You Shouldn't Be Scared Of Getting Sick On A Plane

A festive PSA: an overview on aircrafts Emergency Medical Kits (EMKs) and how air crews deal with in-flight medical emergencies.

Dec 01, 2024

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‘Ladies and gentlemen, This is your doctor speaking. I would like to welcome everyone onboard this newsletter of The Feel Good Life. Our reading time today will be approximately 7 minutes (1400 words). We expect good weather on the way, only mild turbulence, and great safety knowledge for everyone. I wish you a pleasant read.’

Time to warm up the engines!

As holidays approach, many of us will find ourselves moving between places, visiting relatives or friends, attending family events, and celebrating special occasions.

Every time I travel, I can’t help but wonder about possible medical emergencies that could show up during a flight. In my 20 years of practising medicine and living abroad, not once have I been needed as a doctor while flying. However, the thought always comes to mind. I somehow get mentally prepared in advance, in case this time, I might need to leave my passenger seat and jump into doctor emergency mode.

It’s interesting, because when traveling by water or land, you know it’s somehow easier to access emergency support through the various systems allocated in each place. Whether it’s an ambulance, a helicopter, a rescue boat, firemen, police brigade, or advanced rescue teams, they all have one thing in common: (in most cases) they can mobilise more quickly and easily to a scene if needed.

But what happens when you’re up in the air?

Well, as is turns out, there are international guidelines that require air crews to know how to respond in medical emergency situations while flying, and how to use emergency medical kits, specifically equipped for aircrafts.

I’ve always been curious about this. Being a doctor and an aviation enthusiast, I set myself the task to investigate this topic to learn more and bring it here today, so that you can have peace of mind and trust-worthy information as holiday travel season approaches. Whether you have a fear of flying, a medical condition, or simply wonder about what happens during an in-flight medical emergency, I trust that this information will make you feel reassured that when you fly, you’ll always be in good, well-trained hands.

Did you know that before every flight, pilots study and trace a route plan to make sure that not matter where in the middle of nowhere you are, there’s always a ‘nearby’ airport on route to land in case needed? Or that pilots study each aircraft and the weather conditions in detail to know what to expect before they take off? Or that crews can know in advance if there’s passengers with health conditions (as reported prior or during boarding) so that they can be prepared in an emergency case? Also, did you know that there’s on-call doctors on the ground to guide the cabin crew whenever required? Fascinating, isn’t it?

It’s not unusual to have medical emergencies while flying.

The most common medical emergencies include gastrointestinal, neurological, musculoskeletal, infectious, and respiratory problems. Anxiety, fear of flying, and heart issues are high on the list too. For this reason, it becomes vital that air crews are properly trained in order to respond to the many possible case scenarios that could happen up in the sky.

Did you also know that air crews have to go through various trainings on top of their flying training—which is already hardcore? Usual added trainings include medical and first aid, safety management systems training, ground training, recurrent trainings to keep knowledge to date, disability training, security training.

Honestly, think about it: in one single staff you have not just people who check your seatbelts or give pre-takeoff instructions, but people who could literally save your life, whether during a medical emergency or a disaster response. There are infinite scenarios crews could encounter and they’re trained and prepared for it all. My R.E.S.P.E.C.T to them all.

Now, there are aviation guidelines and regulations that need to be met by commercial airlines worldwide. Aircrafts, for example, should carry certain equipment and medications to aid during in-flight medical emergencies. Such equipments and meds can be as simple as a blood pressure measurement device and paracetamol, or as complex as IV lines, syringes, defibrillator, and epinephrine.

These in-flight EMK (Emergency Medical Kits) are mostly developed by a company called MedAire, dedicated to offer remote medical, security and operational travel support. Basically, they build ‘solutions to mitigate risks to crew, passengers and guests’, whether in the air or at sea. This includes training, education, support, and equipment development, such as the emergency kits. Everything must meet both local and international aviation regulations accordingly. MedAire isn’t the only company offering this service, but it’s the main one as I found throughout my research.

Now, this blew my mind…

According to MedAire, there are several types of in-flight medical emergency kits. Let’s have a brief look at some of them:

First Aid Kit (FAK): for managing minor medical incidents during flight, such as cuts, burns, headaches, and nausea. Includes first aid materials, ointments, basic medications, vital signs measuring equipment, survival items and oxygen support.
Emergency Medical Kit (EMK): for managing both common and complex conditions, allowing crew members to act as first responders until additional help is accessible. Includes all the above plus medications for nausea, vomiting, allergies, dehydration, motion sickness, diarrhoea, and heart attacks.
Enhanced Emergency Medical Kit (EEMK): extensive supply of tools and medications to manage more complex in-flight medical emergencies, such as cardiac problems or severe allergic reactions.
Universal Protection Kit (UPK): a specialised kit for shielding crew and passengers from potential infectious disease exposure during in-flight medical emergencies. Includes personal protective equipment (PPE) and cleaning materials for managing and safely containing biohazardous substances.
Paediatric Medical Kit (PMK): specialised kit for passengers under 12, addressing the most common paediatric medical conditions, including suitable equipment and medications.
Advanced Aviation Medical Kit (AAMK): the king of in-flight first aid kits. Provides prescription medications and essential equipment to help stabilise various types of severe medical emergencies until landing. Includes more than 100 crucial medical supplies, and access to prescription medications facilitated by MedAire's 24/7 on-ground doctors.

