Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, NC.
MedAire, Inc, Phoenix, AZ.
Ann Emerg Med. 2020 Jan;75(1):66-74. doi: 10.1016/j.annemergmed.2019.06.004. Epub 2019 Jul 25.
More than 4 billion passengers travel on commercial airline flights yearly. Although in-flight medical events involving adult passengers have been well characterized, data describing those affecting children are lacking. This study seeks to characterize pediatric in-flight medical events and their immediate outcomes, using a worldwide sample.
We reviewed the records of all in-flight medical events from January 1, 2015, to October 31, 2016, involving children younger than 19 years treated in consultation with a ground-based medical support center providing medical support to 77 commercial airlines worldwide. We characterized these in-flight medical events and determined factors associated with the need for additional care at destination or aircraft diversion.
From a total of 75,587 in-flight medical events, we identified 11,719 (15.5%) involving children. Most in-flight medical events occurred on long-haul flights (76.1%), and 14% involved lap infants. In-flight care was generally provided by crew members only (88.6%), and physician (8.7%) or nurse (2.1%) passenger volunteers. Most in-flight medical events were resolved in flight (82.9%), whereas 16.5% required additional care on landing, and 0.5% led to aircraft diversion. The most common diagnostic categories were nausea or vomiting (33.9%), fever or chills (22.2%), and acute allergic reaction (5.5%). Events involving lap infants, syncope, seizures, burns, dyspnea, blunt trauma, lacerations, or congenital heart disease; those requiring the assistance of a volunteer medical provider; or those requiring the use of oxygen were positively correlated with the need for additional care after disembarkment.
Most pediatric in-flight medical events are resolved in flight, and very few lead to aircraft diversion, yet 1 in 6 cases requires additional care.
每年有超过 40 亿乘客乘坐商业航班。尽管成人乘客的机上医疗事件已经得到很好的描述，但缺乏描述儿童的相关数据。本研究旨在利用全球样本描述小儿机上医疗事件及其直接结果。
我们回顾了 2015 年 1 月 1 日至 2016 年 10 月 31 日期间，在全球范围内为 77 家商业航空公司提供医疗支持的地面医疗支持中心参与治疗的 19 岁以下儿童的所有机上医疗事件的记录。我们对这些机上医疗事件进行了描述，并确定了与目的地需要额外护理或飞机改道相关的因素。
在总共 75587 次机上医疗事件中，我们确定了 11719 次（15.5%）涉及儿童。大多数机上医疗事件发生在长途航班上（76.1%），14%涉及腿上婴儿。机上护理通常仅由机组人员提供（88.6%），而医生（8.7%）或护士（2.1%）乘客志愿者提供帮助。大多数机上医疗事件在飞行中得到解决（82.9%），而 16.5%需要在着陆后进行额外护理，0.5%导致飞机改道。最常见的诊断类别是恶心或呕吐（33.9%）、发烧或发冷（22.2%）和急性过敏反应（5.5%）。涉及腿上婴儿、晕厥、癫痫发作、烧伤、呼吸困难、钝性创伤、撕裂伤或先天性心脏病的事件；需要志愿者医疗提供者协助的事件；或需要使用氧气的事件与下机后需要额外护理呈正相关。
大多数小儿机上医疗事件在飞行中得到解决，很少导致飞机改道，但 1/6 的病例需要额外护理。
