[DoubleF]

So... to fill in the gaps to get an idea what the criteria is to divert a plane...

Here's a CDC article from a USA perspective (it seems) about whether or not to go forward if you had medical training:

https://wwwnc.cdc.gov/travel/yellowb...sible%20stroke.

It does say this:

Medical emergencies occur on ≈1 of every 604 flights. The most common emergencies include syncope or presyncope, respiratory symptoms, or nausea and vomiting. For 90% of these emergencies, aircraft continue to their destination. For the remaining 10%, however, aircraft divert to an alternative landing site, most frequently for cardiac arrest, cardiac symptoms (e.g., chest pain), obstetric or gynecologic issues, or possible stroke. Despite the frequency of medical emergencies, the death rate is only ≈0.3%.

In the CBC article, it says he was clutching his chest and at one point his face was drooping on one side. The individual was moved to first class. Unless there was some serious misunderstanding of the symptoms involved in the analysis and recommendation, it does seem like there should have been enough evidence to presume a potential cardiac or stroke related event either of which are of the most frequent reasons for diverting to an alternate landing site.


Then I checked this article here:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3789915/

Interestingly enough, this article coincidentally uses Air Canada data as the support for diverting.

The act of diverting a full aircraft to the nearest city is expensive, estimated to range between $3,000 and $100,000 depending on the size of the plane and costs of additional fuel and passenger re-routing, and has far-reaching consequences.22 Diversion is usually made in consultation with ground-based medical expertise and should account for regional medical resources along the flight path. The final decision to make an emergency landing rests with the pilot in command. An article published by Ruskin et al23 advised diversion for unremitting chest pain, shortness of breath, or severe abdominal pain. Grendreau et al22 add stroke, persistent unresponsiveness, refractory seizures, and severe agitation to this list.

A 2010 study reviewing 4 years of flight diversion data from Air Canada revealed that the majority of diversions occurred following cardiac complaints.7 Regardless of the presenting symptom, in-flight or ground-based providers must assess a patient’s stability and perceived medical condition based on the limited clinical information available and then make a risk-based recommendation. Factors affecting this decision include the differential diagnosis of the patient’s condition, available in-flight resources, the patient’s response to initial treatments, and ground resources along the flight path. International flights that traverse oceans or large tracts of sparsely populated land may have a lower threshold for diversion before crossing these spaces given the paucity of resources once they are entered.

Again, it seems there should have been enough reason to divert and that AC hasn't shied from diverting before. However, what I find weird is this: Air Canada refused to comment, fair enough. But MedAire the company that consulted with the pilot also refused to comment. That's weird. They can refuse to comment on the case, but even stating that they go through a private checklist and typically reasons for diverting a plane include specific scenarios... they don't even say that. Shouldn't there be at least some insight into the standards of how a decision is made? (ie: We cannot comment but we do have a standard protocol and list of criteria we go through with the pilot for in flight emergencies. We will review the information to see if it was followed. etc.)

Introduction:
Research and data regarding in-flight medical emergencies during commercial air travel are lacking. Although volunteer medical professionals are often called upon to assist, there are no guidelines or best practices to guide their actions.

In-flight medical incidents during commercial air travel are common yet poorly understood and studied phenomena. The cramped quarters of an aircraft cabin environment and limited available resources make responding to such events fraught with challenging clinical decisions.

Existing data on both the incidence and classification of in-flight medical events are limited by the lack of a central registry with standardized data collection. Such a data collection tool has been advocated for by several international aviation organizations and could inform the development of emergency medical kits, flight crew medical training, and passenger screening protocols.

Based on this... it could be a situation that Air Canada is just the first to get flack for a situation that is potentially a global aviation issue. It's perhaps that there just isn't enough reason to push for improved procedures for this relatively rare scenario.

It's possible that Air Canada might not be totally at fault here. I wouldn't stand in anyone's way if they wanted to throw disdain at Air Canada though. Certainly we'd glean insight into the scenario if Air Canada does not use this event to spearhead the creation and deployment of a significantly improved and unified inflight medical emergency guide and best practice that many other airlines can adopt. It's crazy that this article is dated September 2023. This isn't a few years ago. This is seemingly ongoing.

If MedAire consults to over 180 Airlines, why does it seem to imply and indicate that there ultimately still isn't a general common standard for dealing with in flight emergencies? Weird.

Originally Posted by BlackArcher101

Procedure relies on a game of telephone where important details are likely lost? That's just stupid, the pilot didn't leave the cockpit to see for himself? Hell, there would have been multiple pilots on board due to the length.

I would venture a guess a pilot is procedurally almost always not allowed out of the cockpit after the plane is in the sky to prevent potential hijacking of the plane? That's why it has to be a telephone tag scenario.

This scenario is ultimately rare. But after reading a few things, I'm actually kinda mind blown how it's been identified in late 2023 that it seems that unified policies and procedures for in flight medical emergencies are inconsistent and lacking for many airlines (not just AC).