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Is there a doctor on the plane?
36th Emergency Medicine for Rural Hospitals
January 17 - 19, 2020
David Topps
Medical Director, Office of Health & Medical Education Scholarship
The Office of Continuing Medical Education & Professional Development
Faculty:
• David Topps, Family Medicine, University of Calgary
Financial Affiliations:
• Honoraria, other rewards: none
• Speakers' Bureaux, advisory boards: none
• Grants, clinical trials: PiHPES and OLab are grant supported
• Patents, royalties: none
• Investments in health organizations: none
• Other influential affiliations: Medbiq
Faculty/Presenter Disclosure
The Office of CME & PD
• I have taken the appropriate steps to ensure that the use of third party
material in this presentation falls under fair dealing in the Copyright Act
https://library.ucalgary.ca/copyright/
• This material is licensed under Creative Commons, BY-NC-SA
• Please do not assume you can reuse all of these images
• I have properly cited third party material in one of the ways outlined
below
Copyright
The Office of CME & PD
Copyright Unknown
https://www.wpclipart.co
m/medical/testing/ECG_He
art.png.html
Order an ankle x-ray if:
• Bone tenderness at A
• Bone tenderness at B
• Inability to weight bear
both immediately and
in the ED
© Ottawa Health research
Institute, 1053 carling
Avenue, Ottawa, Ontario,
Canada, K1Y 4E9
1. List common medical issues that can worry you on flights
2. Describe how the environment can affect what you can do
3. Inventory useful approaches before take-off
4. Explain liability issues for physicians, nursing professionals off-duty in
restrictive environments
Learning Objectives
The Office of CME & PD
Agenda
5
• Case #1
• Overview & common points
• Case #2
• Teamwork tips
• Case #3
• Debrief & discussion
• Today I learned…
Case #1
6
• https://demo.openlabyrinth.ca/renderLabyrinth/index/
1785
• 3-5 mins
• 3 players or as single group
Common Points
7
• What are your concerns?
• Good Samaritan guidelines
• Are you obligated?
• How common?
• What is common?
• Whose call is it anyway?
Case #2
8
• https://demo.openlabyrinth.ca/renderLabyrinth/index/
1786
• Role play required
• 5-10 mins
• 3-7 players
Case #2 scenario outline
9
• You are all on a long distance flight back to Canada
from South America, which will take 11 hours. Your
flight has already been delayed 3 hours so everyone is
tired, grumpy and anxious to get home.
• Finally, the flight has departed about an hour ago and
the crew are just serving drinks. You are on the new
Dreamliner, which should make for a more pleasant
and restful flight.
• You are just starting to relax when the call comes, “Is
there a doctor on the plane? We have a medical
emergency.”
Case #2 debrief
10
• What came out of this?
• What went well?
• https://www.facebook.com/toppsd/videos/101570697
44223454/?lst=655338453%3A655338453%3A157895
3565 – guess what this is?
Teamwork & tools
11
• You are not alone
• Ground Medical Staff very experienced & helpful
• Big flight usually has several HCPs
• Coordinate and play nice
• What should your role be?
• Limits to what you can do
• Environment: noise, space, lighting
• What is in the kit?
Case #3
12
• https://demo.openlabyrinth.ca/renderLabyrinth/index/
1787
• 5-10 mins
• Role play not required – can use for group discussion
Final recap
13
• GMS are helpful and experienced
• KISS
• Other CLEO questions?
• Compensation?
Today I learned…
14
• Single sentence wrap-up
• ”…that the pilot makes the decision”
• NOT “I liked the interactiveness…” etc
• Group effect reinforces the learning for all.
Resources
15
• Quick link: http://tiny.cc/docaboard
• Materials: https://olab.ca/in-flight-emergencies/
• App: AirRx
• Contact: https://openlabyrinth.ca/contact/
Thanks to…
16
• Jim Chung & team – CMAJ plus pointers
• Paulo Alves, Medaire
• TJ Doyle, Stat-MD
• CMPA

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Doctor on a Plane: Handle Medical Emergencies in Flight

