In Reply. —
Nicoll and Edge raise critical issues about in-flight medical emergencies. These issues have received attention in both medical1-3 and lay publications (Los Angeles Times, April 1, 1988, View Section, D, pp 1-2; and New York Times, Oct 9, 1988, Section XX, p 3). Actual death during air travel is extremely rare, approximately one death per 3.2 million passengers.4 How often do severe emergencies, as described by Nicoll and Edge, occur? What can be done to assist extremely ill patients during flight? Who bears responsibility for the care of in-flight medical emergencies? Airline officials claim that in-flight emergencies and deaths seldom occur. If they do, emergency help can be obtained within 30 minutes by a priority landing. On long, overseas flights, physicians "usually" are available (Los Angeles Times, April 1,1988, View Section, D, pp 1-2; and New York Times, Oct 9, 1988, Section XX, p 3).