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ACEP Now: Vol 41 – No 12 – December 2022

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Legal Considerations

On flights within the United States, as a health care professional, you are protected under Good Samaritan laws, meaning that you are not required to assist and if you choose to do so, you are protected from lawsuits (barring gross negligence or willful misconduct).⁶ This was codified under the Federal Aviation Medical Assistance Act of 1998 and applies to non-U.S. carriers as well.⁶ However, on international flights, rules and regulations are different and often differ to the country in which the airlines are based or sometimes which countries’ airspace an aircraft is at the time of an event. It’s important to note that some countries, such as Australia, require physicians to help.

Case Resolution

Since there’s no EpiPen auto-injector in the medical kit, you painstakingly draw up the epinephrine into a syringe and inject it into the patient’s thigh. The patient rapidly improves, and after observing him for a little longer, you return to your seat. As a reward, the flight attendant brings you a handful of extra snacks, including a bag of salted cashews. You cringe a little as you wonder: Who else on this flight has an allergy to nuts?

Dr. Görgens is resident fellow of ACEP Now.

Dr. Ho is assistant editor of ACEP Now.

References

1. Peterson DC, Martin-Gill C, Guyette FX, et al. Outcomes of medical emergencies on commercial airline flights. N Engl J Med. 2013;368(22):2075-2083.
2. Martin-Gill C, Doyle TJ, Yealy DM. In-Flight medical emergencies: A review. JAMA. 2018;320(24):2580-2590. doi:10.1001/jama.2018.19842
3. Ballough, JJ. Federal Aviation Administration Advisory Circular 121-33B: Emergency Medical Equipment. https://www.faa.gov/documentLibrary/media/Advisory_Circular/AC121-33B.pdf. Published January 12, 2006. Accessed November 13, 2022.
4. Aerospace Medical Association Air Transport Medicine Committee. Guidance Document. https://www.asma.org/asma/media/AsMA/Travel-Publications/FAA-med-kit-Guidance-Document-June-2019.pdf. Published June, 2019. Accessed November 13, 2022.
5. Federal Aviation Administration. Exemption No. 10690J, Regulatory Docket No. FAA-2013-0034, Extension of Exemption. https://www.regulations.gov/document/FAA-2013-0034-0039. Published March 29, 2022. Accessed November 13, 2022.
6. Family Practice Management editors. How to respond to mid-air medical emergencies. Blog post. https://www.aafp.org/pubs/fpm/blogs/inpractice/entry/good_samaritan.html. Published July 20, 2018. Accessed November 13, 2022.