Can a Nurse Give Medications During In-Flight Medical Emergencies?

Carolyn Buppert, MSN, JD

Disclosures

August 21, 2015

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Question

When the call comes over the loudspeaker, 'Is there a doctor or nurse on board the aircraft,' what, if anything, can the nurse do beyond administering first aid?

Response from Carolyn Buppert, MSN, JD
Healthcare attorney

A nurse wrote in with a question about rendering care "in flight," on board an airplane:

Airplanes keep medications on board for emergency situations. When a medical emergency unfolds on the aircraft during flight, and the nurse offers assistance, is there a way for the nurse to get orders to be able to use those medications or other available supplies appropriately, or is it better to just stick to basic first aid? Assuming that the nurse acts solely within his or her scope of practice, are there any liability risks (eg, negligence) to assisting in this situation?

I understand that many airlines have access, by phone, to medical advice in emergencies. And flight attendants undergo first-aid training. So airline staff may no longer ask for nor need the assistance of passengers who are healthcare providers. And although flight attendants may appreciate the assistance of a nurse or physician, they can decline that assistance at their discretion.

If airline staff request help, and if a nurse offers to perform cardiopulmonary resuscitation or other services, the flight attendant may ask for proof of competency. If a flight attendant asks for help in assessing and treating a passenger, the nurse could ask whether ground-based physician services are available, and what equipment or treatments are available. Federal rules require airlines to carry a first-aid kit and oxygen on board, but the treatment options may vary from airline to airline.

Flight attendants are cautioned in training materials that they may offer a passenger medications, but the customer must be able to self-administer. Likewise, a nurse should not become involved with administering medications provided by the airline without a physician order, nor should a nurse administer a patient's own medication unless there is communication with a qualified medical service engaged by the airline.

My rationale for that statement is that nurses, emergency medical technicians, paramedics, physician assistants, and physicians are covered by Good Samaritan laws that limit the healthcare provider's liability when providing emergency services in the air. However, nurses or other providers must provide only those services within their scope of practice under their home state law. And the provider must provide care that is within the standard of care, given the specific circumstances.

If a nurse is on board and flight attendants ask for medical assistance, it is appropriate for the nurse to offer to help. The flight attendants will decide how much help is needed.

Here is a helpful resource on handling in-flight medical emergencies

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