Emergencies usually happen unexpectedly. Sometimes doctors or nurses find themselves in situations where they are the only ones who can help. Audra Podruzny what she experienced on board an airplane. She is from the US state of Washington and is currently studying at Washington State University in the Doctor of Nursing Practice Family Nurse Practitioner program.
My husband, Scott, and I were flying back to Washington State with our two children, who were about 1 and 4 years old at the time. We had been in Florida for a family vacation and were nearing the end of the flight when both children fell asleep on me.
Audra Podruzny with her two children, shortly before she helped an injured passenger.
Suddenly there was a commotion among the flight attendants. An announcement came over the loudspeaker: “Are there any doctors on board?” My husband and I are nurses. We looked at each other and at our sleeping children. Should we raise our hands?
One of the flight attendants came over and looked very excited. My husband was sitting in the aisle, so he leaned out and told her we were nurses. Her eyes went big and she said, “Oh yeah, come with me.”
I figured it wasn’t that big of a deal. Besides, the kids were sleeping on me.
Scott went to the front of the plane. But a few minutes later, the flight attendant came back and said, “You have to help me.” I had my 1-year-old son in my arms, so I gave her my child. She sat down next to him, and I went to the front of the plane.
A passenger with severe bleeding from the head
I entered the first class area, where the toilets and the galley with the food and drinks are located. I saw an elderly man lying on his back on the floor. He was unconscious and bleeding heavily from the head.
When I saw the bleeding, my first reaction was: we need to apply pressure. I asked for a towel. There were no towels. A blanket? Anything to help soak up the blood? No, nothing. They had nothing. They gave me a pair of gloves that were way too big and some cocktail napkins.
The room was so small that I couldn’t stand next to the man, so I somehow crouched over him to reach behind his head. I put a stack of napkins on top and pressed as hard as I could with the fingertips of one hand.
I’m a recovery room nurse, so my next thought was to check his pupils and make sure his airway was clear. I noticed he had blood in his mouth. His breathing was labored. I tried to do all of this with my free hand without crushing him with my body.
Scott had prepared ice packs, which I also applied to stop the bleeding. Then he checked the plane’s medical equipment and tried to set up an IV. It wasn’t easy. The IV set was very different from what you normally use. Also, the plane had already begun to descend, so we were banking. But he tried.
We asked what had happened. Flight attendants said the man had fallen and hit his head on one of the stainless steel cabinets. He appeared to be 70 to 80 years old, a tall, strong man.
Help under difficult conditions
His wife was sitting nearby, quite calm and stoic given the circumstances. We asked her about his medical history and tried to figure out why he might have passed out. She told us he had diabetes. He was also on blood pressure medication and a blood thinner.
The plane continued to descend. I was in a really awkward position, crouching down and leaning against the cupboards. I continued to talk to the man and tried to get him to wake up. “Can you hear me? It’s all right. You hit your head.”
Someone brought us an oxygen cylinder. I looked for the mask. And realized there was no mask. It was a plastic bag. I put it on the patient’s face and it felt like I was suffocating him. So I tried to increase the oxygen level of the air near his face by blowing the gas near him.
Suddenly his breathing was erratic for a few minutes, which really worried me. I was afraid he was going to stop breathing. I rubbed his chest and said, “Hey, we shouldn’t do that!” I would have felt much better with a proper oxygen mask.
The patient wakes up…
The amount of blood definitely looked alarming. I couldn’t tell how much more he was bleeding, but it was a lot. His complexion didn’t change, though; that was a good sign.
Eventually he came to and opened his eyes. I introduced myself and asked him, “Do you know where you are? Do you know what’s going on here?” I tried to see if he was even oriented.
The man was able to talk to me, so I continued to ask questions: “Have you been on vacation? Where are you flying to? Where are you staying?”
He told me they were going to visit his granddaughter and he was able to talk about it. He didn’t try to get up, which I was glad about because that would have been a real challenge.
I could tell he was embarrassed about what had happened. I’ve helped many older men after a fall, and their egos are often bruised. They don’t want to be in the situation of needing help.
Help after landing
Finally, the plane landed. There was blood everywhere. The ice packs had melted and the water had mixed with the pool of blood. It was a mess.
The pilots had informed the airport that we needed medical help. The first team arrived immediately. Rescue workers stabilized the man with a board, put a neck brace on him and did everything you do with a patient after a fall.
I gave them a report – that’s just my way. But it seemed like they didn’t need much information at that point.
Eventually I was able to speak to the man’s wife, who was visibly frightened. I hugged her and told her he would be OK. She thanked us.
The emergency team also appeared to have nothing to stop the bleeding, as the stretcher left pools of blood all over the corridor, posing a significant biosafety problem.
The flight attendants let one person off the front who had a connecting flight, but everyone else had to exit the back of the plane and walk across the tarmac.
When we finally got back to our seats, the stewardess was still sitting with our children. They were both completely relaxed and watching some show. Our daughter asked us what was wrong and I said, “Oh, someone got hurt at the front of the plane.” She is so used to hearing that we work with sick people that it doesn’t bother her in the slightest.
Many people who were sitting at the front and saw what had happened thanked us.
When we got home, there was still blood on my shoes. I remember looking at them and thinking: disinfect them or throw them away? I disinfected them.
Checklists for medical incidents would be helpful
A few days later we received an email from the airline with a voucher as a thank you for our help. That was nice and unexpected.
I responded with a suggestion: How about protocols for medical incidents on airplanes? Pilots go through checklists for almost everything they do. Why shouldn’t they have something similar for medical procedures?
I also asked how the man and his wife were doing, but they couldn’t give me that information.
It was certainly strange helping a patient in that tiny room. I’m used to working in a recovery room where you literally have everything you need within reach, the Ambu bag, suction equipment and dressings. And with airway management, there’s usually more than one person in the room to help. If there’s a problem, there’s quickly a whole bunch of people gathered around the bed.
I definitely think about situations like this a lot more. When debriefing with my mom (a registered nurse), she pointed out that we should have asked passengers for pads or diapers to stop the bleeding instead of cocktail napkins. Brilliant idea! I didn’t think of that at the time. But I’ll keep this little tip in mind for any future bleeding in awkward situations.
This article originally appeared on Medscape.com As part of the translation process, our editorial team may also use text editing software including AI.
