26 February 2008

Death from Above

It's been a bad week to be in the air.

Scalpel and his commenters pretty thoroughly covered the case of the woman who died en route from Port-au-Prince to New York, and I don't have much to add to their comments, except to agree that oxygen probably would not have made the critical difference between surviving and not. While all health professionals tend to grit our teeth whenever we read lay media reports of medical care, it's particularly cringe-worthy that numerous media reports describe the AED as "malfunctioning" or broken. If it didn't fire, it's because the heart rhythm was not VT or VF. That is not a failure of the device -- it's working as designed.

I'm presuming the pads were properly attached. I once saw someone try to put them on over the patient's clothing. Not gonna work.

Erik pointed out a link to a really cool gadget which allows remote telemetry and diagnostics. I could see wearing it in the ER if all that data was displayed on the wristband. It's like a tricorder, almost. But looking at the pics, I suspect that the data would be available only to the remote consultant, which is a bummer. (Hey, that might be a neat moonlighting opportunity.)

I recall when I had to perform rounds on sequential trans-atlantic flights, it was maddening because Olympic Air didn't even have an AED; Delta did have one, but there is no display, so I couldn't even see a rhythm (a key limitation, since the patient's pulse was about 160).

In an unrelated but oddly coincidental story, a co-pilot of a British Airbus A320 died in flight on a trip from Manchester to Cyprus, forcing an emergency diversion to Istanbul.

It's a little surprising and different from the first story, since the passenger was known to have heart problems, whereas the pilot was young and healthy. I don't know as much about England's CAA medical standards, but the FAA is relatively stringent with regard to a First-Class Medical required to pilot large jets -- any history of Coronary Artery Disease or Diabetes will get you grounded. There are provisions for getting your ticket back, but it requires excellent control and rigorous documentation. The net result is that as a group, professional pilots tend to be much healthier than most. Which makes an episode of sudden death that much more surprising. Maybe he flew so much he developed a DVT and died when the blood clot went to his lung. We'll never know; lotsa things can kill you quick. Sad for his family.

Curiously, it was almost exactly a year ago that the same thing happened, only it was in the US, and the captain, not the first officer. I wonder how often that sort of thing happens?


  1. Actually, the Tempus has both local and remote displays. It's designed to be grokable by untrained users and useful to medical professionals at the same time.

    I'm in awe of the sensor vest.


  2. the title and picture of this post made me all misty eyed for my past, when i was a young one in the 101st.


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