Is There a Doctor on Board? What to do When Fellow Travelers Need a Good Samaritan

David S. McClellan, MD, FACEP

Perhaps once a year while flying, I hear a flight attendant ask over the intercom, “Is there a doctor on the plane?” I always respond. I’ve helped people with small problems like nausea, and I’ve helped people with life-threatening conditions. On one flight I even asked the pilot to divert the plane.


An elderly man with COPD was experiencing shortness of breath. When a flight attendant asked for help, I approached the passenger and could tell the cause was simply COPD—he was not experiencing another kind of event. I knew the airline kit had an albuterol inhaler, which would be helpful, but he could use more. As luck would have it, I had prednisone with me, and knew that it could make a difference in his breathing. The flight attendant handed me a headset, and in a short time I was on a three-way call, via VHF radio, with in-flight medical control—an emergency-physician service in Denver that contracts with many U.S. airlines—and the pilot. I explained the passenger’s symptoms and described why I believed my personal prescription of prednisone would help. The Denver physician agreed that this would be a safe course of action, and the pilot listened to our conversation, asked questions, and granted me permission to administer the prednisone and put the passenger on oxygen. The passenger also took a few puffs of the albuterol inhaler from the airline kit, and in a short time, he was feeling good. I checked on him every half-hour or so, and his breathing stayed under control.


A hyperventilating man was experiencing malaise, dyspnea, and light-headedness when a flight attendant requested medical assistance from other passengers. I pushed the call button to offer my assistance and was brought to the passenger’s seat, where he was sitting upright. A few questions about his condition revealed that his symptoms were the aftermath of a night of drinking; the conditions of air flight had exacerbated his hangover! I easily obtained two Tylenol for him and had him drink two bottles of water. With the flight attendant’s help, I repositioned the passenger across the floor of the galley to elevate his feet. During this episode, it was nice to see three other passengers offering to help—a nurse, a pediatrician, and a paramedic. Since I was able to quickly get a handle on the passenger’s more concerning symptoms, these three Good Samaritans returned to their seats. Within half an hour, the passenger’s breathing was normal, his light-headedness had abated, and he was also able to return to his seat.


My plane had departed from San Francisco on its way to Mexico. Not long after we passed Los Angeles, a passenger began experiencing chest pain, shortness of breath, and leg pain. After I answered the flight attendant’s request for assistance, I discovered through an interpreter that the Spanish-speaking passenger had recently undergone knee surgery, and had stopped taking his anticoagulants. A quick assessment convinced me that he had a potentially fatal condition and would benefit from a rapid evaluation on the ground. If we continued on course, he might not make it to Mexico.

To complicate things, the plane was not in a good situation for landing. The load was heavy, fuel would need to be dumped, and an unplanned landing in San Diego meant we’d hit a notoriously short runway—and we’d hit it hard, since, as all pilots know, a plane with a full tank can hit the ground with enough force to critically damage the plane. After such an emergency, an airline might need to spend tens of thousands of dollars on mandatory inspections and repairs.

Once again, I took the headset and told the pilot and the Denver physician—whom I had met personally at a medical conference, and with whom I had spoken just a few hours earlier—what was going on. The pilot expressed concern about the heavy plane, and I thought he was going to keep heading to Mexico, but he surprised me. He circled the San Diego airport, made the emergency call to the control tower, and landed the plane—really hard—on the runway. He’d called ahead for an ambulance, so shortly after landing, I escorted the passenger to the ambulance, talked to the EMT about his condition, and wished him well. I never found out if the passenger survived, but I knew I’d helped him have a shot.


The usual events on a plane involve shortness of breath, nausea, dizziness, chest pain, palpitations, and headaches. Studies show that health-care providers provide assistance in 80 percent of medical events on a plane.1 If you’re a general physician, and you have a wide breadth of medical knowledge, you shouldn’t be afraid to identify yourself and do something to help. If you’re a specialist with a narrow scope of knowledge, you might not be able to give as much help; if you do identify yourself, though, assess the situation. If it’s not serious, tell the flight attendant that this is out of your scope of practice and ask him or her to call for another volunteer. If it is serious, but you don’t feel comfortable administering care, encourage the flight attendant to ask for anyone else with medical training. There’s almost always a willing paramedic, nurse, or Eagle Scout on a flight, ready to help. In fact, most flight attendants have training in first aid, CPR, and AED use, so you can let them use their training to care for the passenger while you encourage and assist them.

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“I can tell you that every time I’ve volunteered to help,
I’ve always had a good experience.”


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All large U.S. commercial airlines should have a first-aid kit and an AED on board every flight. That means you’ll most likely have basic first-aid supplies, plus a stethoscope, a blood-pressure cuff, a bag valve mask, aspirin, dextrose, atropine, lidocaine, saline, albuterol inhalers, injectable epinephrine, an oral antihistamine, an IV catheter, IV antihistamines, an IV drip set, and several syringes.2 With regional planes, prop planes, and international planes, the supplies aboard can vary. If you decide to help on any plane, don’t wait for a flight attendant to tell you about the supplies they have. Ask for the ones you need by name.


I’ve talked to colleagues about helping passengers, and they’ve sometimes expressed worry that with the lack of equipment, they might not be able to help the patient, and could get sued. But don’t let this prevent you from doing all you can to help. In 1998 the Aviation Medical Assistance Act provided that state-qualified EMTs, paramedics, physicians, nurses, and physician assistants should not be liable for negative results of medical help given to a passenger in good faith, provided there is no gross negligence or willful misconduct.3


Don’t be afraid. It’s humanitarian to help. People are supportive and appreciative—and you’ll never be alone. If you know what you’re doing with CPR, aspirin therapy, and an AED, the odds of something serious happening are very small. I can tell you that every time I’ve volunteered to help, I’ve always had a good experience. On one flight, when I dealt with two different emergencies, my wife said, “I’m never flying with you again”—but she wasn’t serious.

Being a Good Samaritan means you don’t get compensated, and often you’ll get a quick “thank you” and that’s it. An airline might give you a few thousand miles or a free drink, but it’s not typical. After we arrived in Mexico, I walked into the hotel lounge and saw a few passengers from my flight. They pointed at me, giggled, and gave me a standing ovation. At that moment, in the lounge with my fellow passengers after a long, eventful flight, it was really nice to be there. 

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Celine Grounder, “Medical Emergencies at 40,000 Feet.” The Atlantic, April 4, 2013. Accessed March 10, 2014, at
Mark Liao, “Handling In-Flight Emergencies.” Patient Care, JEMS Emergency Medical Services, June 3, 2010. Accessed March 10, 2014, at
U.S. House of Representatives, Aviation Medical Assistance Act of 1998, March 20, 1998. Accessed March 10, 2014, at


Dr. David McClellan is a board-certified emergency medicine physician in Spokane, Washington. He is affiliated with Providence Sacred Heart Medical Center & Children's Hospital and has been in practice for 35 years.