Lesson 1Physiology of cabin altitude and hypobaric hypoxia: effects on oxygen saturation, cardiovascular compromise, and symptom thresholdsThis lesson describes cabin altitude physiology and hypobaric hypoxia, covering usual cabin pressures, impacts on oxygen levels and heart workload, symptom limits in healthy and at-risk passengers, and treatment implications.
Typical cabin pressure and equivalent altitudeGas laws relevant to the aircraft cabinEffects on oxygen saturation and dyspneaCardiovascular strain and ischemia riskVulnerable groups and symptom thresholdsImplications for oxygen and diversion decisionsLesson 2Oxygen therapy titration, fluid resuscitation principles in the cabin, and safe use of medications (aspirin, nitrates, bronchodilators, intramuscular adrenaline) with aviation constraintsThis lesson details oxygen adjustment at cabin altitude, fluid revival with scarce resources, and safe key drug use, including contraindications, dosing, delivery methods, and aviation rules for storage, labelling, and records.
Oxygen delivery devices and flow settingsTitrating SpO₂ targets in hypobaric hypoxiaFluid resuscitation with limited suppliesSafe aspirin and nitrate use in flightBronchodilators and inhalation techniquesIntramuscular adrenaline: dose and precautionsLesson 3Available onboard equipment and medications: typical first-aid kit, emergency medical kit contents, oxygen delivery systems, AED, and limitationsThis lesson lists standard onboard medical supplies, including first-aid and emergency kits, oxygen setups, AED features, and main limitations, noting differences across airlines and effects on clinical choices.
Regulatory minimum first-aid kit contentsEmergency medical kit drugs and devicesPortable and fixed oxygen system typesAED functions, prompts, and safe useEquipment variability between operatorsPlanning care around equipment limitsLesson 4Common in-flight cardiopulmonary emergencies and differential diagnoses for sudden dyspnea and hypotension (ACS, PE, pneumothorax, anaphylaxis, arrhythmia, syncope, hypovolemia)This lesson reviews frequent in-flight heart-lung emergencies, focusing on recognising patterns and differentiating sudden breathlessness and low blood pressure, such as ACS, PE, pneumothorax, anaphylaxis, arrhythmias, syncope, and low volume.
Recognizing life-threatening dyspnea patternsDifferentiating ACS from pulmonary embolismIdentifying tension pneumothorax in the cabinAnaphylaxis versus isolated bronchospasmArrhythmias, syncope, and hypotensionHypovolemia and occult blood loss in flightLesson 5Criteria and process for diversion decisions: clinical thresholds, flight phase, time to suitable diversion airport, passenger stability, and operational/legal considerationsThis lesson explains clinical and operational diversion criteria, including instability limits, treatment responses, flight stage, suitable airport access, legal duties, and joint decisions with the captain and ground support.
Clinical red flags mandating diversionTime-critical versus time-tolerant conditionsAssessing time to a suitable diversion airportCommunicating risk to the flight crewLegal and liability aspects of diversionDocumenting the diversion decision processLesson 6Immediate management algorithms for suspected acute coronary syndrome, pulmonary embolism, anaphylaxis, and cardiogenic or hypovolemic shock in flightThis lesson provides step-by-step algorithms for handling suspected ACS, PE, anaphylaxis, and shock in flight, modifying standard emergency steps for limited tests, cabin hypoxia, and restrictions on drugs, fluids, and monitoring.
Suspected ACS: assessment and first-line careManaging suspected pulmonary embolism aloftRapid recognition and treatment of anaphylaxisCardiogenic versus hypovolemic shock stepsUse of oxygen, positioning, and fluidsWhen algorithms trigger diversion or CPRLesson 7Documentation steps during and after the event: in-flight records, handover information for ground emergency services, incident reporting to airline operations and aviation medical authoritiesThis lesson covers precise documentation during and post-events, including structured in-flight notes, timings and treatments, clear handovers to ground teams, and required reports to airline operations and aviation medical bodies.
Essential elements of in-flight medical notesTime stamping assessments and treatmentsPreparing handover for EMS at landingCommunicating with cockpit and operationsIncident and safety reporting requirementsConfidentiality and data protection issuesLesson 8Systematic in-flight assessment using remote medical consultation: focused history, vital sign targets, use and interpretation of portable pulse oximetry, and monitoringThis lesson explores structured in-flight assessments with remote medical help, stressing focused history, symptom timelines, vital sign goals, pulse oximetry constraints, and continuous monitoring suited to cabin altitude and tools.
Primary survey in the aircraft cabinFocused history and symptom timelineTarget vital signs at cabin altitudeUse and limits of portable pulse oximetersWhen and how to call ground medical controlContinuous monitoring and reassessment
