In-Flight Medical Conditions

Aviation Medicine and First Aid

• Oxygen should be administered to those with medical problems using aircraft portable oxygen bottles.
• Cabin Crew should offer oxygen promptly to all distressed people.
• Always seek professional medical help.

Aviation Physiology

• Human physiology is designed to function best at sea level.
• Flight at altitude is unnatural to human beings and imposes considerable demands on the body's physiology.

Atmospheric Pressure

• Atmospheric pressure decreases with increasing altitude.
• The pressure of oxygen also decreases because 20% of air is oxygen.
• Hypoxia occurs as a result of reduced oxygen levels available to supply the body's tissues.

Body Gases

• Atmospheric pressure decreases with increasing altitude.
• Reduced atmospheric pressure culminates in the expansion of gases within the body.

Effects on Oxygen and Respiration

Respiration

• Respiration or breathing is the process by which oxygen, absorbed via the lungs, is transported by the blood to every cell in the body.
• Carbon dioxide, the waste product, is expelled from the body through exhalation.
• The normal adult resting respiration rate is 12 - 18 breaths per minute, but this may increase if hypoxia occurs.

Oxygen

• Oxygen (02) is essential for life and must be present in adequate quantities for body cells to function.
• Brain cells can be permanently damaged if left with no oxygen for 4 - 5 minutes.
• At sea level, the percentage saturation of oxygen is 97%.
• At levels above 12 000 ft, normal functioning of the brain is compromised.

Administering Oxygen from a Cylinder

• Passengers who require oxygen to be administered continuously or intermittently will have notified the Company when booking the flight.
• Such passengers are responsible for supplying the oxygen cylinder, securing the oxygen bottle with Company assistance, and the flow rate at which the oxygen is administered.

Medical Problems Related to Altitude

Hypoxia

• Hypoxia is a condition when the supply of oxygen to the body's cells is inadequate ('Hypo' = under, 'oxia' - oxygenation).
• Commercial airline aircraft are pressurized to prevent the fatal effects of hypoxia; Cabin altitude of between 6000 ft - 8000 ft is maintained.

Mild Hypoxia

• Persons may present with fatigue, listlessness and vague distress, and/or lack of concentration.

Moderate Hypoxia

• Persons may present with lack of self-criticism, mood changes and confusion, and/or breathlessness.

Severe Hypoxia

• Persons may present with a blue tinge to lips and fingers, loss of consciousness, and/or death.

Management of Hypoxia

• Give oxygen at 4 L per minute (high flow rate).
• Loosen tight clothing around neck, chest and waist.

Hyperventilation

• Hyperventilation ('hyper' = over, 'ventilation' = breathing) is a condition caused by over-breathing to the point where too much carbon dioxide is exhaled, resulting in the disruption of the delicate brain chemistry.
• Emotional upset and anxiety, and/or fear and nervousness can cause hyperventilation.

Recognition of Hyperventilation

• Persons may present with rapid or over-deep breathing, numbness and tingling of body extremities, spasms in the hands or feet, feelings of panic, dizziness and agitation, vision disturbance, and/or fainting episodes.

Management of Hyperventilation

• Reassure the person.
• Ask the person to deliberately decrease the speed and depth of respiration.
• Give oxygen at 4 L per minute (high flow rate).

Gas Expansion

• Gases expand at altitude due to a decrease in atmospheric pressure.
• This affects closed or semi-closed cavities in the body that contain air: The middle ear, sinuses, bowel and teeth.
• Problems in ears and sinuses are usually due to head colds or hayfever and often occurs on descent.

To relieve difficulties with Gas Expansion in adults, have passengers:

• Swallow
• Yawn
• Chew on a sweet
• Blow nose
• Hold and exhale gently through nose

To relieve difficulties with Gas Expansion in infants, have them:

• Cry
• Swallow
• Suck

Otitic Barotrauma

• Otitic Barotrauma (painful blocked ears) occurs if the Eustachian tube is blocked, causing deflection of the ear drum, pain, deafness, fluid formation and possible rupture of the eardrum.
• The common cause of eustachian tube obstruction is an upper respiratory tract infection (URTI) - for example, a cold, influenza, sinus or throat infection or hay fever.

