80% emergency landings are due to medical reasons

MUMBAI: Indian carriers operate 13,000-odd domestic and international departures in a week and one out of these ends in an emergency landing.

Going by the data, one emergency landing per week would have presented a scary picture if these had been on account of the condition of the country's aircraft fleet. But the figures reveal that in the past one year over 80 percent of such landings were carried out because of medical emergencies involving onboard passengers.

Data collected by the Directorate General of Civil Aviation show that between August 2012 and August 2013, a total of 46 emergency landings were carried out by Indian carriers in the country and abroad. Out of this, 38 were because of medical emergencies and the rest were due to technical problems with the aircraft.

Of all Indian carriers, only Air India did four emergency landings because of technical reasons and four because of passenger-related medical emergencies on board. In the case of all the rest, the number of emergency landings done to help a passenger in distress outnumbered those done because of an aircraft in trouble.

"There was a time when the term, emergency landing, conjured up an image of an aircraft in distress with its passengers braced for a hard touch down. That is hardly the present day scene what with an increase in number of senior citizens, infants and even unwell passengers taking flight," said a medical practitioner at Mumbai airport, requesting anonymity. With increase in life expectancy, the number of senior citizens on board flights is only bound to rise and the trend will only grow stronger.

For instance, on August 09, a 67-year old Air India passenger suffered a cardiac arrest on board a Mumbai-Bangalore flight. So minutes after take-off, the aircraft did an emergency landing back into the city and the passenger was revived by the airport's medical team. About two weeks earlier, on July 21, an IndiGo flight from Mumbai to Chennai returned to the city after an infant suddenly took ill. The pilot sought an emergency landing, but the child died on arrival. The same day on another IndiGo flight, a senior citizen fell unconscious soon after the aircraft took off from Mumbai. In this case too the aircraft returned and did an emergency landing, but the passenger was declared dead on arrival in Mumbai.

Another indicator of the change is the fact that Mumbai airport currently has 43 Automatic External Defibrillators (AEDs), while a decade ago it did had none. These AEDs, the largest number any Indian airport has, are placed at different locations including the inter terminal coaches, said a Mumbai International Airport Pvt Ltd (MIAL) spokesperson.

13 out of 38 medical emergency landings involved flight diversion

The trend brings financial consequences as well as out of the 38 medical emergency landings done, 13 were flight diversions. "Flight diversions increase expenditure on account of fuel, it upsets the schedule of other flights lined up in the day, it is bad for passengers with connecting flights to board," said a top official, with a private airline, requesting anonymity. "There are two types of passengers, those who do not reveal their medical condition to the airline as they would be deemed unfit to fly and others, who are generally fit to fly but because of the stress involved in flying, an existent medical condition, known or unknown aggravates and lands them in trouble," he said.

Passenger cabins are maintained at a pressure equivalent to that found at 7000 to 8000 feet which means less oxygen to breathe, dry cabin air because of lower humidity and all this coupled with restricted movement for hours can mean trouble for some passengers.

The global airline and medical industries have been clued into this trend for a while now. A study done in 2009 by Critical Care, an international peer-reviewed clinical medical journal analysed 10,189 medical flight reports and it revealed syncope (medical term for fainting, passing out) (53.5%), gastrointestinal disorders (8.9%), cardiac conditions (4.9%), fear of flying (4.3%) and generalized pain (4.1%) as being the five most frequent diagnoses on board flights. "The most frequent diagnosis causing flight diversion were myocardial infarction (22.7%), apoplexy (11.3%) and epileptic seizures (9.4%)," it said.

Airlines in India too have registered this trend. During a medical emergency on board, it is the commander who takes a call on whether to continue with the flight or to land at the nearest airport available so as to help the passenger in distress. Under the conventional practice , the cabin crew informs the commander about the condition of the passenger concerned. If there is a doctor on board the flight, the commander gets a better understanding of the state of the passenger which makes it easier for him/her to decide on the next course of action.

Certain private carriers like Jet Airways have taken the guess work out of the commander's job by subscribing to a service (called MedLink) that helps pilots take a studied call on the course of action to be taken during a medical emergency. Said a Jet Airways commander: "During a medical emergency, we call the doctor on ground and give him information about the passenger." Like the sequence of events giving details about the symptoms, problems experienced by the passenger, what remedial measures were taken, how did the passenger respond, the age, medical history of the passenger etc.

"With this information, the doctor studies the case instructs on the steps to be taken to handle the emergency, which includes their suggestion on whether the flight should be diverted or not," he added.

Source:  http://timesofindia.indiatimes.com