In-flight medical emergencies are attracting increasing interest from the media, travelling public, aviation industry and the medical profession.
In the year ending 31 March 1999 British Airways carried 36.8 million passengers and there were 3386 reported in-flight medical incidents: about 1 per 11 000 passengers.
Although 70% of cases were managed by cabin crew without the assistance of an on-board health professional, doctors and nurses were asked to help in almost 1000 incidents.
According to crew reports and feedback from assisting health professionals, abdominal problems are common.
Diarrhea and vomiting are frequent occurrences, and are usually managed using oral anti-emetics, rehydration solutions and anti-diarrheal agents.
The doctor's role is principally one of providing a diagnosis and advising on the need for urgent medical care, which might require the aircraft to divert.
A parenteral anti-emetic such as metoclopramide may help in cases of persistent vomiting. Some airlines include intravenous fluids as part of their medical kit. Although the amount of fluid carried will be small, it would be sufficient to maintain venous access pending diversion.
Although health professionals are encouraged to help, Dr Nigel Dowdall, a consultant occupational physician and author of the report says, "Doctors are advised to practice within the limits of their training and knowledge."
Current data on emergencies and deaths world-wide are scarce, but this should improve now that there is an agreement to monitor and report in-flight incidents.