Recognition of Otitic Barotrauma

• Persons who have increasing ear pain on descent recognize otitic barotrauma.

Management of Otitic Barotrauma

• Instruct the person to chew, yawn or move the lower jaw around in an attempt to open up the bottom end of the eustachian tubes.
• Encourage infants to feed or suck on a dummy, or to cry vigorously.
• If pain persists after descent: advise the person to consult a physician.

Sinuses and Sinus Barotrauma

• Sinuses are air pockets in the bones of the face with narrow canals opening into the nose.
• Pressure is equalised through these openings.
• Sinus barotrauma occurs if the openings become blocked by infection

Recognition of Sinus Barotrauma

• People who have severe pain in the sinuses on ascent or descent recognize sinus barotrauma.

Management of Sinus Barotrauma

• Instruct the person to blow the nose one side at a time.

Gas Expansion - Other Areas of the Body

Bowel

• The bowel contains air swallowed with food and gas produced during digestion.
• On ascent, these gases expand. The bowel usually dilates to accommodate the increased volume without discomfort and bowel colic rarely occurs.
• Abdominal/intestinal trapped gases are relieved through natural means.

Teeth

• Decay under a dental filling can lead to a hollow cavity with gases of putrification.
• On ascent, this gas will expand resulting in severe toothache due to pressure on the nerve ending; on descent the gases compress.

Recognition of Teeth Issues

• Toothache is recognised by people who have severe tooth pain on ascent and subsiding on descent.

Management of Teeth Issues

• Manage the toothache by applying an ice pack to the area.

Recognition of Teeth Issues

• Toothache is recognised by people who have severe tooth pain on ascent and subsiding on descent.

Management of Teeth Issues

• Manage the toothache by applying an ice pack to the area.

Decompression Sickness

• Decompression sickness occurs when nitrogen, normally dissolved in body fluids, forms bubbles throughout the body.
• Decompression sickness is most likely to occur after a person goes scuba diving and then flies without waiting an adequate period of time.

Recognition of Decompression Sickness

• Patients may present with joint pains, tingling, numbness and general discomfort of the skin, weakness, chest tightness, visual impairment, dizziness, and/or an altered conscious state or unconsciousness.

Management of Decompression Sickness

• Place the person in a horizontal position.
• Give oxygen at 4 L per minute (high flow rate).
• Observe the person.
• Keep the person warm.
• Advise the person to keep still.

Upper Respiratory Tract Infections

• Upper respiratory tract infections (URTI) may result in Eustachian tube blockage and dysfunction causing middle ear pain, infection and hearing damage, or incapacitation.
• The ability to 'clear the ear' is essential before returning to flying duties.

Blood Donations

• Crew members should ensure a 48-hour period free of duty after donation.
• Crew members should not donate more than one standard unit at one time and make no more than two donations per year.

Scuba Diving

• For non-decompression diving with a total bottom time of less than two hours, wait 12 hours before flying.
• For non-decompression diving with a total bottom time of more than two hours, wait 24 hours before.
• For decompression staging diving: wait 24 hours before flying.

Fatigue

• All humans have a natural 24-hour body 'clock' cycle that is designed to make a person sleepy at night and alert during the day.

