What started as a typical scheduled flight from Singapore to Sydney turned into an incredible emergency in-flight after a male passenger from Australia had a heart attack while on board the plane; three doctors from Singapore, who happened to be on their way to attend a medical conference, immediately jumped in to save the passenger.
How this incident started was roughly three hours after the plane took off and around the time that this gentleman passed out in his seat, and then his wife called for anyone that could assist. At that moment, Kanwar S. Lather, a physician (specialising in emergency medicine) with previous experience dealing with CPR patients and patients in potentially serious situations, was already looking around as I was because, because of his previous experiences as well as training, he had assessed the seriousness of the situation and reacted before the crew even announced over the intercom that they needed a doctor on board.
Upon getting up to the passenger, Kanwar assessed him and at that point realised that this was a critical life-threatening condition. In addition to Kanwar, two of his colleagues, Ian Mathews (from National University Hospital) and Michale Fung (from Khoo Teck Puat Hospital), came to the passenger’s assistance, making up a very effective impromptu medical team in the middle of the cabin; the team proceeded to rotate between themselves while performing CPR, establishing an IV for the administration of medication and using an Automated External Defibrillator (AED). The AED indicated that the passenger did not require a shock.
The fact that the response is an incredible act, however, is more than the speed of the response time and how much medical equipment was on board for coordination and general smoothness throughout the entire process, as noted by specialists, means that the aircraft was supplied with what experts have deemed to be a “mini-hospital” on behalf of Singapore Airlines. One of the key pieces of equipment onboard was an O₂ tank. Additionally, there were several emergency tools that assisted with continuing treatment for the individual until he regained his quality of life. The physicians noted that they discovered an unexpected fact about the actual performing of CPR; laying the individual out over the seats was far easier than trying to place him down on the floor prior to initiating the treatment.
The resuscitation process took almost 45 minutes for the individual to finally demonstrate to the doctors he was alive again by achieving a steady pulse and becoming able to breathe on his own. The physician indicated that the fluctuation of the heart rates helped determine how close this individual could have come to surviving. This particular physician emphasised that the speed of treatment initiation after the initial cardiac arrest was the key factor in the successful resuscitation. In fact, this physician stated that the attempted resuscitation attempt began perhaps within one minute of the individual’s cardiac arrest. Furthermore, if the treatment attempts had not begun to occur within 5–10 minutes of his cardiac arrest, the patient’s survivability would have had no chance at all, as this patient had a previous history of suffering multiple heart attacks prior to travelling that day.
When the doctors advised the flight crew to redirect their flight to Adelaide, the plane was still three hours from Sydney. The medical crew was aware that the passenger was still in danger of becoming unstable. During the flight and between the point of departure and the point of arrival, both at 6:00 am in Adelaide, the medical crew gave their attention and assisted the passenger at every step, monitoring his oxygen and communicating continuously with both him and his wife until the time he was disembarked from the aircraft, when he was taken by ambulance to a hospital in Adelaide. The other passengers on board the aircraft then continued their way to Sydney, Australia, to join their respective journeys.
The story is very compelling because it brings to light a part of emergency medicine that most people are not aware of, namely, decisive action taken in a limited amount of space, with urgent time constraints and without time for second-guessing oneself. According to Mathews, Fung and Lather, this experience reinforced the significance of emergency medical care in strange locations, where time and resource constraints must be duly recognised as important determinants of the success of any emergency medical care. Mathews and Lather additionally highlighted the legal protections afforded by Charitable Samaritan laws to individuals who help others in an emergency and in excellent faith.
Ultimately, flights today do much more than just transport the people who are flying with them and their luggage; they are also able to carry expertise, preparedness, and the type of sudden professional judgement that can potentially save a life. For the wife of the passenger, for the cabin crew, and for the three physicians who accidentally happened to be on that particular flight, what was at first an ordinary evening in an aeroplane turned into an extraordinary rescue operation.
