Fainting during flight is the number 1 airline medical problem

The most common passenger medical emergency during flight is fainting on board.

When a flight attendant calls a doctor in the middle of a flight, it is likely that a passenger has fainted on the plane. This is the most common medical emergency that occurs during flight. The medical term is syncope – a temporary loss of consciousness that is usually related to inadequate blood flow to the brain. This is also called fainting or “passing out.”

I know firsthand about passing out on an airplane. I have fainted on planes three times, most recently on a DC-Munich flight in December. I have now become “awakened” to the growing issue of fainting on airplanes. I take it seriously. So should the Department of Transportation and the FAA, which are burying their heads in medical issues in order to get more and more passengers on planes.

Flight attendants know that fainting on airplanes is very common.

A recent article in the LA Times highlighted the same problem I faced on my flight to Munich.

On long-haul flights of six hours or more, it is not unusual for at least one passenger to faint.

During my 30-year career as a flight attendant, at least 300 passengers died while I was on duty. (This is a conservative estimate based on approximately one fainting victim per month over the past three decades.)

According to WebMD.com, people faint for a variety of reasons, including dehydration, irregular heartbeat, low blood sugar, hyperventilation, a sudden drop in blood pressure, standing up, and of course, drinking alcohol. On airplanes, where ventilation is extremely poor, a lack of oxygen to the brain due to high cabin pressure can worsen the problem. Warm cabin air can make matters worse, which is why the temperature in airplane cabins is often set at uncomfortably cool levels.

Fainting events follow a similar pattern

All the scenarios for my death on the plane were the same – long-haul flight, uncomfortably hot cabin temperature, mid-flight nausea, scrambling to the galley for help, fainting en route, vomiting, confusion.

On the flight to Munich, the Lufthansa cabin staff apparently knew the drill. He immediately made me horizontal, raised my legs and cleaned me. Soon I had two doctors, an emergency room specialist administering oxygen, and a general practitioner checking my vitals. Monica, the angel GP, gave me a change of clothes from her carry-on in place of my vomit-soaked T-shirt and tights.

“Why does this happen to me?” I asked curiously. “It’s a vasovagal episode,” the ER doctor said. “you’ll be fine.” He explained several factors contributing to fainting: insufficient oxygen (hypoxia) due to cabin pressure, immobility, drop in blood pressure, and possible dehydration. Also, the Airbus plane that took me to Germany had no personal ventilation.

Doctors run out of space to treat sick passengers on overcrowded planes.

With no vacant seats available, I spent two hours lying on the floor near the back exit. The cool comfort of the galley floor was an improvement over my cramped economy seat row, where I sat with my backpack and two grown men in the seats next to me. After I recovered, a flight attendant served me a Coca-Cola and took me back to my seat. By the time I reached Munich, I was fine and caught the connecting flight to Poland.

Back home, I did some research and met with my doctor to learn how to avoid fainting the next time you fly. All my medical tests checked out normal, so I turned to online searches, which turned up a plethora of references and personal testimonials from travelers like me.

Flight attendants can confirm if passengers are unconscious

A flight attendant quoted on www.airliner.net, who was also a registered nurse, confirmed that fainting is very common. “Basically, this happens when you sit for long periods of time and your blood concentrates in the lower extremities,” he wrote. “You start feeling dizzy, nauseous and so you try to get to the lav. Virtually all fainting, 99 percent, happens right outside the lav. Once your body is horizontal the blood flows more evenly and you wake up. I’ve seen this more on long-haul flights…”

on-line publishing aviation health noted that “passengers seated in the back of aircraft such as the Airbus 340 and Boeing 767 are more likely to experience dizziness on long-haul flights, usually resulting in fainting.”

This temporary loss of consciousness due to decreased blood supply to the brain may occur after a meal and/or when a traveler gets up after sitting for a long period of time. An additional factor is the lack of oxygen in the cabin, so that a small drop in blood pressure can have a significant impact on brain function. Alcohol also increases blood flow to the intestines and heart rate. ,aviation-health.co.uk)

Medical problems during flight are a growing problem

I suspected that there was an increasing tendency to faint during flight. The shrinking of seat size and legroom and reduced maneuverability during flight may play a role. I looked for statistics. A study of 11,920 in-flight medical emergency calls reported by five domestic and international airlines from January 1, 2008, to October 31, 2010, found that syncope or presyncope contributed to 37.4 percent of cases (John Riefler, MD, Consultant360.com).

The Medical Profession page on Lufthansa’s website reports that the IATA Medical Advisory Group has noted an increase in on-board medical incidents in recent years. Lufthansa has also registered growth. The airline said it records 10 to 15 medical incidents a day on its 1,700 flights. This means that there are 17,000 to 25,500 departures per day on Lufthansa alone. German airlines fly only less than 5 percent of commercial flights worldwide. A simple extrapolation would mean that the airline system experiences between 340,000 and half a million faints every day.

My guess seems correct: in-flight emergencies, the most common of which is unconsciousness, are on the rise.

Where have the videos from the 1990s gone about the importance of flying practice?

In the 90s, airlines were concerned about deep venous thrombosis (blood clots). This condition can arise from immobility during long flights. In the safety video, passengers were advised to exercise while sitting and to walk in the aisle from time to time to keep circulation flowing. That advice has now disappeared. Today we have been told to remain seated and out of the aisle.

On the Munich flight, Lufthansa urged passengers to “remain in their seats until the light is green before going to the toilet.” It rarely turns green.

Advice and tips direct from flight attendants and medical personnel

Some flight attendants offer solid hands-on advice. American Airlines cabin staff, Woody Watkins, describes the ‘Coke Fix’ as a tried and tested method for preventing fainting in flight. “As soon as passengers complain of heat and dizziness, I bring them Coca-Cola as quickly as possible.”,

Here are some other suggestions:

• Stay well hydrated before and during the flight. Avoid caffeinated beverages and alcohol.
• Sit in an aisle seat whenever possible. Stand up from time to time, take a few steps down the aisle, and stretch your legs and feet.
• Exercise while sitting to maintain blood circulation in your lower limbs. Heel-toes raise, rotate the legs and do lots of tension-and-release isometrics in the hips and legs.
• Wear light clothing in layers. Hot air temperatures onboard have been linked to fainting. Adjust ventilation if possible to stay cool, or alert cabin staff if it becomes excessively hot.
• At the first sign of feeling sick, press the call button and get a Coke.

Bottom Line: To reduce the chance of fainting during your next long-haul flight – stay cool, stay hydrated and move on!

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