To minimise fatigue crew should adopt the following:

• Before an international tour of duty, ensure sufficient time is set aside for sleep for at least two or three nights.
• Before late evening departures, take a nap between 1400-1500 hours.
• Keep on your own time zone if your duty time is less than 48 hours on another time zone.
• Take naps whenever there is an opportunity to sleep on another time zone.
• There are two best times that crew should make use of according to their body clock to sleep: midnight-0600 hours, and/or 1300-1500 hours.
• Avoid drinks containing caffeine for four hours before any sleep.
• Avoid alcohol before sleeping as it causes disrupted sleep and do not have more than two units of alcohol before sleeping.
• Do not exercise within 90 minutes before sleep.
• Ensure a quiet, darkened room for sleeping.
• Avoid interruptions to sleep by disabling the phone and activating a 'Do not disturb' sign.
• You cannot force sleep; rather than tossing and turning in bed, read a book, watch TV and then retry to sleep in one or two hours.

Aircraft Environment

Cabin Air

• The total airflow on the aircraft is approximately 20 cubic feet per minute per person, resulting in 20-30 total air changes per hour.
• Half of the air coming into the cabin is fresh from outside the aircraft; half is re-circulated through high-efficiency particulate air (HEPA) filters.
• HEPA filters remove micro-organisms and contaminants down to 0.3 microns (0.0003 mm) with 99.97% efficiency at removing bacteria and viruses.
• The filters are replaced every 4000 hours.

Infection Risk

• Cabin air-conditioning systems are not a significant infection risk.
• The major airborne infections are viruses that cause the common cold.

Hearing and Noise Damage

• Repeated exposure to high frequency noise can damage hearing leading to permanent damage.
• Crew are encouraged to wear hearing protectors to protect their hearing when walking across the tarmac to avoid over exposure to high frequency noise from other aircraft.

Aviation First Aid

The Function of the First Aider

• A first aider provides immediate and continuing care until a physician (doctor), nurse or ambulance officer (paramedic) is available.

Handling an Unconscious Person in a Seat

Finding a Person in an Aircraft Seat

• An unconscious breathing or non-breathing person should be placed in the aisle for further management techniques to be implemented.

How to Lift an Unconscious Person from a Seat

• Three people are required to perform the lift and each person is allocated a position to ensure that the weight of the body is shared.

Neck Breathers

• Some people may have undergone partial or total removal of the larynx (laryngectomy) requiring a surgical opening in the neck to permit breathing.
• A metal or plastic tube may be worn in the opening, called a stoma.

Administering First Aid to Neck Breathers

• If there is a tube in the Stoma (opening in the neck), do not remove the tube.

Oxygen to Neck Breathers

• If first aid oxygen is required by a neck breather, administer it via the stoma (opening in the neck).

CPR for Neck Breathers

• The Laerdal resuscitation face shield ™™ is located in the first aid kit.

Medical Procedures in Flight

• The Captain is responsible for deciding if first aid management by Cabin Crew can continue during landing.

DRSABCD

Danger

• Check for danger, hazards and risks to yourself, the casualty, and bystanders.

Response

• Use COWS acronym:
• Can you hear me
• Open your eyes
• What's your name?
• Squeeze my hands
• Squeeze their shoulder firmly to elicit a response. If they are responsive, place in recovery position and monitor. If no response, Send for help.

Send for help

• Call for assistance of another Cabin Crew member.

Airways

• Check the airway is clear by opening the mouth and removing any foreign material that may be present.

Breathing

• Check for breathing by look, listen and feel method

CPR

• Commence CPR as directed by your first aid institution training.
• Continue compressions and breaths in a 30:2 ratio until medical aid arrives

Defibrillation

• Apply the defibrillator as soon as possible and follow the voice prompts.
• An automatic External Defibrillator (AED) should only be used on a casualty who is unconscious, unresponsive and not breathing.

First Aid Principles

• Preserve life
• Prevent further harm
• Prevent the condition from worsening
• Promote the unconscious
• Promote recovery.

Recovery Position

• Place their furthest arm directly out from their body.
• Place other (nearest) arm across their chest.
• Bend their nearest leg and place foot on floor.
• Roll them away from you onto their side, carefully supporting their head and neck.
• Keep their leg bent with their knee touching the ground to support the body.
• Place their hand under their chin to stop their head from tilting and to keep their airway open.
• For pregnant women who need to be placed in the recovery position, they need to be placed on their left side only, called the left lateral tilt.

