• Alexandre T Rotta, Paulo M Alves, Neil Nerwich, and Steven L Shein.
• Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, NC. Electronic address: alex.rotta@duke.edu.
• Ann Emerg Med. 2020 Jan 1; 75 (1): 66-74.

Study ObjectiveMore than 4 billion passengers travel on commercial airline flights yearly. Although in-flight medical events involving adult passengers have been well characterized, data describing those affecting children are lacking. This study seeks to characterize pediatric in-flight medical events and their immediate outcomes, using a worldwide sample.MethodsWe reviewed the records of all in-flight medical events from January 1, 2015, to October 31, 2016, involving children younger than 19 years treated in consultation with a ground-based medical support center providing medical support to 77 commercial airlines worldwide. We characterized these in-flight medical events and determined factors associated with the need for additional care at destination or aircraft diversion.ResultsFrom a total of 75,587 in-flight medical events, we identified 11,719 (15.5%) involving children. Most in-flight medical events occurred on long-haul flights (76.1%), and 14% involved lap infants. In-flight care was generally provided by crew members only (88.6%), and physician (8.7%) or nurse (2.1%) passenger volunteers. Most in-flight medical events were resolved in flight (82.9%), whereas 16.5% required additional care on landing, and 0.5% led to aircraft diversion. The most common diagnostic categories were nausea or vomiting (33.9%), fever or chills (22.2%), and acute allergic reaction (5.5%). Events involving lap infants, syncope, seizures, burns, dyspnea, blunt trauma, lacerations, or congenital heart disease; those requiring the assistance of a volunteer medical provider; or those requiring the use of oxygen were positively correlated with the need for additional care after disembarkment.ConclusionMost pediatric in-flight medical events are resolved in flight, and very few lead to aircraft diversion, yet 1 in 6 cases requires additional care.Copyright © 2019 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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