<p>Charles Alcock is managing editor of the AIN Media Group, having rejoined the company in 2019. He has been an aviation journalist since 1986, and previously worked for AIN from 1990 to 2017, most recently as editor-in-chief. His main focus is on covering new aviation technology and business models, as well as international news.</p>
<p>Having been raised in the London area, Alcock studied at the University of Manchester in the UK and earned an honors degree in Politics and Modern History. He speaks English and French, and some German.</p>


Managing Editor

<p><span><span><span>The eVTOL air taxi flight was halfway between Newport Beach and Los Angeles International Airport when one of its passengers started feeling seriously unwell. The single pilot at the controls thought to herself, “Now what do I do?” That was quickly followed by another thought:&nbsp;“Gee, how would this play out when these things are operating autonomously?”</span></span></span></p>
<p><span><span><span>This is just the sort of alarming scenario being contemplated by experts in inflight medical care as they seek to determine how the new advanced air mobility (AAM) industry will take care of its passengers. The different approach being taken by prospective operators of these new aircraft is prompting a fresh look at what a realistic and effective response would look like in the context of the relatively short flights envisaged by most use cases.</span></span></span></p>
<p><span><span><span>MedAire is an established&nbsp;specialist in this field that is already supporting more than 4,500 aircraft flown by two-thirds of the world’s top commercial airlines and multiple corporate flight departments and private charter operators. However, when the U.S.-based group started addressing the AAM sector, it soon realized that medical emergencies are not yet on the radar for the new market entrants.</span></span></span></p>
<p><span><span><span>“One company we spoke with has signed a deal with a major airline to provide city-to-airport travel, and even though the airline concerned is already supported by MedAire, the eVTOL company itself admitted it hadn’t yet thought about this issue,” MedAire CEO Bill Dolny told <strong>FutureFlight</strong>.</span></span></span></p>
<p><span><span><span>Some might say that with air taxi flights as short as 15 minutes, inflight medical care is a solution in search of a problem. After all, passengers hop in cabs on the ground every day without considering what would happen to them if they had a stroke on a crowded freeway.</span></span></span></p>
<p><span><span><span>However, according to Dolny, a standard of care for passengers will be expected of aircraft operators in use cases that could range from gridlock-busting hops across cities to sightseeing tours and new short-haul regional airline services. Just as the prospect of a fatal crash in the early days of the eVTOL age has some convinced the new mode of air transportation would inflict irreversible reputational damage on the new sector, horrifying stories about heart attacks inflight could seriously dent public confidence, especially in ridesharing scenarios.</span></span></span></p>
<h3 class="subheading"><span><span><span><strong>Medical Emergencies Could Trigger Wider Safety Problems</strong></span></span></span></h3>
<p><span><span><span>“The wrong type of medical event could cause a safety concern for the flight,” Dolny said, painting a mental picture of a passenger panicking in a small cabin. “There is not going to be a crew member in the back, and in some cases, there might not be a crew member at all.”</span></span></span></p>
<p><span><span><span>This conundrum has prompted MedAire to fundamentally rethink how it could provide a version of the life-saving support it offers in other types of aircraft. New technology could deliver an answer with options being considered&nbsp;including embedding a version of the company's customer-facing app&nbsp;and a recently&nbsp;introduced Digital Assessment Kit. </span></span></span></p>
<p><span><span><span>Now the company is talking with eVTOL aircraft developers seeking guidance on where microphones and cameras might be installed in cabins. They are also considering how scaled-down medical kits could be provided to take account of weight and space limitations that will make it hard to install, for example, normal-sized defibrillators. </span></span></span></p>
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            <div class="field field--name-field-media-image field--type-image field--label-hidden field__item">  <img loading="lazy" src="/sites/default/files/futureflight/import/screenshot3.PNG" width="2048" height="1536" alt="MedAire provides easy-to-follow instructions to help people without medical training to deal with inflight health emergencies." title="MedAire provides easy-to-follow instructions to help people without medical training to deal with inflight health emergencies. (Image: MedAire)">

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            <div class="field field--name-field-caption field--type-string-long field--label-hidden field__item">MedAire provides easy-to-follow instructions to help people without medical training to deal with inflight health emergencies. (Image: MedAire)</div>
      
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<figcaption>MedAire provides easy-to-follow instructions to help people without medical training to deal with inflight health emergencies. (Image: MedAire)</figcaption>
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<p><span><span><span>MedAire’s ground-based medical teams routinely speak with passengers and crew during flights, as part of the 300-plus calls fielded on average each day from its facilities in Phoenix and London. In some cases, cameras are used to help with diagnosis and the guidance provided.</span></span></span></p>
<p><span><span><span>Dr. Paulo Alves, a cardiologist who is MedAire’s global medical director of aviation health, is leading efforts to refine how care can be provided to meet the needs of a changing industry. He sits on the safety committee of the National Business Aviation Association.</span></span></span></p>
<p><span><span><span>The company recently updated its entire case history to identify ways to provide the right support, equipment, and training. “We’re focusing hard on the 10-minute window [in which to respond most effectively to medical emergencies],” Alves explained. “We’re brainstorming possible scenarios around major events occurring in flight. What’s clear is that these always depend more on the person than on the [type or duration of] flight. The percentage of cardiovascular events for long or short flights is more or less the same.”</span></span></span></p>
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            <div class="field field--name-field-caption field--type-string-long field--label-hidden field__item">MedAire's ground-based doctors deal with thousands of calls each year to support aircraft operators and their passengers. (Image: MedAire)</div>
      
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<figcaption>MedAire's ground-based doctors deal with thousands of calls each year to support aircraft operators and their passengers. (Image: MedAire)</figcaption>
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<p><span><span><span>Also fundamentally the same, even in new types of aircraft, is the need to quickly identify what is happening and what best to do about it. MedAire is looking at how emergency responses could be built into the algorithms used to control the aircraft, perhaps supporting an automatic flight-divert function that would be especially important in an autonomous aircraft. “One of the main use cases we are looking at is one in which there is no pilot to help, and so what we provide has to be completely intuitive for the passengers,” Alves said.</span></span></span></p>
<p><span><span><span>With regulatory requirements being relatively minimal for inflight medical care, the mission is fundamentally one of going above and beyond in safeguarding aircraft passengers. Insofar as there are defined requirements, these come under the safety management systems that are now almost universal in the world of fixed-wing and helicopter operations. </span></span></span></p>
<p><span><span><span>“Our objective is how do we work with this [AAM] industry to create the right standard of care and what is the next level of innovation that won’t overburden manufacturers and operators,” Dolny said. “The operators will need to assess where they want to put their bet [on what support&nbsp;is provided] because we’re sure they will find there is a standard of care that people will expect.”</span></span></span></p>
<p><span><span><span>In 2022, the MedAire assistance teams handled just under 61,000 cases, with about one-third of these involving direct inflight medical aid, on top of providing support for crew and assessing whether passengers were fit to fly. The top five medical issues dealt with were ear, nose, and throat (17 percent),&nbsp;gastrointestinal (16 percent), neurological (15 percent), musculoskeletal (9 percent), and respiratory (6 percent).</span></span></span></p>
<p>&nbsp;</p>


Charles Alcock

MedAire has introduced a Digital Assessment Kit to help doctors assess medical emergencies during flights. (Image: MedAire)

How Inflight Medical Emergencies Pose a Safety Management Challenge for eVTOL Aircraft Operators

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