Managing a Medical Incident

• Managing a medical incident may involve two Cabin Crew members: primary first aider and/or communicator/assist.
• The first person to discover a medical problem is the primary first aider who should assess the situation.
• The second person will be the communicator/assist and will also collects the first aid equipment and assists the primary first aider in assessing the person and performing first aid management.
• If a severe medical incident occurs in flight, Cabin Crew should make an announcement, brief the Captain, take any advice, follow all first aid procedures and complte documentation.
• A Medically Qualified Volunteer (MQV) should be a registered doctor, nurse or paramedic; crew must verify an MQV's credentials by sighting their medical license/registration number.
• Complete the SHOR (Form CSM099) when time permits and enter details into iQSMS at completion of duty.

When to Stop Cardiopulmonary Resuscitation

• CPR may be stopped if the person recovers with spontaneous breathing and circulation, a physician (doctor) pronounces the person dead or medical help takes over.

Death in Flight

• A person can be pronounced dead only by a physician (doctor), or an escorting nurse if the flight is ceased due to exhaustion by the operators.
• Place the body in a seat and fasten the seatbelt, move other people from the immediate vicinity, if possible, cover the body with a blanket and pass the person's particulars to the captain for transmission to the destination airport.

Chain of Survival

• Early recognition that the casualty has a problem.
• Early call for help: notify cabin crew and flight crew and make the “Request for Medical Assistance" PA.
• Early CPR to keep the brain and heart alive by pumping oxygenated blood around the body long enough for a defibrillator to arrive.
• Early defibrillation (AED).
• Early advanced care by ambulance and hospital personnel.

Medical Conditions in Flight

Loss of Consciousness

• Head injury - damage to the brain and its blood vessels.
• Stroke - burst or blocked brain arteries.
• Fainting - body's blood vessels widen causing a drop in blood pressure.
• Drunkenness.
• Seizures.
• Diabetes.
• Heart attack.
• Asphyxia; and
• Poisons.

Management of Loss of COnsciousness

• Place in the recovery position.
• Loosen tight clothing around the neck, chest and waist.
• Give oxygen at 4 I per minute (high flow rate).
• Stay with the person, maintaining close observation.
• Seek medical aid immediately using the severe medical incident procedure.

Heart Conditions

Angina

• A condition caused by a narrowing or spasm of the coronary arteries supplying blood to the heart muscle brought on by anxiety, excitement or even exertion.

Recognition of Angina

• Pain and discomfort in the chest, sometimes radiating into the neck and down the left arm, and/or a pale appearance and skin that is clammy to the touch.

Management of Angina

• Loosen tight clothing around the neck, chest and waist.
• Give oxygen at 4 L per minute (high flow rate) and stay with the person, maintaining close observation.
• If requesting Nitrolingual Pumpsray from Physicians Kit, prime the pump by holding spray upright and press nozzle 5 times spraying in the air.
• Ask passenger to open mouth, put tongue on top of mouth and aim pump under the tongue and get passenger to press the nozzle firmly once with forefinger to release the spray under tongue.
• Only if pain persists after 5 minutes, repeat with a second dose.

Precautions for Angina

• Ask passenger if they have used Viagra or a similar drug in the last 3-5 days and do not use more than three sprays during an attack.

Heart Attack

• A sudden blockage of a coronary artery occurs.

Recognition of a Heart Attack

• May present with symptoms that are similar to, but more severe than those relating to angina and may include loss of consciousness.

Management of a Heart Attack

• Refer to text under the heading 'Angina' for further information

Cardiac Arrest

• Cardiac arrest is caused by an electrical malfunction in the hearts electrical system ad presenting as either a complete standstill or vibrating rapidly in a chaotic rhythm.

