Aviation Auscultation

To the Editor.—  In June 1989, on a domestic commercial flight of 4 hours' duration, the flight crew requested that I attend to a fellow passenger who complained of acute symptoms. Her case demonstrates that deficiencies in the on-board medical supplies may not adequately be addressed by a mere listing of required items, as provided by the Federal Aviation Administration.¹

Report of a Case.—  A 35-year-old woman complained of acute right lower quadrant abdominal pain that had been present for 3 hours before boarding and had worsened during the 3 hours of elapsed flight time. The remainder of the history suggested that the differential diagnosis should include pelvic inflammatory disease, acute appendicitis, and ectopic pregnancy. During the attempt to obtain vital signs, the stethoscope provided in the enhanced medical kit was not sensitive enough to pick up arterial sounds, although it adequately transmitted the (considerable) extraneous cabin and