The Telegraph
It was 2.30 in the morning, maybe even closer to 3. All was quiet in the flight deck, just the odd ripple of turbulence occasionally bumping the aircraft. Peering 38,000ft down below us, the moonless sky gave little away of northern Canada. A black abyss of nothing; no roads, no towns, no people. We were truly in the middle of nowhere. Wed been hoping for the Northern Lights to keep us entertained as we sped through the darkness, but they never seem to play ball when you want them to. Flying through the night from the west coast of the USA can feel like a long slog. Nothing to see, few people to talk to and, normally, very little to do. Until the phone rang. Captain, a passenger has collapsed and is unresponsive, the cabin crew member informed us. Weve got them on oxygen and have just made an announcement for a health care professional. A phone call like that gets your attention. Getting ill is never a good thing but doing so seven miles above the snowy wilderness of the Arctic Circle is less than ideal. At any point during a flight, a switched-on pilot will always know where, and how far away, the nearest diversion airport is. At 70 North, Iqaluit was relatively close, just an hour away. However, a snowstorm had reduced the visibility to levels which would make landing impossible. It would take just under three hours to reach Goose Bay, where the weather was better, a long time for a seriously ill passenger. During a medical emergency, timing and expert knowledge are critical. Accurate communication is key to making the best decision not only for the sick individual but also for the rest of the passengers on board. Divert the aircraft too soon and it could result in thousands of pounds of unnecessary costs and scores of missed connections. Divert too late and the passenger may not survive. Its a tricky tightrope to walk. Luckily, in these situations, we have an ace up our sleeve. Understood, replied the captain, well call Medlink A mere 4,500km away, just outside Phoenix, Arizona, is Banner University Medical Center. At the centre of the emergency room, a level 1 trauma centre, sits MedAires MedLink Global Response Center. Providing support in more than 140 different languages, MedLink gives aircrew ready access to Emergency Department doctors who are able to assess the passenger and make recommendations to manage the situation. Getting in touch with MedLink is almost as easy as using a mobile phone. With the use of satellite communications in the flight deck, we are able to speak to the doctors in Phoenix from almost anywhere around the world. Only the Polar regions above and below 75 latitude fall out of signal range. Advanced systems on aircraft such as the 787 Dreamliner then allow us to connect the call to interphones in the cabin, allowing cabin crew to speak to the doctors without the need to run back and forth to the flight deck. Not only does this speed up communication, but it also reduces the amount of time the flight deck door is open. From their high-tech hub, not only are MedLink staff able to see where exactly in the world the flight is, but they also know what medical equipment is available on that particular aircraft. The doctor is then able to use this information to make their recommendation of treatment to the crew. All commercial airliners have a basic first aid kit, but most also carry a more advanced medical kit, containing equipment such as Nitrolingual spray, Ventolin inhalers and Epipens. It also contains a selection of drugs which can be administered only by a health care professional; a doctor, nurse or paramedic. If a passenger has suffered a heart attack or is suffering from high blood pressure, there are drugs to help. In the majority of cases, the patient responds well to the prescribed treatment and the flight continues on its way, as was the case in our situation. However, if the passengers condition deteriorates, the doctor may recommend that we consider diverting the aircraft to allow them to receive better care on the ground. Read more: What happens when someone dies on a plane? Using their knowledge of the aircrafts global position and specialist medical facilities available nearby, Medlink staff are able to suggest preferred diversion airfields, specific to the patients needs. Nevertheless, the decision to divert ultimately lies with the Captain. They have a responsibility, not only to the sick individual, but for the overall safety of the other passengers and crew on board. Just because Medlink has suggested a particular airfield would be ideal for the ill passenger does not necessarily mean that it is ideal for the flight. Diverting an aircraft is not a simple action, a number of factors must be considered before making such a decision. Is the weather suitable? Is the runway long enough for the current aircraft weight? Will we even be able to take off again? Like with many decisions in life, theres not always a simple answer. Depending on the problem and all the variables that come with it, there may be a number of viable options to take. A pilots job is more than just landing the aircraft in gusty winds or in zero visibility. We are decision-makers, each small choice potentially affecting hundreds of lives. What we decide to do, in the small hours of the morning in the middle of nowhere, is the reason why we are there.
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