Causes of Cardiac Arrest

• Heart attack
• Drowning
• Electrocution
• Heart failure
• Allergic reaction
• Trauma

Recognition of Cardiac Arrest

• Not breathing, or not breathing normally.
• Unresponsive.

Management of Cardiac Arrest

• Follow DRSABCD.
• Commence CPR.
• Defibrillate as soon as possible.
• If consciousness regained, place in recovery position and give oxygen at 4 I per minute (high flow rate).

Stroke (Cerebral Haemorrhage)

• A stroke is induced by the rupture of a blood vessel in the brain, or by a blockage of a blood vessel due to the presence of a blood clot.

Recognition of Stoke

• Paralysis and loss of feeling on one side of the face or body.
• Loss of normal speech and/or loss of balance.

Management of Stoke

• Support in a semi-reclined comfortable position and support the paralysed side with soft articles to protect from injury.
• Loosen tight clothing around the neck, chest and waist.
• Give oxygen at 4 I per minute (high flow rate) and stay with the person, maintaining close observation. Seek medical aid immediately using the severe medical incident procedure.

Asthma

• Asthma is a spasm of the small air tubes involving preventers that assist in the prevention of asthma attacks and relievers that are used to relieve the symptoms of an asthma attack.

Recognition of Asthma

• Obvious respiratory distress; also indicated by an audible wheeze.

Management of Asthma

• Loosen tight clothing around neck, chest and waist.
• Give oxygen at 4 I per minute (high flow rate) and stay with the person, maintaining close observation.
• Seek medical aid if there is no response to the management or the person's condition is worsening.
• If requesting Asthma puffer from Physicians Kit, ask if the person has been diagnosed with a medical condition then shake inhaler before giving.
• Deliver one puff of medication through a spacer if available and ask passenger to take four breaths from the spacer device repeating three more times.
• Wait for minutes from the last puff; ask for an MQV and stay with the person, maintaining close observation.

After use of an Atha Puffer:

• Dispose of red cap, place used spacer in H Bag and place used salbutamol inhaler in D1 Bag

Diabetes

• Diabetes is a metabolic disease characterised by an imbalance between levels of glucose and insulin.
• Diabetics on treatment may suffer with a too high or too low blood sugar reaction, the most common reaction being a low blood sugar reaction.

Low Blood Sugar Recognition

• Dizziness.
• Confusion.
• Sweating.
• Shaking.
• Hunger; and/or
• Weakness.

High Blood Sugar Recognition

• Thirst.
• The need to urinate frequently.
• Hot dry skin; and/or
• Smell of acetone on their breath.

Seizures

• A seizure is caused by a disturbance of the electrical activity within the brain.

Recognition of Seizures

• A loss of consciousness and strong rhythmic body movements.
• Seizures that may last several minutes.
• A blue tinge to the face and foaming at the mouth.
• A loss of bladder and bowel control; and/or An altered conscious state and possible confusion after the seizure.

During a Seizure

• Recline the seat and loosen the seatbelt (if the person is in a seat).
• Protect from injury, provide soft articles to 'pad' the person and time the seizure.

After a Seizure

• Place the person in the recovery position.
• Loosen tight clothing around the neck, chest and waist.
• Give oxygen at 4 I per minute (high flow rate); reassure and gently orientate the person back to normal surroundings when he/she regains consciousness.
• An ambulance must meet the aircraft if the seizure lasts longer than 5 minutes, the person remains unconscious, it is possibly their first seizure, or one seizure is followed by another seizure.

Febrile Convulsions in Infants

• Febrile convulsions are a common medical condition in children aged between 6 months to 6 years when they are suffering from a high fever.

Recognition of Febrile Convulsions

• Fever.
• Stiffness or floppiness.
• Jerking or twitching movements; and/or
• Unconscious or unaware of their surroundings.

