You're in your airline seat, cruising comfortably and getting into your in-flight movie, when you hear an announcement asking for a passenger with medical credentials. Nothing to worry about, right? Passengers become ill on flights now and then, after all.
But what if you then discover they're seeking medical help for one of the pilots? That's rare, but considering the number of flights and pilots in the air at any given moment, chances are sooner or later a pilot will have a medical situation in flight.
Airline pilots are required to have a semi-annual physical, and any pilot age 40 or older has an annual EKG. Regardless, pilots are human and medical incidents can't be fully predicted or avoided, as two recent incidents of pilot incapacitation — including a tragic fatality — have proven.
If this possibility scares you, you should know what this means for passengers, and what procedures and safeguards are in place to assure a safe landing.
First, rest assured: The flight is going to continue safely to landing.
The cockpit procedures for every flight are designed to be performed in tandem, one pilot reading the checklist items, the other performing the required action and confirming its completion. It's a checks-and-balances approach that both creates a division of responsibilities and provides an extra set of eyes and hands.
And that's the key: Extra.
In the cockpit, we know from training and experience that if the other pilot, or if we ourselves, experience any extraordinary medical condition, the remaining pilot can perform the descent, approach and landing.
On long-haul flights (over 8 hours), there are relief pilots aboard. On shorter domestic flights, there are often pilots in the cabin who are either on their way to another flight assignment or traveling.
But even if there's only one pilot in the cockpit, landing safely is not a problem.
"Incapacitation" isn't always as dramatic as a pilot fatality. In fact, the degree of incapacitation spans the spectrum from a bad case of the flu to kidney stones to ear blocks, none of which will make headlines.
But as with any passenger medical issues, beyond an announcement asking for a doctor, there are resources on board at the ready. We always have a medical kit with essentials a credentialed medical professional could use in flight for immediate triage. Also, there's a defibrillator that flight attendants are trained to use.
In the cockpit, there's a direct radio telephone line to a live physician — on duty 24 hours a day. We have a preprinted list of data the doctor will need and the onboard medical equipment to detect and record vital signs. That collection process begins immediately, as our trained cabin crews gather data to relay from the aircraft to the doctor at our operations center, who can direct the cabin crew in medical intervention as well as set up the emergency medical response at the landing airport.
If it is one of the pilots who is incapacitated, the other pilot first focuses on navigation, then coordinates the assistance of the physician on call.
From cruise altitude, a safe and orderly descent to a suitable en route airport with medical care available can be accomplished in about thirty minutes, easily, and by one pilot only.
All controls necessary to do so are within reach of both pilot positions because typically, we alternate flight duties every leg. On the first leg of a trip, one pilot will fly the takeoff, climb, cruise and landing; the next leg, we'll switch. Every copilot is fully competent to perform all "pilot flying" duties, and they get plenty of experience with takeoffs and landings in their monthly flying schedule.
In other words, despite the ominous ring of news reports that "the copilot had to take the controls," that's standard practice. Every day, every other leg.
The aircraft was designed that way and so are the standard procedures at every airline. From the moment a medical problem is brought to the attention of air traffic controllers, the aircraft gets priority handling and expedited clearance and to the nearest suitable airport.
I once managed to get from cruise altitude to a divert airport and on the gate for paramedics to treat a passenger having a heart attack in 20 minutes.
I had a very good copilot, as usual, but could have landed regardless. I've always thought that such a quick response should be heartening for passengers, knowing we could and would do the same for anyone needing medical care.
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