The crew was informative and professional. After landing in Atlanta many passengers came up to me and thanked me selleck products for what I had done. Frankly, although a bit shaken, it never occurred to me at all not to do what I had done. I felt sad, cried, and questioned whether there was anything else I could have done to alter the outcome. Should I have tried to place an intravenous line, even into her neck? Injected epinephrine? On arrival at home I researched the mortality of out-of-hospital cardiac arrests and was surprised to find out that in several decades it has not changed substantially—92% in the United States.[4] The mortality decreases with cardiopulmonary resuscitation, rapid emergency medical services
involvement, a rhythm such as ventricular tachycardia or ventricular fibrillation that can be shocked with an AED, and with early and sophisticated post-resuscitative care. Intellectually I think that she probably would not have survived with the best of care; emotionally I continue to feel that perhaps I could have done more; philosophically I wonder if she wanted to survive. Woven into the fabric of each medical publication, be it a brief communication such as this or an original research report, there is an essential message or learning point. What lessons can be learned from this experience, and how might those lessons help improve the practice of travel medicine? Perhaps there are a few lessons here for providers: Be more
realistic and less inhibited about verbalizing concerns regarding elderly travelers who arrive INCB018424 chemical structure in clinic appearing unenthusiastic, while accompanied by their well-intentioned children, for counseling
about “the trip of a lifetime.” Be more candid when elderly or infirm travelers consult about complicated and risky travel when a less risky alternative destination Benzatropine could be more appropriate. Encourage travelers to break up trips into manageable pieces for those who are elderly or infirm. Encourage pre-travel consultations for those who are taking low risk trips, but will be returning home with others who may be at greater risk (eg, such as in this situation). Be more realistic about recommending that ill passengers should be placed in areas of the cabin that have empty seats surrounding them. (Most cabins are full nowadays.) Learn basic life support, including cardiopulmonary resuscitation and know how to use the AED. Be up to date with advanced cardiac life support. Be familiar with the contents of the enhanced medical kits carried by most commercial long haul carriers. On a more personal note, I continue to be grateful for the privilege of being able to care for others. I need to remember to use better infection control precautions. When trained in the 1970s we did not use gloves in handling most patients; consequently, when responding to an emergency these days, my reflex reaction is to do what I had routinely practiced in similar situations in the past.