Management of Febrile Convulsions During

• Place the child in the recovery position or on the floor.
• Protect from injury, provide soft articles to 'pad' the person and time the seizure.

Management of Febrile Convulsions After

• Remove excess clothing or wrapping (ie; sweaters, jackets).

Choking

• Choking is an obstruction of the upper airway by impacted foreign material.

Partial Obstruction

• Wheezing or noisy breathing.
• Difficulty in breathing.
• Violent coughing.
• Blue tinge to the skin; and/or
• Flaring nostrils (in infants, children and young adults).

Total Obstruction

• Inability to breathe, speak, cry or cough.
• Agitation, with the possibility that the person may grip his/her throat.
• A blueness of the face and bulging neck veins.
• Rapid deterioration; and/or
• A loss of consciousness.

Management of Choking

• Encourage the choked person to relax and cough to remove the object, bend them forward and give 5 back blows.
• Have oxygen available (if required) at 4 I per minute (high flow rate). Seek medical aid immediately using the severe medical incident procedure if there is no improvement.

Shock

• Shock is a loss of effective circulating blood volume and may be caused by pain, trauma, infections, or allergic reactions.
• Other causes include poisoning, inadequate supply of oxygen to the brain (due to a heart attack or asphyxia), severe burns or injury, severe haemorrhage (internal or external), and/or severe dehydration.

Recognition of Shock

• Giddiness, faintness and anxiety.
• Thirst, nausea or vomiting.
• A pale appearance and clammy skin to touch.
• A rapid or weak pulse.
• Rapid, shallow respiration; and/or An altered conscious state or unconsciousness.

Management of Shock

• Place the person in a horizontal position if conscious, elevating legs if injuries permit
• Cover with a blanket, but do not overheat.
• Loosen tight clothing around the neck, chest or waist.
• Give oxygen at 4 I per minute (high flow rate) and stay with the person, maintaining close observation.

Fainting

• Fainting is a temporary disturbance of consciousness due to inadequate blood pressure supply to the brain that can be brought on by any emotional or physical upset including nervous shock, pain and/or from sitting and standing still for long periods.

Recognition of Fainting

• Dizziness and light headedness.
• Anxiety and restless.
• A pale appearance or clammy skin to touch.
• Nausea; and/or
• Unconsciousness for a few seconds.

Management of Fainting

• Place the person in a horizontal position with legs elevated.
• Loosen tight clothing around the neck, chest and waist.
• Give oxygen at 4 I per minute (high flow rate).
• Stay with the person, maintaining close observation.

Allergic Reaction

• An allergy occurs when a person reacts to a substance in the environment known as an allergen found in pollen, insects, mites, moulds, foods and some drugs (medications).

Recognition of Allergic Reactions

• Swelling of lips, face, eyes.
• Hives or welts.
• Tingling mouth.
• Abdominal pain, vomiting.

Management of Allergic Reactions

• Loosen tight clothing around neck, chest and waist. Give oxygen at 4 I per minute (high flow rate) and stay with the person, maintaining close observation Seek medical aid even if condition is improving Follow the procedure including the Physcians Kit:
• Locate medications sleeve in Physicians Kit then break security seal and place one tablet in passenger's hand then reseal medications sleeve and place back in Physicians Kit.

Precautions when dealing with Allergic Reactions

• Not for pregnant tor breastfeeding mothers.
• Ensure the passenger has used the medication before and confirm they are not allergic to the medication.
• For use by adults and children over 12 years old.

Anaphylaxis

• Anaphylaxis is a severe allergic reaction which often involves more than one body system caused by food, bites, and medication.

Recognition of Anaphylaxis

• Difficulty/noisy breathing.
• Swelling of the face/tongue and or swelling/tightness of the throat. Difficulty talking or hoarse voice and wheeze or presistent cough. Abdominal pain and vomiting alongside hives, welts, and body redness; and/or pale and floppy (young children).

