Airmedevac

Dr Bruce Elliott

Posts Tagged ‘flying doctors

Why I decided to become a Flying Doctor

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Most people think flying doctors only work in Australia. Not true. Every year thousands of travellers rely on flying doctors based in the UK to get them out of dangerous locations abroad or fly them home after they’ve fallen ill.

So it seems strange that so little is written about British flying doctors. Where do they fly to and what kind of emergencies do they deal with? How is it different from the Australian stereotype?  Who foots the bill? This series of articles answers these questions and breaks down the stats on 140 consecutive flying doctor missions in and out of the UK over a four year period.

I am a British flying doctor and have been since 2005.  Before that I spent 12 years working as a surgeon in the UK National Health Service with a few years in intensive care medicine and various other hospital specialties along the way. Around the time I should have been applying for higher specialist training a friend told me that I could get paid by the hour to fly abroad, pick up medical patients and bring them home on a plane.  Curious, I took a job out to Australia to bring a young tetraplegic patient back to the UK who had been stabbed in the neck.  It was a difficult and exhausting journey but he and his family were hugely grateful to get back safely and I found the whole thing immensely satisfying.  I decided to switch specialties.

Basically, it works like this.  The Brits travel abroad more than any nation on earth, roughly half the population every year.  Inevitably a percentage of them fall ill while they’re abroad and not all of them get well enough to fly home again on their own.  Some need doctors to look after them on board the flight.

Sometimes the patient gets better but still carries a risk of falling ill again on the flight, for example heart attacks, epileptic seizures and collapsed lungs.  The airlines don’t want to risk diverting their aircraft because it costs them so much money, so they issue medical clearance provided there’s a doctor on board the jet to deal with any inflight emergencies.

Sometimes the patient needs specialist equipment or treatment such as ventilators, intravenous infusions or constant monitoring.  These patients need private jets kitted out like intensive care units – in other words air ambulances.

Or sometimes people are unlucky enough to fall ill in parts of the world that simply don’t have the resources to treat them.  For example some countries have blood transfusion stocks contaminated with HIV, or have no intensive care units for very sick patients.  This requires evacuation to the nearest regional centre and a flying doctor to give emergency treatment en route.

So there are some similarities to the Australian Flying Doctor service, but most of the action takes place on board international flights.  It’s generally paid for through UK travel insurance, but sometimes the NHS covers repatriation of foreign nationals to their home country, and sometimes people without insurance or high net worth individuals pay privately.

Next: Which medical conditions are UK based flying doctors needed for?

Which medical conditions are UK based flying doctors needed for?

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Medical Condition Requiring UK Doctor on Flight 2007-12
This breakdown of the primary medical condition responsible for each of 138 consecutive sorties between 2007 and early 2012 shows the most common reason why UK based flying doctors are needed: heart attack. This is followed by epileptic seizures, collapsed lungs and cardiac arrhythmias. All of these conditions can relapse on board and require prompt treatment by a doctor to avoid diverting the aircraft.

Next: Where are UK based flying doctors needed?

Previous: Why I decided to become a Flying Doctor

Where are UK based flying doctors needed?

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Destination Requiring UK Doctor on Flight 2007-2012
Work tends to be seasonal and follow the leisure travel market. During the summer there is more work in Europe, especially Spain and the Canary Islands. Over the UK winter I travel all over the world, especially Thailand, South Africa and Australia. Passengers falling ill and disembarking from cruise ships take me off the beaten track to destinations such as Borneo and Alaska.

Next: What is your success rate? How common are inflight emergencies?

Previous: Which medical conditions are UK flying doctors needed for?

Top Ten iPad Apps for Flying Doctors

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I love my iPad.  I bought it last August in California to see what all the fuss was about.  At the time I couldn’t understand what everyone was banging on about.  “It’s like an iPhone but you can’t phone anyone.”  Why would you want a phone which wasn’t a phone?