…Despite being a doctor, I had no clue how much goes on behind the scenes in this in-flight medical department!

Now, let’s take a detailed look into an aircraft’s EMK (Emergency Medical Kit), just to have a general idea of what basics are available during a flight in case of medical emergencies:

The EMK shown up here (being the 2nd tier in the list of kits above) has:

Prescription Medications: for heart attacks, vomiting and nausea, infections, and allergic reactions.
Non-Prescription Medications: for aches and pains, dehydration, motion sickness, coughs, and diarrhoea.
Survival: LED flashlight, emergency blanket, moleskin, insect repellent.
First-Aid: Wound and burn dressings, antibiotic ointment, antiseptic scrubs, bandages, splint.

The enhanced kit (EEMK), on top of all these, also includes:

Assessment: Digital blood pressure cuff and monitor, digital thermometer, reading glasses.
Survival: Signal mirror and guide, blankets, flashlight.
Dental: Solutions for toothaches, lost crowns, and fillings.
First-Aid: Dressings, antibiotic ointment, antiseptic scrubs, bandages, splint.
Respiratory: Bronchial inhaler, oxygen tubing, CPR pocket mask with oxygen inlet.
Source: MedAire Medical Kits & Refurbishment

So basically, what I see here from my medical perspective, is an absolutely well-built emergency kit with which you can treat a wide range of medical conditions, from basic simple things such as headache or a stomach ache, to complex issues such as a severe allergic reaction, an anxiety attack, and even risky heart problems.

I mean, being able to put an intravenous line or apply oxygen support up in the sky is absolutely incredible. The possibilities that any doctor and emergency-trained staff have with these emergency kits are quite ideal.

Now, let’s not forget Automated External Defibrillators (AEDS), which is the most life-saving device that you’ll find in every single building, offices, arenas, open areas, transport systems, airplanes, ambulances, etc. who comply with the right safety regulations worldwide. You’ll probably recognise these (or similar versions):

In case you’re wondering, an AED is a:

‘Portable device that can be used to treat a person whose heart has suddenly stopped working. This condition is called sudden cardiac arrest. AEDs are easy to use and come with clear instructions, so anyone can use them, even without training.
Source: Mayo Clinic

AEDs usually (a) look something like this, and (b) are stored in boxes like this:

Anyone can access them, and even without training, they are quite safe to use. Sounds scary but I assure you: an AED’s instructions are easy to follow. Although having further training becomes helpful to have a notion of what it does, how it looks like, and how it works so that given the situation, you can efficiently help save a person’s life.

Aircrafts must carry AEDs too. And there are of course, AED trainings for cabin crews to take as part of their professional education and flying requirements.

As you can see, the equipment and possibilities to aid someone requiring first aid during a flight are extremely well curated. Not to mention that cabin crews can always access communication with on-ground medical personnel to advise during these emerging situations — except in those short periods of time where radar communications are not available. Hence why all training matters.

I know that a big part of flying anxiety comes from feeling nervous about the different sounds an airplane makes, the idea of turbulence, or the enclosing sensation of being trapped inside a metallic tube suspended on air. In all cases, anxiety is absolutely valid, but it becomes important to be aware of your own fear of flying so that it can be addressed and properly treated. Thankfully, there are many successful therapy options nowadays to help with this. The most common therapy used to treat fear of flying is called Cognitive Behavioural Therapy. Other options such as Hypnotherapy have proven successful too. (Fore more info, read links below.)

Whatever your case, please know that it’s common to feel travel-related anxiety, and that there are plenty of tools to help you understand, improve, and even overcome these feelings.

For more resources on fear of flying, please read through the following:

CN Traveller - How to overcome a fear of flying, according to a psychologist

AADA - How can I overcome my fear of flying?

Hypnotherapy - Fear of Flying & What to Expect

Medical News Today - How can someone manage their fear of flying?

Center for Anxiety Disorders - Fear of Flying

Disclaimer: I am no expert in medical aviation. So if by any chance, you’re a cabin crew member or an aviation professional, please correct me as needed regarding the information I just shared. I’d be more than happy to edit for all readers’s sake. TY!

Now, time to pack, because maybe you (just like me) are getting ready to fly and visit family over the holidays. If that’s the case, get ready, prepare in advance, and enjoy! (In two weeks, we’ll be exchanging the Scottish winter for the Costa Rican Summer, so expect a lot of sunny updates, fruit smoothies, and beach writings over the next few months.)

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