title: Outcomes of medical emergencies on commercial airline flights.
abstract: BACKGROUND
  Worldwide, 2.75 billion passengers fly on commercial airlines annually. When in-flight medical emergencies occur, access to care is limited. We describe in-flight medical emergencies and the outcomes of these events.
  
  
  METHODS
  We reviewed records of in-flight medical emergency calls from five domestic and international airlines to a physician-directed medical communications center from January 1, 2008, through October 31, 2010. We characterized the most common medical problems and the type of on-board assistance rendered. We determined the incidence of and factors associated with unscheduled aircraft diversion, transport to a hospital, and hospital admission, and we determined the incidence of death.
  
  
  RESULTS
  There were 11,920 in-flight medical emergencies resulting in calls to the center (1 medical emergency per 604 flights). The most common problems were syncope or presyncope (37.4% of cases), respiratory symptoms (12.1%), and nausea or vomiting (9.5%). Physician passengers provided medical assistance in 48.1% of in-flight medical emergencies, and aircraft diversion occurred in 7.3%. Of 10,914 patients for whom postflight follow-up data were available, 25.8% were transported to a hospital by emergency-medical-service personnel, 8.6% were admitted, and 0.3% died. The most common triggers for admission were possible stroke (odds ratio, 3.36; 95% confidence interval [CI], 1.88 to 6.03), respiratory symptoms (odds ratio, 2.13; 95% CI, 1.48 to 3.06), and cardiac symptoms (odds ratio, 1.95; 95% CI, 1.37 to 2.77).
  
  
  CONCLUSIONS
  Most in-flight medical emergencies were related to syncope, respiratory symptoms, or gastrointestinal symptoms, and a physician was frequently the responding medical volunteer. Few in-flight medical emergencies resulted in diversion of aircraft or death; one fourth of passengers who had an in-flight medical emergency underwent additional evaluation in a hospital. (Funded by the National Institutes of Health.).
authors.affiliation: Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Drew C
authors.initials: DC
authors.lastname: Peterson
authors.forename: Christian
authors.initials: C
authors.lastname: Martin-Gill
authors.forename: Francis X
authors.initials: FX
authors.lastname: Guyette
authors.forename: Adam Z
authors.initials: AZ
authors.lastname: Tobias
authors.forename: Catherine E
authors.initials: CE
authors.lastname: McCarthy
authors.forename: Scott T
authors.initials: ST
authors.lastname: Harrington
authors.forename: Theodore R
authors.initials: TR
authors.lastname: Delbridge
authors.forename: Donald M
authors.initials: DM
authors.lastname: Yealy
mesh_terms: D000337:Aerospace Medicine / Q000706:statistics & numerical data*; D001359:Aviation; D004630:Emergencies / Q000145:classification / Q000453:epidemiology*; D004638:Emergency Treatment / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D008297:Male; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000628:therapy; D013575:Syncope / Q000453:epidemiology / Q000628:therapy; D014195:Travel; D016896:Treatment Outcome