Aviation medicine: challenges for telemedicine.

The number and seriousness of medical problems on passenger-carrying aircraft in flight are increasing. Medical incidents occur at a rate of approximately 10-50 per million passengers carried. Medical equipment carried on commercial aircraft is limited to three items: a first-aid kit, an emergency medical kit and sometimes an automatic external defibrillator. Telephone medicine, a lower level of telemedicine support, is well established for commercial air operations. The availability of satellite telecommunications on passenger-carrying aircraft permits more sophisticated forms of telemedicine. Recent telemedicine experiments have involved the transmission of three-lead electrocardiograms (ECGs), heart rate, blood pressure, arterial oxygen saturation, end-tidal CO2, respiratory rate, body temperature and realtime video. The challenge is to demonstrate that such techniques are practicable, improve patient outcomes and are cost-effective.