Authored by: Mindy C.
I am a young doctor, recently graduated. I fly frequently and a few weeks ago I faced a very scary situation that I would like to share here. My actions helped save a life, I think.
The plane had started moving on runaway and we were just about to take off, when a kid started screaming 3 rows behind me. I assumed he was cranky about flying until suddenly I noticed the flight crew rushing past. She grabbed the child and started shouting, “Is there a doctor on this flight?” I stood up reflexively without even thinking ( part of me screaming this was a very bad idea) and she immediately dumped the kid in my lap.
He was about 1 year old. I don’t have much experience with such an young age. Actively seizing. Grand mal. Frothing secretions from his mouth. Chest not rising. My mind went perfectly blank for a couple of seconds. This was bad, very bad. In the background I could hear the mother screaming her head off about her baby dying.
Training kicked in fast. A crowd was rapidly building up, someone slapping him, someone else trying to open his mouth. I shouted at everyone to back off and told the air hostess to bring the medical kit and oxygen asap. We created a empty space for him and I put him in recovery position, removing any big objects in vicinity.
Now the problem arose. The air crew had no medical training and did not know the contents of their kit. There was no drug to stop his fits, no anti epileptics, no benzos or any sedative. Nothing to establish i.v. access with or anything I could give nasally or rectally. I had no means to stop his seizure. I briefly asked mother about any recent history of fever, any prior history of fits, any medical problem. Everything was normal so far. This was his first fit apparently. He had eaten 2 hours prior.
By this time they had brought oxygen cylinder and a mask which was useless as he wasn’t breathing anyways. I had to take control of his airway as his fits were continuous and I was worried about hypoxia, aspiration or a cardiac arrest. There was nothing to control airway either. There was a neonatal ETT but no pediatric size laryngoscopes. A small miracle happened and someone brought a AMBU and mask, all adult sizes. They actually had nothing pediatric with them.
I stuffed gauze around the mask and started ventilating with AMBU. They had no suction or monitors either, not even a pulse ox. He had started developing peripheral cyanosis although it could be me imagining things in panic. I was trembling head to toe. He thankfully had a good pulse so far. I asked for a big roll of gauze and in between breaths, tried to mope up as much of his secretions as I could. They found a steth in the meanwhile.
He stopped seizing after 5 mins. He still wasn’t breathing. Not responding to pain either. I continued ventilation, trying to avoid hyperventilation, checking pulse intermittently. On auscultation I could tell he had aspirated a bit. I kept on mopping excess secretions. His cyanosis disappeared. After 10-15 mins he started breathing. Chest was rising again. I put a mask on him, covered him with a blanket and kept on rubbing his back to stimulate him. He still hadn’t opened his eyes and wasn’t responding to painful stimuli either.
In the meanwhile, another issue had arrived. This was a flight on way to USA. The cabin crew wanted to take off. The pilot came to speak with me, emphasizing how important it was to start on time as delay would cause a massive financial loss. I told him not to continue, in my professional opinion. I couldn’t release an unconscious kid to them as I was scared of another fit and cardiac arrest. The family involved agreed to let me decide the plan of action.
30 mins after it started, he opened his eyes and started crying. I can’t tell how relieved I was to hear that cry. The on ground pediatrician came after 45 mins. They attached monitors and his saturation was 96%. The pediatricrian agreed that my decision to stop the flight was the correct one. They took him in an ambulance to a nearby hospital. I was afraid they would come after me for stopping the flight and I was very relieved when he agreed with my decision. The family couldn’t thank me enough.
I struggle with imposter syndrome a lot. I make mistakes often and I don’t know everything. But when I left that flight as we landed eventually, I knew I had helped save that kid so apparently I am not entirely useless.