Management of Anaphylaxis

• Loosen tight clothing around neck, chest and waist.
• Give oxygen at 4 I per minute (high flow rate) and stay with the person, maintaining close observation.
• Ask if the anaphylactic person has been diagnosed with a medical condition and requesting Adrenaline Auto Injector (EpiPen) from Physicians Kit.
• Support in a semi-reclined comfortable position and support the paralysed side with soft articles to protect from injury.
• Ask if the person has been diagnosed with a medical condition of stroke then ask the the person if they are carrying any medication for the conditions they present with.

Anaphylaxis Treatment

• Remove them from their seated area and do not let them walk around
• Administer Adrenaline Auto Injector (EpiPen) with fist around Adrenaline Auto Injector (EpiPen); remove the blue safety release and hold leg still. Place orange end against outer mid-thigh (with or without clothing) and push down hard untill click can be heart. Adminsiter for 3 seconds and note time administered on passenger's hand;

Anaphylaxis Precautions

• Check passenger's thigh pockets for phone, keys etc as auto injector will not penetrate.
• The used Adrenaline auto injector (EpiPen) shall be placed in a sick back and taken off with passenger to hospital.
• If person is unresponsive and not breathing normally, commence CPR

Adrenaline Auto Injector Information

• The auto injector can be administered through most clotinh materials.
• Adrenaline auto injector (EpiPen) comes in two different doses.
• Junior Pen - Green – 150 micrograms of adrenaline for children 7.5 kilograms to 20 kilograms.
• Adult Pen - Yellow – 300 micrograms of adrenaline for children and adults over 20 kilograms.

Bruises, Strains, Sprains and Fractures

• A bruise occurs when an injury causes bleeding into the body tissues of the injured part.
• A strain is a pulled muscle.
• A sprain is a torn ligament.
• A fracture is a bone that is either broken or cracked.

Recognition

• A recent obvious injury.
• Pain (particularly when moving).
• Difficulty in moving, or inability to move the injured part.
• Tenderness at or near the affected area.
• Some deformity of the injured part; and/or Swelling at the site or injury.

Management

• Rest to keep weight off the injury.
• Ice to minimise swelling, pain and stiffness.
• Compression from bandaging, to reduce swelling; and
• Elevation to prevent excessive swelling through gravity.
• Manage open or closed fractures by controlling any bleeding, immobilizing and supporting the fracture in the positon it is found.
• Obseve the circulation of the injuried limb and treat it as for shock.

Head and Neck Injuries

Recognition

• Blurred or double vision, nausea and/or vomiting, or mild or severe headache.
• Ope wounds, bruising around the eyes and/or ears, restlessness and irritability, and general confusion.
• May have uneven pupils, evidence of fluid leaking from ears and/or nose or deformation of the skull. Alternated or deteriorating level of consiousnesess

Management

Follow these procedureds to manage:

• Immobilise the persons head and spine and place them in a horizontal position, and treat any wounds.
• If unconscious or drowsy, put the person in the recovery position while supporting the head and neck allowing fluid to drain from the ears freely.
• Cover with a blanket, but do not overheat.
• Give oxygen at 4 I per minute (high flow rate) and stay with the person, maintaining close observation.

Burns and Scalds

• Superficial is where the top layer of skin and unferlying tissus dies.
• Deep in where the full thickness dies.

Recogntition

• Superfical have reddened area of skin, blisters and pain. Deep wounds have pale , brown or charred black and red Skin around the outer area of the burn (superficial burn).

Management

• Saturate the burn in cool water for up to 20 minutes, then remove clothing, rings or bracelets, if possible.Apply Burn-aid gel then cover the burnt area witha loose and light sterile dressing and stay with the person while maintaining closed observation.

Foreign Bodies in Eyes, Ears and Nose

Recognition

• A foreign body in the eyes, ears or nose is recognised by people who have embedded material in these body parts causing discomfort or pain.

