The Necessity of an International Database of In-Flight Medical Emergencies

How it could aid industry recovery & provide benefits in the post COVID-19 era of Aviation

By Sarah Arkinstall

Covid-19 is essentially a global health crisis, yet this has impacted the aviation sector as humans spread disease & flights spread people.

We’ve witness States around the world endeavour to uphold their commitment to, ‘take effective measure to prevent the spread by means of air navigation.. communicable diseases.’ Which comes from Article 14 of the Chicago Convention, of 1944, which formed the International Civil Aviation Organisation (ICAO). Though this has been at a massive cost to the commercial aviation sector through the consequential restrictions, quarantines & boarder closures.

In order to assist commercial aviation overcome this downturn period, we must adequately address this new prevalent safety concern. It’s not in the traditional senses of safety, such as emergencies responses, security, pilot training or aircraft engineering, but relating to personal safety, our health.

This is not to imply that health hasn’t always been an area of concern in aviation — it has. For it must, as in-flight medicals incidences are a common occurrence. Regardless of investments in preventative measures, pax screening & cabin crew training, medicals occur inflight & they shall continue to.

If our intention is to return to the levels of global passenger travel experienced in 2019 & achieve continued growth, we must to be better prepared to deal with these medical events. This is where a global database will help.

The create of a global database that I am proposing is a starting point. It’s an action which can be immediately implement, that will be beneficial for Aviation in the long term. Airlines have this information already, but by centralising it & allowing researchers access to it, we can start to receive the numerous benefits & importantly, regain the public’s confidence in air travel.

These benefits include, firstly-

Improved understanding of the nature of in-flight medicals & the frequency at which they occur.

  • Studies estimated that a medical emergency occurs on 1 in 40–604 flights (Liao), which is approximately 1 per 10,000–40,000 passengers (Graf).

You can notice these estimates are incredibly broad, this is because of the lack of data available to researchers.

From my experience of 4 years as Cabin Crew, I was immediately struck by how just frequent on board medicals were. Though I predominately was on long haul flights, which pose an increased risk, I’d estimate crew were dealing with at least 1 in 4 flights. Though these cases vary from minor to severe, singular case to multiple.

This brings me to the Second Benefit,

A database would provide direction, on how to improve First Responder Training, particularly in areas related to health in aviation & the aircraft environment.

The general public is not widely aware of procedures if they fall sick in flight — yet the immediate action is to inform the crew. From there Cabin Crew use first aid training to assess the situation & respond appropriately. A British study on medical incidences in flight found that 70% of cases are managed by the Cabin Crew, without making an announcement for medical assistance (Bird).

This refers to that P.A. which you’re all probably familiar with, “Is there a Doctor on board?” This statistic highlights that this announcement doesn’t always happen, besides even if it does, you’re not guaranteed a Doctor is onboard.

It’s used if the medical case is serious enough that a Doctor is required, if one is found they help stabilise the casualty & also advice Aircrew if a diversion is necessary, or unnecessary for diversions are extremely costly. Airlines invested in training, air-to-ground communication technology, screening procedures, even developing rewards programs for Doctors in order to ensure they travel with them. This is all in an attempt to mitigate this risk.

Thirdly- through improved understanding of in-flight medicals we can ensure appropriate emergency medical equipment is on board aircraft.

Furthermore, the standardisation of the location & content of on-board medical kits available, specifically those for Doctors to use.

One of the most common medical situation on board is fainting, for which the responsive action is to give oxygen. In fact giving oxygen is a primary response in nearly every medical case. We really ought to understand how frequently incidences happen, so flights can be appropriate stocked with not only oxygen masks, but sufficient portable oxygen. For this is also required for emergency crew use, incase of a decompression.

In the past, fainting isn’t an event that you’d inform or reassure other passengers about, but in a post COVID-19 environment we’re dealing with increased levels of anxiety in the public related to health. It’s important that we have adequate equipment, streamlined procedures & are seen to be taking effective measures to deal with these incidences.

Benefit №4- By sharing data, we assist Aviation Medical Professionals ameliorate knowledge of health issues associated with flying.

COVID-19 has to date affected approximately 59,000,000 people world wide, according to the World Health Organisation. We need to understand if there are new risks for these people associated with flying.

We already know that flying puts us in an unnatural environment. And as flights have been steadily increasing in duration, we have people exposed to cabin altitude for longer periods of time. This environment has lower partial pressure of oxygen than sea level, which is why it can effect passengers, even causing mild hypoxia in healthy people.

This necessary information will come from health professionals, so through assisting them in progressing with their research, we also assist aviation’s rate of recovery.

The benefit №5 is related to-

Investment in Future Health Technology

This is a rapidly developing field. We’ve seen ‘Fitbits’ & smart watches go from simply counting our steps, to now monitoring our sleep patterns & heart rhythms. Smart phones can be used as a Medical ID, providing not only our blood type but our complete medical history.

Improving our understanding of health incidences in the air, through this proposed global database, will enable us to wisely invest in future health technologies that could be useful in Aviation.

Lastly —

A Live Database could assist with recognition of concerning health trends & identifying hotspots.

We must need to change our attitude from looking back on this information, but rather, we must look at it in a live format in order to receive this benefits. We can also improve contact tracing & reduce the risks associated with people using multiple air transport carriers.


In looking to the recovery of the Aviation industry, it is clear that health is going to be a key part. The establishment of a Global Database of In-Flight Medical Emergencies would demonstrate a strong commitment to ensuring passengers health. It would also lead towards improving our understanding of this overlapping field of Health & Aviation.

Through co-operation & collaborating of global airlines and with health professionals, we can work towards safeguarding passengers health on board aircraft. Furthermore, this shall assist us in safeguarding the future health of the Aviation industry.

A Global Database of In-Flight Medical Emergencies ultimately improves passenger safety, in the sense that we now need to address, for a post COVID-19 era.




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