Sunday, November 17, 2013


Vancouver to Hong Kong was 13 hours.
 A woman became faint on the plane. Apparently her eyes rolled back and she almost fell over in her chair.  The flight attendant had witnessed this and called for medical help.  She was dizzy when I arrived but could speak so with a nurse I was monitoring her after a relatively complete history and physical,the nurse as translator.  Again the question was whether to turn back the plane and again I felt it wasn't necessary.  Later I wondered if it was a conflict of interest, wanting to get on with the long flight.  She perked up after our care, amazing what relatively thorough and matter of fact history and physical exam does.   She was well on arrival so most likely vassal vagal.  Her history of hypertension, no meds or treatment, with normal blood pressure was a red herring.    The nurse thanked me for my very thorough examination and was most impressed with my attention to neurological and cardio.   I think head injury or drug abuse if asked to help with a broken finger nail these days.  I gave a report to the flight crew who duly wrote down my findings.  The Air Canada equipment was adequate.  The flight crew was exceptional.  I only used the stethoscope and penlight, the nurse used the blood pressure cuff I handed her,  but in retrospect would have like to have known if there was a laryngoscope and needles with fluids for maintaining volume.  I didn't check to ensure that was present. When I was called to help on a Northwest flight there was pretty well all the makings of a combat medical service.  I should have checked more here though it wasn't needed. Can't assume different airlines have the same equipment. Made that mistake once with a hospital emergency and had a hell of time without "standard" equipment dealing with an emergency.   The flight crew consulted their on shore medical expert. Presumably the company doctor agreed with me. We didn't turn back.  I thoroughly loved the nurse, so concerned, caring, competent and bilingual.
Due to turbulence and wind and such the plane arrived late.  I missed my connecting flight to Singapore so was an hour delayed before the 3 hour flight. Singapore Airlines were really special.  I loved the Flight Attendants uniforms.  Great meal and service.
Now I've had a shower and it's night in this beautiful city.  Hannah got me a fine room in Miramar Hotel. Would only be better with Gilbert here.  He likes hotel rooms.  I'm going to the port in the morning so will get to bed now that I'm winding down a bit.  Long flight. I feel for my friend John when he flies home toIMG 4262 Australia.  IMG 4266IMG 4269
Here's the Miramar Hotel in the morning.  Nice place.  Central.
IMG 1420IMG 4270

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