Management - Eye

• Flush a foreign body out of the eye using an eye irrigating solution if necessary.
• Cover the eye with a sterile bandage and advise the person to seek medical aid if the foreign body cannot be removed.

Management - Nose

• Instruct the person to breathe through their mouth rather than his/her nose. Advise the person to blow his/her nose in an attempt to remove the foreign body; and and seek medical aid if it cannot be removed.

Management - Ear

• Turn the person's head so the affected side is facing down, allowing the foreign body to fall out and advise the person to seek medicla aid if cannot be removed.

Poisons

Recognition

• A wide range of signs and symptoms can occur with poisoning, confirmation is the person admitting he/she has taken a substance. Can may present:
• Nauseau, vomiting, burning pain in moth / throat, headache.
• Distrubted vision, Seizure and/or loss of consciousnes.

Management

• Stay with the person, maintaining close observation
• Give reassurance, determine type of substance if possible and keep a record and seek medical aid immediately using the severe medical incident procedure.

Air Sickness

• Air sickness can be related to turbulence, anxiety, fear or overindulgence in food and alcohol.

Recognition of Air Sickness

• Nausea or vomiting, a pale appearance and skin that is clammy to touch and/or excessive salivation and swallowing.

Management of Air Sickness

• Advise the person to hold his/her head still, then apply cool pack to forehead and give sips of iced water.

Gastrointestinal Disturbances

• Associated with infectious diseases, anxiety, fear, turbulence or overindulgence in food and alcohol.

Recognition

• Pale and abdominal pain.
• Vomiting.
• Sweating.
• Nausea.
• Fainting.

Management of Gastrointestinal Disturbances

• Advise the person to hold his/her head still, then apply a cool pack to their forehead and give sips of iced water.

Nose Bleed

Management of Nose Bleeds

• Sit the person upright; incline his/her head forward, then instruct the person to breathe through his/her mouth.
• Apply finger pressure to the soft end of the nose for 10 minutes, using protective gloves then seek medical advice if bleeding continues.

Flu-Like Symptoms

• Iif possible: ill passengers (and their close personal contacts including family members) or crew experiencing cough, fever, sore throat, sweats or chills should be given a face mask to wear.
• Cabin Crew should spray Netbiokem in and around the toilet area after use by the ill passenger should wear gloves when handling and receiving items from affected passengers.
• Ensure removal of gloves before touching other persons or any surfaces then use appropriate PPE if close contact with an ill passenger or their bodily fluids is required.

Childbirth

• Full term pregnancy is between 39-41 weeks.
• Three stages: First stage onset of labor, second stage - delivery of the baby and final stage with delivery of the after birth (placenta). Follow these steps in Active Labor: Check for crowning as the baby moves into the birht canal at stage 4. If baby is pushed through, support the head and place the baby on the mothers chest. Encourage ecaly initiation of breast feeding and record all info on the baby;

DVT

• Deep Vein Thrombosis (DVT) is a blood clot that occurs in a deep vein

Recognition of DVT

• Inflammation, redness or swelling of the calf, ankle or thigh area alongside an injury.
• Breathlessness and chest pain. Possible cyanosis and pain / heat when moving/ flexinf the foot;

Management of DVT

Rest the casually comeferbaly. Kep immblised and give oxygen at 4 1 the seek aid.

Mental Illness

Recognition of a patient suffering from mental illness

• Mood swings and Irrational behavior. Disjointed speech patterns while may refering to religios sigures. Depresson in appropiared consercations

Management

• Listen to what is said, but dont stare with open ended questoins, Speak calmly as you asses the.
• Assess the casually withe polite never laugh as they. Be aware and careful while
• Do not delay any violent behavior while maintaing support

Explore in-flight medical conditions like bowel discomfort and toothache from gas expansion. Learn about decompression sickness risks after scuba diving and appropriate first aid. Understand symptoms and responses to chest tightness and altered consciousness during flight.