In-flight medical events and aircraft diversions: one airline's experience

An aging population combined with the increasing mobility of people with acute and chronic illnesses could make an increase in the frequency of in-flight medical events aboard commercial aircraft likely.

To determine the incidence of each type of in-flight medical complaint, the appropriateness of medical kit contents, which factors lead to aircraft diversion, and which factors effect the appropriateness of the decision to divert.

Medical complaints reported aboard a sample airline from July 1, 1999 through June 30, 2000 were studied. The frequency of aircraft diversion was related to complaint and medical assistance provided. The appropriateness of the decision to divert was determined as a function of hospital admission rates.

There was an incidence of 22.6 medical complaints per million passengers and 0.1 deaths per million passengers. There were 210 diversions per million flights with one of every 12.6 incidents resulting in a diversion. When a passenger volunteer was used, they opened the medical kit 62% of the time. When a physician participated in the decision to divert the hospital admission rate was 49% versus 15% with no physician input.

Variations in incidence of medical complaints cited in previous studies demonstrate the need for an industry-wide standardized reporting method of in-flight medical events. All in-flight medical complaints could likely have been adequately treated with the contents of the FM's newly mandated medical kits. Physician participation in decisions to divert aircraft should be sought as it is associated with more appropriate divert decisions.