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QUESTION: Dear D. Norkus

Is it possible to design a Mini Operation Theater within Aircraft in future by Aircraft Manufacturers ?.

Space could be a constraint in current design of aircraft.

This would be useful for passengers who are small children, adults, pregnant women, old people on aircraft board.

Surgeon will be available on the Airplane to attend emergency medical cases of passengers.

The Mini Operation theater will have facilities such as Blood bottles, ECG Machines, Bloop Pressure Machines, Surgical Instruments, Saline bottles etc

Awaiting your reply,

Thanks & Regards,
Prashant S Akerkar

ANSWER: Prashant
I am sure is COULD be possible to design such a thing (use ORBIS as an example). However, WOULD it be done on passenger airliners? No. It's just not needed enough to justify the expense. It's a rarity when a passenger dies in flight compared to the number of people flown annually, so the figures just don't support the expense. The airlines will be happy to keep the medical kits they have on board, with a few tweaks as necessary, and that will be enough for them.

Regards, D.

---------- FOLLOW-UP ----------

QUESTION: Dear D. Norkus

Thank you.

Is it possible to design a Mini Operation Theater within Aircraft in future by Aircraft Manufacturers ?. Space could be a constraint in current design of aircraft.

This would be useful for passengers who are small children, adults, pregnant women, old people on aircraft board.

Surgeon will be available on the Airplane to attend emergency medical cases of passengers.

The Mini Operation theater will have facilities such as Blood bottles, ECG Machines, Bloop Pressure Machines, Surgical Instruments, Saline bottles etc.

I feel it will be a value added service offered by Airline carriers / operators.

Remember i use the word "Mini" -> It means that it is not a Big Hospital built within a Commercial Airplane, but a small nursing room having basic facilities.

A Small room built within Aircraft where in emergencies, the passengers can be taken for nursing care.

As i mention before, Announcements will be made before flight departure on the board "Fasten your air belt, flight takeoff will take in moments, there is a Doctor / Medical Practitioner on board who will help you, assist you in emergencies".

Imagine you are a passenger on the Flight Board, As a customer/passenger of the flight, you will be happy about the caring services offered by the air carrier.

I feel Major airliners (Aviation industry) viz Lufthansa, Delta Airlines, Air India, British Airways, Cathay Pacific, Qatar Airways, Qantas Airways, Singapore Airlines, Jet Airways, Kingfisher Airlines, should take this initiative and see to it that in future, this facility is available to the customers.

For this to happen two things are required to be implemented.

1. Air carriers/operators tie up with Medical Practitioner / Doctors.
2. Airplane manufactures in future design the air crafts for adding a small nursing room for serving the customers in emergencies.

Note :

1. I am putting emphasis on the word "Mini" - i.e. Small.
2. Private Jet i.e. Charter planes may already have these facility inbuilt.

I feel the word "Operation Theater" could be misleading,henceforth we will refer to it as a small nursing room within the aircraft.

It can happen that the passengers who are travelling internationally or local flights are taking the flights also because of emergency reasons.

Emergency Reasons
-----------------

1. Attend  Business Meeting/s.
2. Attending Conferences/Seminars.
3. Marriage, Engagements and other social religious customs.
4. Meeting those who are critically ill who is a friend, relative of the passenger
5. Funeral (Death).

In the above cases, it can happen that the passenger catches the flight because its a do or die situation for him/her. But it can also happen that the passenger (child, adult) was suffering a high fever, cold, viral/bacterial infections, stomach pain etc. So in this case the doctor on board will treat the passenger.

The medical expenses incurred on the board will be given by the passenger to the doctor for his/her services.

So irrespective whether on the aircraft the patient was unwell or medically fit, the passenger will have a comfort level zone for his flight journey.

Its finally "Value Added Service". Imagine yourself to be passenger of the plane irrespective whether you are ill or fit. You will have comfort level zone during the flight journey.

Paying the Doctor for his services on plane can be easily afforded by the aircraft carriers who are earning handsomely.

As you know there are billions of money spend on manufacturing aircraft.
so for the airline manufacturer its addition of some more money for making space available for the small nursing room within the aircraft.

A Computer aided design (CAD) software can easily help the Aeronautical Design engineer to locate the small nursing room within the aircraft.  I Feel the length of the plane has to be extended and maybe the optimum place could be behind the cockpit.

http://en.wikipedia.org/wiki/Dassault_Systèmes
http://www.3ds.com/products/catia/

I feel it is worthwhile to send these suggestions to British Airways, Lufthansa, Delta Airlines, Cathay Pacific, Qantas Airways, GulfAir, Air India, Qatar Airways etc and other major airliners and get their feedback.

If they like the idea they will implement otherwise no.

I feel the word "Operation Theater" could be misleading, henceforth we will refer to it as a small nursing room within the aircraft.

I Feel the Maximum - Max would be 3 Doctors on board in which Two Doctors
General Physicians (Doctor of Medicine - M.D), in emergencies they can perform small surgery/operation and One Nurse.

I Feel the Min would be 1 Doctor on board in which the Doctor
General Physician (Doctor of Medicine - M.D), in emergencies can perform small surgery/operation.

So the Range is 1-3.