  • 1. Is there a doctor on the plane? 36th Emergency Medicine for Rural Hospitals January 17 - 19, 2020 David Topps Medical Director, Office of Health & Medical Education Scholarship The Office of Continuing Medical Education & Professional Development
  • 2. Faculty: • David Topps, Family Medicine, University of Calgary Financial Affiliations: • Honoraria, other rewards: none • Speakers' Bureaux, advisory boards: none • Grants, clinical trials: PiHPES and OLab are grant supported • Patents, royalties: none • Investments in health organizations: none • Other influential affiliations: Medbiq Faculty/Presenter Disclosure The Office of CME & PD
  • 3. • I have taken the appropriate steps to ensure that the use of third party material in this presentation falls under fair dealing in the Copyright Act https://library.ucalgary.ca/copyright/ • This material is licensed under Creative Commons, BY-NC-SA • Please do not assume you can reuse all of these images • I have properly cited third party material in one of the ways outlined below Copyright The Office of CME & PD Copyright Unknown https://www.wpclipart.co m/medical/testing/ECG_He art.png.html Order an ankle x-ray if: • Bone tenderness at A • Bone tenderness at B • Inability to weight bear both immediately and in the ED © Ottawa Health research Institute, 1053 carling Avenue, Ottawa, Ontario, Canada, K1Y 4E9
  • 4. 1. List common medical issues that can worry you on flights 2. Describe how the environment can affect what you can do 3. Inventory useful approaches before take-off 4. Explain liability issues for physicians, nursing professionals off-duty in restrictive environments Learning Objectives The Office of CME & PD
  • 5. Agenda 5 • Case #1 • Overview & common points • Case #2 • Teamwork tips • Case #3 • Debrief & discussion • Today I learned…
  • 7. Common Points 7 • What are your concerns? • Good Samaritan guidelines • Are you obligated? • How common? • What is common? • Whose call is it anyway?
  • 8. Case #2 8 • https://demo.openlabyrinth.ca/renderLabyrinth/index/ 1786 • Role play required • 5-10 mins • 3-7 players
  • 9. Case #2 scenario outline 9 • You are all on a long distance flight back to Canada from South America, which will take 11 hours. Your flight has already been delayed 3 hours so everyone is tired, grumpy and anxious to get home. • Finally, the flight has departed about an hour ago and the crew are just serving drinks. You are on the new Dreamliner, which should make for a more pleasant and restful flight. • You are just starting to relax when the call comes, “Is there a doctor on the plane? We have a medical emergency.”
  • 10. Case #2 debrief 10 • What came out of this? • What went well? • https://www.facebook.com/toppsd/videos/101570697 44223454/?lst=655338453%3A655338453%3A157895 3565 – guess what this is?
  • 11. Teamwork & tools 11 • You are not alone • Ground Medical Staff very experienced & helpful • Big flight usually has several HCPs • Coordinate and play nice • What should your role be? • Limits to what you can do • Environment: noise, space, lighting • What is in the kit?
  • 12. Case #3 12 • https://demo.openlabyrinth.ca/renderLabyrinth/index/ 1787 • 5-10 mins • Role play not required – can use for group discussion
  • 13. Final recap 13 • GMS are helpful and experienced • KISS • Other CLEO questions? • Compensation?
  • 14. Today I learned… 14 • Single sentence wrap-up • ”…that the pilot makes the decision” • NOT “I liked the interactiveness…” etc • Group effect reinforces the learning for all.
  • 15. Resources 15 • Quick link: http://tiny.cc/docaboard • Materials: https://olab.ca/in-flight-emergencies/ • App: AirRx • Contact: https://openlabyrinth.ca/contact/
  • 16. Thanks to… 16 • Jim Chung & team – CMAJ plus pointers • Paulo Alves, Medaire • TJ Doyle, Stat-MD • CMPA

Editor's Notes

  1. Top 5 presentations: Syncope/presyncope 37% Resp symptoms 12% Nausea/vomiting 9% Cardiac 8% Seizures 6% Other 28% -- long tail curve – Forest Gump’s chocolates https://www.flickr.com/photos/raymaclean/3441339723 CC BY
  2. https://www.flickr.com/photos/davidpacey1975/12013577576 CC BY
  3. https://www.piqsels.com/en/public-domain-photo-souhd CC0