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EMS, Patient Care

Is there a Doctor on board?

Or should the more accurate question on board an aircraft with a passenger feeling ill be “Is there anyone who has assessed a patient in person in the last, say 3-5 years?”


Tower reports an aircraft returning to the gate due to an unknown medical emergency, man unconscious.


Units are racing over since a plane returning to the gate means delays and considerable cost to the airline and a loss of possible connections for those onboard.  It also means that the rest of that day for that plane and crew are now delayed.  They don’t make this decision lightly.

The cabin doors open to a nervous looking flight attendant pointing us towards the rear of the fully packed 737, all 150 people wondering why they aren’t in the air.

On the floor near the rear galley is a few vacant seats and no less than half a dozen people blocking our access.

“Hi folks, Paramedics, can I have all but one of you step out please?”

The man closest to me and still not at the patient’s side simply breathes over his shoulder “I’m a nurse, we’re going to get an IV going.”

“I’d really wish you didn’t until we have a look see.  What happened?”

“I told you,” he says turning around so I can see the silly quote on his T-shirt, “We’ll give a report once he’s stabilized.”

“Nope” comes out of my mouth as I direct him to be seated along with 4 more onlookers who have opened the MD kit on board and are slapping the AC of a man lying supine, shirt off, covered in vomit.

“Airway?” I ask so that my crews behind me can hear.  I step over the patient and pull the tourniquet on the far forearm and wipe vomit from the patient’s mouth.

“He’s dehydrated!” the woman calls to me from over her reading glasses. “I see it all the time in the office.”

“He’s unconscious and his airway isn’t clear.  Folks thank you but please let us work.” I said to the patient, who was slowly beginning to open his eyes.

A few moments later we have him breathing nice and deep, his color improving and we extricate him quickly down the aisle only now seeing the mound of vomit on the floor in front of one of the seats as well as partially on a young woman, clearly concerned for his well being.


Off the plane we are able to make a full assessment and place a line for some fluid.  Part of me wanted to go back on the plane and ask them what they were thinking trying so hard to start an IV on a patient with a mouth full of vomit, but I knew I’d be dismissed as an EMT who probably doesn’t understand what it’s like to treat patients on the mean streets of General Practice USA.

These folks are the minority but not the exception to the rule.  Luckily we are met with “Thank goodness you’re here and a brief puff of dust as the person who helped until we got there gets out of the way.

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