More attention needed for pediatric in-flight emergencies

Although in-flight emergencies are well-characterized events when they occur with an adult, the data for in-flight emergencies that occur in children are lacking. A new study published in the Annals of Emergency Medicine emphasizes the need for more information.

Researchers used records from all in-flight medical events that occurred from January 1, 2015, to October 31, 2016, that involved children and adolescents aged younger than 19 years. The children were treated with consultation from a ground-based medical support center and involved 77 commercial airlines. The researchers examined the factors linked to a child requiring more care when the flight reached the intended destination or the flight was diverted.

The investigators found 11,719 in-flight events that involved a pediatric patient. The majority of the medical events, 76.1%, happened on long-haul events. Fourteen percent of the medical events involved infants who were seated on a lap. Crew members provided sole care in 88.6% of in-flight medical events. Nurse and physician passenger volunteers were found to provide in-flight care 2.1% and 8.7% of the time, respectively. The medical events were resolved in flight 82.9% of the time and 16.5% required additional care when the plane reached the destination. Only 0.5% resulted in the plane being diverted.

The most common events included nausea or vomiting (33.9%), fever or chills (22.2%), or acute allergic reactions (5.5%). Additional care following the flight was correlated with events that required oxygen use and necessitated the assistance of a volunteer medical provider. Lacerations, blunt trauma, syncope, seizures, burns, congenital heart disease, dyspnea, and events involving infants seated on a lap also saw a correlation with additional care.

When describing the study, lead author Alexandre T. Rotta, MD, Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, North Carolina, said the study highlighted not only the need to improve in-flight safety equipment, but also the need for parents to take necessary precautions to prevent an in-flight event, such as keeping a child’s medication in the carry-on luggage rather than leaving it in checked luggage.