Seizure at 37,000 Feet

What happens when someone experiences a medical emergency at 37,000 feet in the air? Will the flight crew have the necessary knowledge to handle the situation, or will they ask for help from passengers? If help is requested, will anyone step up to assist? Additionally, where are the AED, oxygen, and other medical equipment located on the aircraft?

This is the scenario I found myself in on a recent flight from Seattle to Las Vegas. The plane had reached its cruising altitude of 37,000 feet when a passenger in the row behind me experienced a grand mal seizure. My seat shook as the passenger's body convulsed, with their arms extended and their head thrown back. Even my noise-canceling headphones couldn't block out their moans and groans.

To give the flight crew credit, they had responded to the seizure within seconds. Almost immediately, an announcement came over the intercom announcing a medical emergency with a call for anyone with medical experience willing to help to come forward. Immediately, I began running through scenarios in my head, realizing that the two tourniquets and the packing gauze I had in my backpack would not be helpful.

With the passenger still seizing, I turned around, introduced myself as a former EMT who, while no longer licensed, has 16 years of experience, and asked if I could help. Immediately, heads nodded yes, and the flight attendants stepped away. Speaking briefly to the people seated around the passenger, I learned that the passenger was traveling alone and that a medical history was unavailable.

The seizure itself lasted no more than a minute, and while it was scary for the other passengers to watch, as far as grand mal seizures go, it was not overly violent. I noted that the passer was breathing normally, did not appear to have been injured, and was already regaining consciousness. With the plane beginning to be tossed around by turbulence, I made the decision to leave the passenger buckled in their seat.

I asked the flight attendants for a small oxygen bottle and nasal canula if they were available. I chuckeled when the flight attendant opened the compartment directly over my head. Lesson learned: always read the signage on the overhead compartments.

It was about this time that four nurses appeared, all offering their assistance. While the EMT in me hates to admit it, the nurses are trained to a higher level of care, and unlike me, they were all licensed. I gave a quick report and stepped aside. I laughed when I later found I shared a last name with one of the nurses, and the flight attendants became confused when trying to record helper information.

As the minutes passed, the flight crew was able to contact the patient's spouse over a flight phone. I am not sure who they got the spouse's name and contact information from, maybe from a flight passenger list? The spouse was able to tell us the passenger has a history of seizures and has medication with them, which they had probably missed due to a busy travel day.

The nurses found the seizure medication and assisted the passenger in taking the pills. As the postictal fog lifted and the passenger became more alert and oriented, they explained that they had been traveling for 36 hours straight and had missed their seizure medication.

With the passenger now stable, medication onboard, and about an hour left in our flight, flight attendants and pilots decided to continue to our original destination at a faster speed. The passenger continued to improve over time, and we arrived in Las Vegas 30 minutes early. The passenger was let off the plane first, I assume to waiting Paramedics, although I do not know this for a fact.

This was the best possible scenario for this patient. The passenger had a former EMT and four nurses, all willing to help. While the seizure most likely ruined their day, there was no injury or long-lasting effects. This is, however, not a common response, and medical professionals on planes are not guaranteed.

This story serves as a reminder of why we all need to be trained. Situational awareness is a skill that must be practiced at all times, even among the rows of passengers behind us. Thought and consideration should go into the gear we take with us when traveling. My tourniquets were of no use in this scenario, and I was left using what was made available to me.

Most importantly, we all need to have confidence and the willingness to act when an emergency arises. Get trained, be ready, stay alert. You never know when your training will pay off.