title: Medical emergencies at a major international airport: in-flight symptoms and ground-based follow-up.
abstract: BACKGROUND
  There is limited recent data about the treatments and outcomes of commercial airline passengers who suffer in-flight medical symptoms resulting in subsequent EMS evaluation. The study objectives are to determine incidence, post-flight treatments, outcomes, morbidity, and mortality of these in-flight medical emergencies (IFMEs).
  
  
  METHODS
  A 1-yr retrospective study of emergency medical service (EMS), emergency department (ED), and inpatient hospital records of IFME patients from Chicago O'Hare International Airport was completed. All commercial passengers or crew with in-flight medical symptoms who subsequently activated the EMS system on flight arrival are included in the study. The main outcome measures are: in-flight sudden deaths, post-flight mortality, hospital admission rate, ICU admission rate, ED procedures, inpatient procedures, and discharge diagnoses.
  
  
  RESULTS
  There were 744 IFMEs for an incidence of 21.3 per million passengers per year. The hospital admission rate was 24.5%. The ICU admission rate was 5.9%. There were five in-flight sudden deaths and six in-hospital deaths for an overall mortality rate of 0.3 per million passengers per year. Emergency stabilization procedures were required on 4.8% of patients. Cardiac emergencies accounted for 29.1% of inpatient diagnoses and 13.1% of all discharge diagnoses.
  
  
  CONCLUSIONS
  The incidence of in-flight medical emergencies is small but these IFMEs are potentially lethal. Although the majority of IFME patients have uneventful outcomes, there is associated morbidity and mortality. These included in-flight deaths, in-hospital deaths, and emergency procedures. Cardiac emergencies were the most common of serious EMS evaluated in-flight medical emergencies.
authors.affiliation: Resurrection Emergency Medicine Residency Program, Resurrection Medical Center, Chicago, IL 60631, USA. schan@reshealthcare.org
authors.forename: Shu B
authors.initials: SB
authors.lastname: Chan
authors.forename: Teresita M
authors.initials: TM
authors.lastname: Hogan
authors.forename: Julio C
authors.initials: JC
authors.lastname: Silva
mesh_terms: D000337:Aerospace Medicine / Q000706:statistics & numerical data*; D002641:Chicago / Q000453:epidemiology; D002648:Child; D004630:Emergencies / Q000145:classification / Q000453:epidemiology*; D004638:Emergency Treatment / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014195:Travel