doesn’t.

In August, the US Department of Transportation clarified which “service animals” should be allowed on flights. Dogs and cats were acceptable, the department said.

So were miniature horses. Dr Quigley says the animals’ presence raises new health issues that regulators will have to deal with. One person’s comfort cat could be another passenger’s allergy.

Source: Financial Times/sl