Emergency aircraft landing: Why Emergency Physicians are irreplaceable!

Hey all!

Life's been way too exciting. Almighty has been kindest this year!  I could not find time to post. Now is the time. This is a real incident that happened during my airport posting.

We got a call stating there was a cardiac arrest in this  flight and emergency landing in 8 minutes. I was a little nervous. Somebody who has intubated handful number of times in a fully equipped atmosphere . I may have to do crash intubation if required there itself not in the aircraft though but in ambulance may be . Even basic CPR would be difficult in a compact space like an aircraft. I check all drugs , equipment and everything. We literally run to the ambulance . The plane landed in about 3 minutes . We rushed into the plane. I see a middle aged man moving his limbs and the other giving compressions. I was like he is moving why are you giving compressions? I didn't know he was a doctor.
Flashback:
The basic background was a
50 year old Male post neurosurgery for meningioma 5 years back had missed his morning dose of drug. He suddenly  fell down became unresponsive for 2-3 minutes .

So , the flight had 4 docs on board... His wife , a practicing gynecologist , one orthopedic surgeon, 2 other doctors who I don't know were of which specialty but somehow put their inputs and of course chest compressions.

# The overenthusiastic orthopedic surgeon thought it was a cardiac arrest. Pushed everyone aside and started CPR.

#The gynecologist wife who  then realized he missed a dose pushed a levipil tab in mouth of his unresponsive husband ! And asked for oxygen support connected high flow oxygen.

# After 2 compressions the patient opened his eyes , started yelling in pain! Stop ! It's paining.

#The gynecologist wife asked the orthopedician to stop since he had gained his conscuousness. But the aggressive person continued CPR on a conscious patient for 20Minutes in turns with the other doctor.
Back to present situation:

I thought he was a layman. I asked him to keep his hands off the  patient. He said , the situation is under control mam ! don't worry ! and gave another compression! I said  please mooove!

I made sure the area is clear. The patient was conscious but confused.moving all limbs. His vitals were absolutely stable.The chest leads were connected and the  monitor had sinus rhythm. I reassured the attendant that he is stable.

#Another attendant who seemed like a priest came near requested everybody for a minute so that he can pray and blow in his ear.The airhostess overheard my words and started announcing. The patient is okay. He is very lucky 4 doctors were on board to help.
And a special round of applause for this doctor who has stabilised the patient by compressions.
I was like  seriously?!
I really didn't want to argue there because whom would I explain what?
Overenthusiastic orthopedic who didn't know the first thing you check in collapse is his responsiveness
Or the panicky wife who knew things but was obviously confused.

We shifted the patient to the emergency . While in ambulance I reassured his wife again, when I thought she was fine. I told her that it was NOT a cardiac arrest.
She confessed. She knew it was not. And it was a seizure but didn't have guts to stop CPR, what if it was actually one?!
She tried conveying the same to orthopedic who was in no mood to listen.
She quickly put levipil tab in unconscious patient. The quality of CPR was also terrible. Airway was not maintained.it was as though somebody was jumping on alive patient.
We stabilised him. Asked them to shift to a higher facility for observation and investigation s. They wanted to go home and so went home against medical advise.

It was few days back in the EM conference my senior consultant had just said.

### Emergency Physicians are irreplaceable.### This incident proved it. They indeed are.

The need for basic life support classes on regular basis . With proper logic are required. Not that I am super cool , super trained.

Every doctor has their forte . Like nobody works like a ER physician in emergencies like these. Nobody works like the orthopedic surgeon or a gynecologist in the OT . To prioritize things.make them work in order. We do the best 😎. 

The need for emergency Physicians. Their irreplaceable space is what I learned with this experience.

Thanks!
So far so much!