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EDUCATION AND DEBATE: W Angus Wallace Fortnightly Review: Managing in flight emergencies BMJ 1995; 311: 374-375 [Full text]

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Airplane descent was not contraindicated

John P Simanonok   (23 April 2008)

Airplane descent was not contraindicated 23 April 2008
John P Simanonok, Hyperbaric Medicine Physician St. Luke's Medical Center, Milwaukee, Wisconsin, USA Send response to journal: Re: Airplane descent was not contraindicated	In reading another account of this incident, mention was made of the surgeon's belief that the plane could not land due to the tension pneumothorax. Descent was believed to be contraindicated because the pneumothorax would expand and cause further hemodynamic compromise. I have not seen this reasoning criticized in subsequent discussion, but it is wrong. On descent, the pneumothorax will increase in pressure, hence decrease in volume, in accordance with Boyle's Law. Mention should at least be made, in this account, of how long it took to cobble together the coat hanger, etc., and why diversion and urgent landing was not entertained once the pneumothorax was identified. Competing interests: None declared