What do you do for a living? I confess that, when asked this question, I have lied many times. At parties, at gyms and at dinners, I’ve been reluctant to talk about being a doctor, often for the sake of whoever I’m with, as I invariably start moaning about NHS politics.

The question of whether or not to lie when called to do a professional duty is easier. Of course one should tell the truth. Still, I do know a few doctors who will admit to pausing, or feigning deafness, when medical services are requested over the tannoy at 30,000ft, hoping that someone else will get there first.

What I find astonishing is that so many health professionals seem to be in the air. One study from the Federal Aviation Authority, a US government body, found that in 85 per cent of mid-air medical emergencies there was a doctor, nurse or paramedic willing to assist. But what can the sky-high practitioner actually do? There are varying amounts of varyingly useful medical equipment on board. Some planes carry defibrillators, and several provide links for crew members to telephone medical advice lines.

A large study published in the journal Critical Care earlier this year tried to find out what kinds of emergency happened on aircraft. They asked 32 airlines for data: only four were forthcoming. Yet it seems crucial, with the increase in air travel, to have at least an idea of what kind of equipment would be most helpful.

Fainting was the most common diagnosis, followed by gastrointestinal disorders and fear of flying. In 2.8 per cent of cases, the flight had to be diverted. The most common types of emergency requiring diversion were heart attacks, followed by apoplexies and epileptic seizures. The authors found a mean of 14 emergencies per billion “revenue passenger kilometres” – a measure used by the aviation industry as a way to work out more profitable routes. This means that, although events like this are relatively rare, planning for them is important because of the number of flights and passengers.

Two doctors on a flight from Hong Kong famously managed to save a life without any planning at all. A female passenger was suffering from a tension pneumothorax, in which air leaks into the space between the lung and the ribs. If untreated, the condition can be fatal. The doctors improvised, using a catheter, a coat hanger, a bottle of Evian, Sellotape and brandy.

Nevertheless, amid the congratulations there was dispute about the way the operation was done. People were quick to point out the potential problems of the doctors’ hastily proffered solution. It would have been much worse to be a patient seized by chest pain on a plane full of cardiologists. I don’t know what the collective term is for cardiological opinions, but I doubt it is an agreement.

Margaret McCartney is a GP in Glasgow.
margaret.mccartney@ft.com

Margaret McCartney is joint winner of the European School of Oncology’s Best Cancer Reporter for 2009. www.cancerworld.org