Liver Doc Helps A Man Mid Air Who Was Breathless, Thanks Akasa Airlines Staff For Support

Kerala-based liver doctor Dr Cyriac Abby Philips aka The Liver Doc on Tuesday shared his experience of using the stethoscope after three and half years. Taking it to social media site X, formerly known as Twitter, The Liver Doc said he used his stethoscope mid-air two days ago when he was traveling from Kochi to Mumbai and a man sitting next to him was not able to breathe properly.

"I was tired from work and it was a late evening flight and I was trying to take a nap. But the commotion nearby woke me up and I found the air hostess trying to plug in the man's nebulizer for emergency inhalational treatment and I helped her get the machine running. He spoke in broken sentences, but he was not getting better. He had an oximeter which showed oxygen saturation was 36%. I asked him if he was asthmatic and he denied. I was confused why he had a nebulization kit. I asked for the stethoscope and found that his left-side lung sounds were completely absent. It was water-filled (a condition called pleural effusion)," Abby Philips said.

"In between breaths, the man tells me that his kidneys are bad. I asked him if he was on dialysis and he was on it three days a week and the next one was planned for the next day. His medications were over last night. I scroll through his unlocked phone images to see his last prescriptions. Most were for high blood pressure. I checked his blood pressure and found it was 280/160 and he was in accelerated hypertension with drowning lungs. We had 1 hour to land for emergency medical services to attend him. We had to keep him alive. I have no idea what happened next, but it felt like I was inside an ICU and had to make quick decisions. Mid air, I did a double puncture on his only accessible vein on the right side and further access was lost. The other upper limb had a dialysis fistula made and I could not use it. So I gave him a frusemide injection into his buttock muscles ( a VERY long time since I gave an adult an intramuscular injection) after telling him it was going to pain, but I had no other options and also because it was so hard to find a vein as he was struggling and the flight was a bit turbulent," he further added.

"At one point, he was leaning on my shoulders and gasping while I comforted him, by lying to him by telling him that we have already arrived. We had another 30 minutes left. The female and male attendants on Akasa Air who helped me were so calm and composed that I was able to work with a clear mind as they followed instructions. They quickly changed and provided oxygen cylinders without haste which helped me get his saturation to above 90%. I found some blood pressure-lowering medications in the flight ER kit and helped the man swallow them in between breaths," Liver Doc said.

"Before he was taken off the plane, he handed me his mobile and asked me to enter my phone number and I did and placed it back inside his sling pouch. One hour on that plane felt like a whole day inside a terrifying ICU. By the time we landed, and before the scheduled time, he was lethargic, still breathless, but blood pressure controlled. I spoke to the family on the phone right after we landed and they took him in an ambulance to the hospital nearby. The next day, his family messaged me to let me know that he was well. In the evening, after my podcast recording, the patient himself called me after he was shifted out of ICU post-emergency dialysis. His potassium level was 9.0 and his kidney functions were haywire. He could have had a fatal cardiac arrest mid-air and I shuddered to hear his reports over the phone. They removed extra fluid during dialysis and he became better by night," he further added.

The Liver Doctor thanked the flight attendants on @AkasaAir QP-1519 going from Kochin to Bombay (Mumbai) at 8 PM on the night of 14th January 2024. "I am sorry I did not ask your names because it was an incredibly difficult time. But we saved this man's life. Would not have been possible without your help. And want you to know this. Thank you," Dr Cyriac Abby Philips said.