Flying Safe - Medics Onboard Qantas

[ozkid]

Good grief. QED to Sprucegoose's comment!

Yes RooFlyer, it does come across as high and mighty. If I said "all medical professionals should weigh up the current evidence and literature, and consider the complexities of each medical or legal situation to arrive at an informed decision", would it make it sound better?

Honestly not ego based. This is what we do.

 

[marki]

A large minority of doctors in Phat study were unable to render assistance, though no fault of there own. Were exercising an abundance of caution in that the BAC was deemed to high and the RSA had not kicked in yet.

 

[Anna]

"all medical professionals should weigh up the current evidence and literature, and consider the complexities of each medical or legal situation to arrive at an informed decision"

They would have to look at the right literature - cases, not articles. Academics don't make law, judges do. In law, academic articles are of, well, only academic interest and not the right place to look in order to reach an informed decision. Only the somewhat uneducated would do that.

 

[RooFlyer]

Yes RooFlyer, it does come across as high and mighty. If I said "all medical professionals should weigh up the current evidence and literature, and consider the complexities of each medical or legal situation to arrive at an informed decision", would it make it sound better?

Honestly not ego based. This is what we do.

Whatever you like, ozkid. I'm a geologist; they call us Rock Doctors, so I'm with you all the way.

But to be honest, I think the lawyers ...

They would have to look at the right literature - cases, not articles. Academics don't make law, judges do. In law, academic articles are of, well, only academic interest and not the right place to look in order to reach an informed decision. Only the somewhat uneducated would do that.

... are currently ahead 30-15. Their 'serving' seems much stronger too.

 

[ozkid]

Their 'serving' seems much stronger too.

Yes RooFlyer the lawyers are very good at 'serving' writs and subpoenas - it's the only thing they appear to do!

 

[Anna]

Yes RooFlyer the lawyers are very good at 'serving' writs and subpoenas - it's the only thing they appear to do!

Some of us do medical indemnity defence work.

 

[artemis]

So medical thread was hijacked by lawyers?

Typical!

 

[RooFlyer]

Some of us do medical indemnity defence work.

40-15.

Service still with the lawyers .

 

[ozkid]

40-15.

Service still with the lawyers .

And when I thought I was done with this thread, a new surreal twist. A tiff between a lawyer and a medico, to be umpired (unsolicited) by a geologist

Sigh. So much for presenting arguments and having a contest of ideas. It has again come down to a DYKWIA pissing competition.
I am a senior specialist at my tertiary referral hospital. An expert witness for an MDO, contribute to my hospital's root cause analysis committee, write medico-legal risk management guidelines for my procedural specialty for the area health service. NHMRC researcher. Simulation courses teaching human factors and leadership (crew resource management principles shamelessly copied from aviation; along with systems error and anonymous incident reporting systems - which vexatious individuals have hijacked, but that is another story).

A lawyer working for an MDO? Good for you at least on the same side. Never crossed paths, would have remembered a feisty barrister/solicitor/case manager/whatever you are.

As for scorelines, RooFlyer, this is the "tennis game" I play and the "percentage shots" I work with:
commit to surgery? 40% mortality for surgery
will need renal dialysis post-op. Risk stratification increases to 60% mortality
Talk to family and patient. Palliation is what we are looking for. Want to proceed, give it your best shot. Ok.
Today - still hanging in there in ICU.
Risk of complications? 100.00000000% I am just waiting for them to declare themselves.

My ego? nil.
Patient? nil all is the current score.

I'm happy for my ego to forfeit to let the patient win Easter

cheers

 

[RooFlyer]

Please lighten up ozkid. I have greatly enjoyed all the medicos - and most everyone's - contributions here. Goodness knows, no-one cares if there is a geologist on board a plane. Make some-one who's ill on a flight better, or at least comfortable until we reach a port, and you can have all the ego - or non ego, you like.

 

[artemis]

And when I thought I was done with this thread, a new surreal twist. A tiff between a lawyer and a medico, to be umpired (unsolicited) by a geologist

Sigh. So much for presenting arguments and having a contest of ideas. It has again come down to a DYKWIA pissing competition.
I am a senior specialist at my tertiary referral hospital. An expert witness for an MDO, contribute to my hospital's root cause analysis committee, write medico-legal risk management guidelines for my procedural specialty for the area health service. NHMRC researcher. Simulation courses teaching human factors and leadership (crew resource management principles shamelessly copied from aviation; along with systems error and anonymous incident reporting systems - which vexatious individuals have hijacked, but that is another story).

A lawyer working for an MDO? Good for you at least on the same side. Never crossed paths, would have remembered a feisty barrister/solicitor/case manager/whatever you are.

