Kimball cardiologist saves life at 35,000 feet

When Samir Jain, M.D., of Cardiology Associates of Ocean County, boarded a plane bound for Mumbai, India in early December, he never anticipated that his skill and expertise as a cardiologist would be put to the test at 35,000 feet.
Dr. Jain was looking forward to his vacation, and meeting up with family that had made the same trip out of Newark Airport earlier in the month.
Nearly halfway through the 15-hour flight, the plane’s crew sent out a plea for help. "Is there a doctor on board?" Not one, but two physicians responded.
Dr. Jain, a cardiologist affiliated with Kimball Medical Center in Lakewood, along with a cardiologist from California, quickly stepped forward to see if they could help. A 42-year-old male passenger had been found unconscious on the floor of the plane and the crew knew he needed immediate medical attention.
The plane, luckily, was equipped with an advanced emergency medical kit, and Dr. Jain and his counterpart were able to administer oxygen and start an IV, administering a liter of saline to their patient.
A fellow passenger had some aspirin, which the two also administered to the patient, along with a second liter of saline. “After the additional fluid he really started to come to and we were able to get a little medical history from him.” Unfortunately, he also began to complain of left side chest pain and difficulty breathing, according to Dr. Jain.
Based on the patient’s cardiac symptoms and a similar episode he relayed he had experienced several years before, the two feared their relatively young patient might be suffering a heart attack.
“My colleague from California mentioned that he had been heading to India to work in a mission and had a portable echocardiogram machine that he’d carried onboard the plane,” says Dr. Jain. The two used the machine to perform a sonogram of the man’s heart. “We didn’t have any lubricating jelly, which is necessary for the sonogram,” he recounts, “but a member of the flight crew provided us with some face cream which we were able to utilize instead.” The outcome of the makeshift sonogram was not encouraging. “The results reinforced our suspicion that he might be suffering a heart attack,” he says.
Administering the last liter of saline in the airplane’s emergency medical kit, the two physicians monitored their patient’s heart on the plane’s portable defibrillator. “We had worked on this man for more than two and a half hours,” explains Dr. Jain, “and while he was relatively stable at that moment, he had been unconscious and completely unresponsive for nearly 30 minutes. We were concerned that he had already suffered a heart attack or might be about to experience a massive heart attack.”
With no IV fluids left to maintain his blood pressure, and little left in the way of medical supplies, the two conferred with the Captain and crew of the airplane. They contacted MedAire – a global emergency medical service that helps airlines handle in-flight medical emergencies. Together, the decision was made to divert the plane, and the Captain made an emergency landing at London’s Gatwick Airport. MedAire had an ambulance waiting to take the passenger to the nearest hospital.
After a brief layover, Dr. Jain and the other passengers continued on their trip to India.
After several days in the cardiac observation unit and a myriad of tests, the London hospital determined that the man had not suffered a heart attack, but couldn’t define what had caused his life-threatening mid-air collapse. Dr. Jain learned this via an email he received from his very grateful in-flight patient a few weeks after the event.
While the cause may not have been found, everyone involved that day – the airplane crew, passengers, hospital staff and the patient himself – agrees that luck was on his side – and that Dr. Jain is one exceptionally skilled cardiologist who can really think on his feet.
13/05/08 krbrown@sbhcs.com/Asbury Park Press, USA

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Categories: Foreign May 2008