But no one told me you could switch it on and off as fast as a calculator.  Or that the battery lasted more than ten hours.  Or that it was as portable as a book.  And I’d never had a 3G connected laptop before because dongles were expensive.  Plus Apple’s obsession with usability made the thing such a joy to use I started to use it for new things I never used to use a computer for, like playing chess and reading books.

Anyway, back to the point.  All of the things about the iPad I love also make it an excellent piece of kit for working as a flying doctor.  So here are my favourite apps in reverse order:

#10 Weather HD – What Shall I Pack? (£0.59)

We get sent almost anywhere at very short notice, sometimes just a few hours, so its helpful to have the weather handy while you’re packing.  No point in taking jeans if it’s going to be 34 degrees in the shade. Weather HD is a gorgeous app which makes full use of the iPad’s screen res with weather appropriate video and detailed information out to five days.

#9 British Airways – Tier Point Pornography (free)British Airways app

Flying Doctors have airmiles coming out their ears.  Some of them are with airlines you’d never use admittedly, but BA has the biggest range of flights out the UK so it’s nice to keep up with itineraries and tallies for planning the next holiday.

#8 OOxford Handbook of Key Clinical Evidence appxford Handbook of Key Clinical Evidence – To be sure, to be sure (£34.99)

Further back in the list as it’s not so much essential as good for you.  Many doctors learn medicine without understanding much of the evidence base for it.  And much of the medicine being used today is based on hearsay.  Well worth digging around to find out what’s really going on, and OHKCE makes that easy.

#7 MedCalc Pro – Every Medical Formula and a Few More (£2.99)Med Calc Pro app

Literally hundreds of them.  Particularly handy for converting foreign blood results, which often catch you out in far-flung exotic hospitals.  You can also keep a record of results against time for different patients. Nice.

#6 Maps appMaps – Never Get Lost Again (free)

I was always getting lost in strange places until I got my iPad. This app is idiot-proof, showing you exactly where you are thanks to instant geo-locationing from the GPS chip/ wireless mast positioning thingmy.  Comes free with the iPad so you don’t even have to download it.  Love it.

#5 The Economist – Be an Ambassador for your Own Country (free with subscription)Economist app

Situational awareness, understanding the big picture, call it what you will.  Every country and region comes with its own set of cultures, politics and people.  To function properly abroad, you need to understand something about how other countries work.  It’s not on the syllabus at medical school and there’s plenty of time to read on the job.

#4 Oxford Handbook of Emergency Medicine – When It All Goes Wrong (£34.99)Oxford Handbook of Emergency Medicine app

Emergency Medicine is a core skill for flying doctors.  Patients are always stabilised as much as possible before flight, but sometimes they’re sick or things just go wrong. This app takes you through just about every medical emergency you can think of.  A must have resource.

#3 BNF – An Indispensable Guide to the Dispensary (£26.49)BNF app

Somehow manages to give encyclopaedic yet concise advice on what drug to give when and how. The world’s finest drugs formulary, in my opinion.  Tradenames are specific to the UK but then you be using the generic names anyway – right?

Foreflight Mobile HD#2 Foreflight – The Ultimate Pilot Resource (£14.99 for 3/12)

If you’re a pilot, you’ll love Foreflight.  Downloads seriously detailed weather for most regions and airports worldwide for flight planning purposes then works as moving map GPS once you’re underway.  If you’re lucky enough to be use it in the US, you’ll have full VFR/ airway/ instrument plate support. Gorgeous layout, I just love this.

#1 MedScape – More Medical Information than you can Shake a Stick at (free!)Medscape app

An amazing resource which I cannot believe is free.  Covers thousands of conditions, drugs and procedures.  Perfect for flight medicine which has to cater for almost any condition on board an aircraft.  Like all the best apps in this list it works offline and only needs a net connection to update itself now and again.

What are your favourite apps?  Look forward to hearing from you!

Dr Bruce Elliott

Written by airmedevac

April 17, 2011 at 1:00 pm

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