Managing medical emergencies at 36,000 ft: A guide to Air Canada’s in-flight emergency medical kit

>Hi, my name is Alan Ackery, and I’m an
emergency physician at St. Michael’s Hospital.>And my name is David Kodama, and I’m an emergency
medicine resident at the University of Toronto. Ackery: Today we’re
going to be talking to you about a article that was published in the CMAJ
in regards to in-flight medical emergencies. Kodama: To supplement that article,
today we’ll be providing you with a detailed tour of Air Canada’s medical
kit, which will be provided to you in response to an in-flight medical
emergency. Ackery: We hope that this video will provide you some information and tools the next time that you are called upon in an in-flight emergency. Kodama: In the event of a medical emergency, a flight attendant or member of the flight crew will provide you with this kit. Please be noted that once the kit is provided to you, it is likely that ground-based medical consulting services will have
been notified to assist you in managing your patient. First, remove these tabs.
Next, unlatch and open the kit. The first thing you’ll notice when you
open the kit is a bunch of documentation. There’s really only a couple things in
here that you really should be aware of. The first is a total list content of
what is in the kit. Take some time and familiarize yourself
with what’s available. The second piece of documentation that is
really important is an algorithm of how to treat the most common causes of medical emergencies that you might encounter. Ackery: I’m just gonna walk us through the top of the
kit and some of the pertinent medications. You can see at the very top here we have
adrenaline or epinephrine, which is in a concentration of one in a thousand.
This should never be given through the IV but should be given IM, unless there
is a cardiac arrest, and there instructions to on how to
dilute that down. The next thing over is we have some
Ativan, some atropine, some Benadryl, in fact there’s even medications like
Haldol and Valium. A couple things to note here is that there is a powder form
of Solu-Medrol which you need to reconstitute with sterile water.
There’s Ventolin that can be administered for people who have
wheezing or some respiratory distress. In our bottom left-hand corner is our pulse oximeter.
It’s important to note that this pulse oximeter doesn’t read normal
values when we are flying at higher altitudes. The cabin is usually
pressurized at approximately seven to ten thousand feet, and as a result of
this, our oxygen saturations will appear much lower, and a saturation of 88 to 93
percent is actually considered normal. Kodama: So we’ll talk a little bit about the
equipment now, which is located starting on the bottom tray. You’ll notice that
there’s a blood pressure cuff, a stethoscope, a sharps container,
a burn dressing, a glucometer. There are various sized oropharyngeal airways,
and even umbilical cord clamps. Something to note: at altitude, it is
very difficult to hear breath sounds and to estimate blood pressure with the stethoscope. You may find it helpful when
using the blood pressure cuff to estimate the systolic blood pressure,
either using the radial pulse or the pulse oximeter. Continuing with
the equipment, you’ll notice that if you remove the tray, there’s more equipment
located in the base. This is where you’ll find your IV administration kit, all of
your syringes, needles and dressings, two two bags of normal saline, IV tubing, some
gloves to protect yourself, and even a Foley catheter.
Please note that every airline will have a different kit with different contents.
When called upon, please make sure you take the time to familiarize yourself
with what’s available in each kit. And that way, you can optimize patient care. Ackery: So in addition to the kit,
there’s also a defibrillator on board. Please look for these symbols for both the BVM and our defibrillator. They can be found in here. So thanks for watching the video. Kodama: We hope you find it helpful
in the event of a medical emergency. Ackery: We’d like to thank Air Canada, WestJet,
and St. Michael’s Hospital for helping put this together.