As for scorelines, RooFlyer, this is the "tennis game" I play and the "percentage shots" I work with:
commit to surgery? 40% mortality for surgery
will need renal dialysis post-op. Risk stratification increases to 60% mortality
Talk to family and patient. Palliation is what we are looking for. Want to proceed, give it your best shot. Ok.
Today - still hanging in there in ICU.
Risk of complications? 100.00000000% I am just waiting for them to declare themselves.

My ego? nil.
Patient? nil all is the current score.

I'm happy for my ego to forfeit to let the patient win Easter

cheers

Well, on a positive note - I'm guessing you ain't a gynaecologist since you have some insight into complications!

GL with your patient. Mine didn't win Easter.

 

[medhead]

Rca committee? That's special. Other places just form an RCA team ad hoc with the mix of skills required by the incident.

 

[Princess Fiona]

Rca committee? That's special. Other places just form an RCA team ad hoc with the mix of skills required by the incident.

RCA's teams are made up this way but IME they are usually overseen by a committee under the umbrella of the LHD Clinical Governance.

 

[Anna]

It has again come down to a DYKWIA pissing competition.

A lawyer and a doctor walk into a bar.

L: You know, being a trial lawyer is harder than being a doctor doing a procedure.

D (spluttering): Whaddaya mean? People's lives are at stake! We save lives every day.

L: Yes, but while you're doing a procedure you don't have to contend with a colleague on the other side of the table simultaneously trying to kill the patient.

 

[Anna]

So much for presenting arguments and having a contest of ideas.

Ozkid, I am more than happy to engage in an intellectual debate with you, provided you agree to leave out the personal remarks that started with "somewhat uneducated' and ended somewhere like "shrill".

I might even concede that you made a couple of points that I agree with. (Only a couple ).

 

[medhead]

RCA's teams are made up this way but IME they are usually overseen by a committee under the umbrella of the LHD Clinical Governance.

Indeed. I would've expected such an umbrella committee to have a number of responsibilities besides just RCAs and possibly not be called the RCA committee. In any case, I'm impressed that they have a specific RCA committee.

 

[monoccular]

I fly around 90 sectors annually, and have done so for the past 4 years.

Touch wood, I have never heard a call for a doctor in flight.

I do not know of anyone who carries their "medical licence" with them though I am sure some carry something akin to one. In Australia there is no such thing as a "medical Licence" per se. I guess the crew, if they had time, could check through AHPRA on line.

My understanding at least from long haul carriers is that the final decision re diversion is made after consultation between the captain and a central medical agency (can't remember its name but it may be in Texas) though input from any medical folk on board is part of the discussion. An EK purser once told me that they do ask for ID, and that it is sometimes difficult to sort the truth from fiction n this regard, especially as some may carry "credentials" in another language or even another script.

i also understand that on EK and QF (long haul at least,) there is always a cabin crew member who has a nursing or paramedic ICU / ED background, which I am sure doesn't happen with the many "low cost carriers".

One can only offer, and one can only do the best one can. UnleSS the doctor is a GP, and intensive study, an ED doc or an Anaesthetist many times they may be of little help, possibly even a hinderance.

 

[artemis]

I fly around 90 sectors annually, and have done so for the past 4 years.

Touch wood, I have never heard a call for a doctor in flight.

I do not know of anyone who carries their "medical licence" with them though I am sure some carry something akin to one. In Australia there is no such thing as a "medical Licence" per se. I guess the crew, if they had time, could check through AHPRA on line.

One can only offer, and one can only do the best one can. UnleSS the doctor is a GP, and intensive study, an ED doc or an Anaesthetist many times they may be of little help, possibly even a hinderance.

AHPRA does provide something to put in your wallet. I also carry my RACS ID and other professional membership cards.

And interesting your comment re: EK and QF - since I've been asked what sort of doctor I am when I've boarded on a recent QF22 and EK DXB-GLA.

Does anyone know what the rate of diversion is for medical emergencies?

 

[legroom]

.

Does anyone know what the rate of diversion is for medical emergencies?

7.3% according to this NEJM article


http://www.nejm.org/doi/full/10.1056/NEJMoa1212052#results

 

[drron]

Well for 10 years I did medico legal work for 2 days a week.One day was for insurance companies the other days for the Barrister representing a Trades Hall Council.
The Barrister was brilliant and understood the difference between legal and medical proof.Some of the other lawyers who ended up questioning me quite frankly knew diddley squat.
I also appeared as a medical witness for the defence in 2 criminal cases.100% record-they both got off.Neither should have been charged if the police or DPP got a medical report before proceeding.
Anna we must have a drink together sometimes and swap stories.I really enjoyed my time in the witness box.Quite a few amusing anecdotes.