If verbal de-escalation is ineffective, consider administering a benzodiazepine or antipsychotic (if available).1 If the passenger is combative, refer to the flight crew for the airline’s security protocols, which may include restraining the passenger or diverting the aircraft. Safety takes priority over attempts at medical management.
If the passenger has respiratory distress, instruct the flight crew to contact ground-based medical support for additional recommendations.1
A challenging situation
Ultimately, the pilot coordinates with the flight dispatcher to manage all operational decisions for the aircraft and is responsible for decisions regarding flight diversion.1 In-flight medical volunteers, the flight crew, and ground-based medical experts can offer recommendations for care.1 Cruising at altitudes of 30,000 to 40,000 feet with limited medical equipment, often hours away from the closest medical facility, will create unfamiliar challenges for any medical professional who volunteers for in-flight psychiatric emergencies.1