Ultimately it is the Top Management's Decision of the Airliners to accept these suggestions.


http://en.wikipedia.org/wiki/Cockpit
http://en.wikipedia.org/wiki/Doctor_of_Medicine
http://www.boeing.com/commercial/airports/acaps/737sec2.pdf
http://www.boeing.com/commercial/airports/acaps/787sec2.pdf

The Mini Nursing room will have all the facilities viz Surgical Instruments (In case a minor and not a major surgery to be performed), Medicines (First aid box) ,Operation Table, Lights, Monitors, ECG Machine, Blood pressure machine, Stethoscopes,  Antibiotics curing the common cold, High fever (flu), stomach pain, diarrhea, vomiting, back pain  etc, Blood bottles, Saline Bottles etc. Remember we cannot and we should not have a Big Hospital (Having Different Labs) built within the plane because of its dimensions restrictions. A Journey time of 4,8,12,16,24 hours. The General Physicians (Doctor of Medicine - M.D) can also also perform minor surgeries if required.

Ultimately, it is the top management of airline carriers viz British airways, Lufthansa, Delta Airlines, Cathay Pacific, Gulf air, Emirates Airlines, Qatar Airways, Air India etc who will be taking the implementation decision and whether it is worthwhile or not after modifying the aircraft design, adding medical instruments and hiring doctor/s and nurse/s for offering their services

A Range of Max - 3, Min - 1 will be the numbers for the nursing team on the board.

Combinations
-------------------

Team of 3 Size
--------------------

All 3 Doctors - Perhaps.
2 Doctors, 1 Nurse - Recommended.
2 Nurses, 1 Doctor - Recommended.
All 3 Nurses - Not Recommended.

Team of 2 Size
---------------------

1 Doctor, 1 Nurse - Recommended.
Both Doctors - Perhaps.
Both Nurses - Not Recommended.


Team of 1 Size
---------------------

1 Doctor - Recommended.
1 Nurse - Not Recommended.

Awaiting your reply,

Thanks & Regards,
Prashant S Akerkar

Answer
No matter how "mini" such a medical compartment may be- even if it were a first class bed chair plus a closet for supplies, I just do not see it happening unless a state ownd airline, like Emirates with lots money, decides to take it on. You must remember, airlines that are not owned by the government are purely for the profit of the shareholders and any space, no matter how small, that takes away from their ability to make revenue is not a good thing to their accountants. Not too long ago American Airlines did away with their extra legroom in coach to cram in more seats because they made money. All the amenities that were touted for the A380 have not come to fruition (onboard salon, gym, bar) but more seats have. To lose seat revenue AND put medical staff on payroll (who would need seats and add weight) for a statistically slim medical event is far from practical, no matter how nice it may be for an ill passenger.

It's a an example from 2004, but at least these are numbers from British Airways as an example:
"BA carried 35.7 million passengers and made contact with MedLink on 2,362 occasions, who advised a diversion in 47 of these cases," a spokesperson said. The airline says it records 8 to 10 passenger deaths a year."
http://www.nytimes.com/2005/07/01/travel/01iht-trfreq.html?_r=0

"MedAire, which advises more than 60 airlines around the world, managed about 19,000 in-flight medical cases for commercial airlines in 2010. Although few were life-threatening, 442 were serious enough to require diverting the plane — and 94 people died onboard."
http://www.nytimes.com/2011/05/24/health/24doctors.html?pagewanted=all

If BA alone carried almost 36 million passengers in one year, imagine the number of passengers carried by 60 airlinesworldwide! It would be well OVER 500 HUNDRED MILLION (the number flown annualy in the USA)  between, American, Delta, United, Lufthansa, Singapore, JAL, Emirates, Air France, Air India, Qatar ect. Consider the more serious events: 442 out of a 500+ million or 94 out of 500+ hundred million. Those kind of figures do not justify replacing the current protocol in place for medical emergencies. An airborne medical station (with staff) would be a costly venture for an airline, no matter what the size. It may seem harsh, but the airlines are in business to provide transportation, not medical services. Recall the first 'stewardesses' (United Air Lines) were required to be nurses? Very few are these days, but it still seems to turn out well the majority of the time with the first aid training crew receives and the medical kit supplies available on board. Even older, but still a statistic for reference:

"In the year ending 31 March 1999 British Airways carried 36.8 million passengers and there were 3386 reported in-flight medical incidents: about 1 per 11 000 passengers. Though 70% were managed by cabin crew without the assistance of an on-board health professional, in almost 1000 incidents doctors and nurses were asked to help with the management of ill passengers."
http://www.bmj.com/content/321/7272/1336

While having services onboard would certainnly be a benefit to passengers in a time of need, it does not benefit the airlines balance sheet and that is the bottom line. When you are in business to make a profit, you don't make business decisions that cost your company money when the current system fills the need.

More on that thought here:
http://www.jems.com/article/patient-care/handling-flight-medical-emerge

In-flight medical emergencies: an overview-
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1119072/

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D. Norkus

Expertise

I can address questions about airline pilot employment & entry level airline careers in the United States, women pilots, flight training, pilot certification, U.S. flight scholarships (mostly for women), aviation & airline safety topics, aviation accident investigation and airline operations. ***Please note, I cannot address flight training & career queries from outside the United States, or aero engineering degree programs/careers, aviation management topics. ****

Experience

Airline captain with 15 years past experience in airline ground operations. I have previously flown as a commercial skydive pilot & ferry pilot and majored in Aviation Science


Organizations
International Organization of Women Pilots- The Ninety-Nines, charter member of Women In Aviation International, Aircraft Owners & Pilots Association, Air Line Pilots Association.

Education/Credentials
Embry Riddle Aeronautical University; Aviation Safety/Accident investigation.

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