May 2012. On a flight from Detroit to LAX for a cruise to Mexico. We hadn’t yet reached cruising altitude when there was a sudden commotion in the row immediately behind me. The flight attendant yelled out, “is there a doctor or nurse on board?” I reflexively responded, “I’m a nurse.” “Please will you help this passenger?”, she said. I stood up and saw a 40ish year old man sitting in the middle seat and laying across the window seat. He was drained of all color, sweaty, and his skin was very cool to the touch. He was nearly unresponsive, making unintelligible sounds. I checked for a pulse and it was thready at about 40 beats/minute. Not good! The flight attendant produced a BP cuff and stethoscope, his pressure was 62/?. I hadn’t nursed at the bedside for about 15 years and I was terrified. For my patient! I asked if they had IV fluids on board and a kit was provided. There I was, starting an IV for the first time in 15 years, at 30.000 feet. I thought I might have a heart attack, I was so scared. (I got the IV on the first stick. Like riding a bike, I guess.) The flight crew contacted a physician on the ground, I reported my assessment to him, he suggested I start an IV and continue to monitor his vital signs. (Whew! At least I was on the right track!) The flight crew informed me we were going to make an emergency landing in Chicago. We didn’t though, we flew all the way to LAX with me tending to this human being, who seemed to be in a very precarious position, without a team to back me. I delivered a total of 2 liters normal saline to this man just to keep his blood pressure at 100. I was terrified I was going to throw him into a fluid overload w all that IV fluid. Did they have Lasix on board?? He did come around and was able to tell me he had no significant health history, took no routine medication, and had no allergies to medications. His lungs remained clear (wo signs of fluid overload). When we landed at LAX, the paramedics were there to haul my patient off the plane. That was 5 full hours of sheer terror in my heart! To this day, I have no idea what was wrong with that man or what his outcome was. When I returned home from my cruise I called the airline, worked my call up to someone that knew of the situation, but wouldn’t tell me if the man survived because of you know, HIPAA.
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