There was a guy on my flight today who lost consciousness and fell out of his seat into the aisle. They got him back into his seat and he came to for a second. But then lost consciousness again. Ive never seen that look on someones face. It looked to me like he was going to die. They started calling for a doctor. Other passengers were trying to get him to come to. Some guy was using his fingers to keep his eyes open. It didnt seem to me there was a doctor because several minutes passed and nobody showed up. I wondered why they didnt immediately begin to divert the flight. Eventually a doctor showed up although I dont know what kind of doctor he was. He put the guy back on the floor. After about 5 minutes the attendants showed up with a medical kit and the doctor grabbed a saline back and gave the guy and IV. The guy was still out of it. And still no attempt to land. After about 10 minutes he started coming to. But he just laid there the rest of the flight. When we finally landed the paramedics came on and took the guy out. He was at least conscious and able to speak. But I wonder if there hadnt been a doctor or if whatever the doctor had determined was the matter meant that he needed immediate help we could at least have been already diverted and about to land.
Certainly is an top issue with airlines... from a report recently about "Are there doctors onbard",
Diversions are costly for airlines at $10,000 to $200,000 per incident. The New England Journal of Medicine estimates that a medical emergency occurs on 1 out of every 604 flights. Of those, 7.3% are diverted (or roughly one in very 4,409 flights). MedAire reports a much lower diversion rate 1.6% for flights where they provide assistance. One might speculate that the airline would prefer that there is not a doctor onboard to keep diversions low.
From what I know/have been told... pilots let company know and either the company (probably dispatch) or the pilots communicate with this outside firm of doctors who help to diagnose the individual having the issues and make a suggestion on when and where to divert. For instance a certain city or airport may be better equipped to handle a particular issue. Any pilots on here please correct this if Im wrong.
Other issues could play a factor in how quickly a diversion may happen as well, such as weight of the aircraft (fuel remaining), weather, or runway length of nearby airports.
In my experience probably at least 80% of the medical emergencies pilots have made me aware of result in the aircraft continuing on to their original destination.
I wish I had known about this thread before now. This is where I came in and I wanted to comment on these posts before reading the whole thing and throwing in my $.02.
Diversions. Medical diversions in particular are tricky things. First a short story: Going to Beijing via a polar route and through eastern Russia. Our divert fields at this particular point in time are
Fairbanks Alaska, and I don't remember if it was
Magadan or Petropavlovsk and finally
Beijing. We were
literally at the equal time point between Fairbanks and Beijing and had a passenger in pretty serious trouble. Magadan or Petro were closer, no doubt. We have a medical person on board that has an opinion but says she cannot make a real diagnosis without lab work. We have the capability to hook up an on board medical person with a medical service we use (I call it Doc in a Box). I don't want to get into too much detail on that. We hook them up on SatCom and they discuss possible diagnoses and what our potential divert situations are. Now if I am on fire, I am going to land in Eastern Russia. For medical reasons... probably not because we might very well have better equipment on the airplane. The other part of this story is the fact that the cockpit crew has to coordinate the diversion process with ATC, and while not that difficult, even with the Russians, buy the time we would have coordinated it with ATC, and our dispatcher (who tracks every facet of our flights) we would have been past the ETP anyway and going back to Fairbanks would have taken longer. We proceeded on to PEK which was still 4.5 hours away.
A little epilogue to this particular story: When I was going back to my rest break I went back and talked to both the passenger and the doctor. The passenger was a very nice man who was obviously in a lot of pain, but he looked at me and mouthed that he was sorry for all the trouble. I felt terrible, but there was nothing else I could do for him at that particular point in time other than to tell him not to worry about that and that getting him quickly and safely to the best care we could was a top priority. We were met by an ambulance and he was taken to a hospital. As I saw him getting off, he seemed much better, but still not feeling the best.
So... from MY perspective in the cockpit. I want to go wherever I can get the passenger the best care as soon possible but if I am in the middle of the Atlantic Ocean or over Eastern Russia it is not always close. It might be 3 or even more hours away. So you are probably asking what about over Nebraska. A lot of times, the FAs will call for a doctor before they ever let us know up front about it. And 'doctors' can be any health professional from EMTs to OB nurses to neurosurgeons (I have had all of those). The Doc in the Box helps us to make not only the decision to divert, but WHERE to divert to, depending on what help is needed. That is information he has at his fingertips. For example if it is a heart issue, we might want to go to a city that has a good heart center as opposed to finding the first piece of concrete available. Oh, and cost never enters the equation.
Sorry for the length. I understand tldr if that applies.