HICKAM AIR FORCE BASE, Hawaii -- (Editor’s note: This article is part one of a three-part series about in-flight medical support among Pacific Air Forces Surgeon General Team members.)
In the dead of the night, on a flight en route to Hawaii from Australia, passengers slept, relaxed or watched movies under dimmed lighting after a meal.
Suddenly, a passenger fell to the center aisle on his walk back from the lavatory, foaming from the mouth and convulsing during a seizure.
Maj. Michael Yim, Pacific Air Forces Surgeon General international health specialist, happened to be on the way back from a bilateral medical planning conference in Australia when the flight attendants made the call to request any medical professionals on the aircraft.
“I gave myself a couple of minutes because if there’s a doctor or anybody else, I wanted to give them a chance to respond because I’m a nurse,” explained Yim. “But I didn’t hear anyone answering the call, so I felt very concerned.”
Yim approached the flight attendant, who brought him to the passenger.
“I realized he was a 15-year-old Australian, who was traveling to the United States with his mom on vacation,” Yim recounted. “So, I was thinking to myself, ‘Okay, what can I do now?’”
Yim described the thoughts going through his mind as he went through his step-by-step process.
“It was dark; the visibility was not there,” pictured Yim.
Fortunately, Yim had a small key-chain flashlight that he wears around his neck, which he then used to examine his patient.
“It’s one of those things I always carry, and I also had a pen with me in my fanny pack,” Yim said. “So, I checked his pupils and things like that.”
Not only was it pitch black, but it was also dead silent, which became a distraction.
“People are waking up and they’re all silently watching us,” Yim detailed. “I could literally feel everyone staring at me. That made me feel unsettled at first.”
Yim shifted his focus to building a solid rapport with his patient and the patient’s mother.
“I could see that the mom was very nervous,” Yim described. “It was my thinking process that if I had that credibility [with her], I could do my job easier.”
Yim had to think about how he could ensure his patient’s mother doesn’t become another injured patient.
“So, by explaining to her what I think is happening and why, it was reassuring for her so she wouldn’t be anxious throughout the whole flight,” delineated Yim. “My secondary job was to make sure all the bystanders were not panicking.”
To keep the patient calm, one of the flight attendants assisted Yim by getting the patient to laugh at some jokes.
Yim explained these types of scenarios are essentially business as usual for medical professionals during training. However, during a real-world situation, mistakes could be the difference between life or death.
“When in-flight medical emergencies happen, the aircrew and attending physicians have to decide if they want to press on to the final destination or go back to where they came from so the patient can get the proper medical care,” Yim outlined.
Yim determined the best course of action was to proceed to Hawaii and have Honolulu’s local medics available at the airport and waiting upon the flight’s arrival so the patient can be expeditiously transported. After landing, Honolulu’s emergency medical services crew arrived with electrocardiography gear and a stretcher.
“It was a big relief for me because during the flight, I was thinking to myself, ‘The first time he was lucky. What if it happens again?’ But thank God that didn’t happen,” Yim exclaimed. “He walked out of the aircraft with the EMS crew.”
Overall, Yim’s medical expertise showcased the capabilities of U.S. medical professionals, even with limited equipment.
“Mike’s a very humble and capable officer,” said Lt. Col. Ross Graham, deputy chief, Medical Readiness Division, PACAF Surgeon General. “I expect him to perform well. So, when he crushes it, he’s lethal in a positive way for medical, which validates that expectation. It’s like when you’re on a sports team and somebody knocks it out of the park; it is no surprise, because he’s amazing!”