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By Travel writer
msnbc.com contributor
updated 8/7/2008 9:27:44 AM ET 2008-08-07T13:27:44

Late last month, as a red-eye Delta flight from Los Angeles to Atlanta was preparing to land, crew members found an unresponsive passenger in the jet's lavatory. Medical professionals were on the flight but, when the plane landed, authorities confirmed that 61-year-old Michaele O'Neil Carnahan had passed away .

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Having a passenger die on an airplane is a very sad and, airline officials insist, very rare occurrence. Yet, given how many people are up in airplanes at any one time, it’s bound to happen.

But why let it happen to you, someone you love — even an annoying seatmate — if it doesn’t have to?  Experts say there are steps you can take to make sure you “arrive alive.” Some of their tips are common sense. Others may surprise you.

And one or two may just save a life.

Dying to fly?
First some statistics: MedAire, which provides on-the-ground emergency medical advice to flight crews, documented 89 deaths in 2006 and 77 deaths in 2007. The company deals with about 30 percent of the world’s airlines, so the actual number of in-flight deaths is likely higher. But since no agency keeps system-wide figures, there’s no way to know for sure.

Still, the overall chance of actually dying in the air is quite low. According to the folks at MedAire, “for every 5.7 million passengers in the air every year, one in-flight death could occur.”

Why take chances?
Airlines try not to. “Every plane large enough to have a flight attendant must carry at least one automated external defibrillator (AED) and at least one FAA-approved emergency kit,” said Katherine Andrus of Air Transport Association (ATA), an airline trade association. “And every flight attendant is trained to use the AED and to perform CPR.”

The airlines also have FAA-required procedures in place to solicit help from any passengers who may have medical training, Andrus added. Plus, there's a pretty good chance that there will be a doctor, nurse, firefighter or someone with useful medical skills on your flight that can — and will — try to help, said Dr. Russell McMullen, director of the Travel Medicine Center at Seattle’s University of Washington Medical Center.

He should know. He's done it. Twice.

Additionally, most airlines contract with on-the-ground emergency medical consultants who can be contacted from the air. “In addition to MedAire,” said ATA’s Andrus, “the University of Pittsburgh Medical Center, the Mayo Clinic and several other companies provide that service and some airlines have their own in-house medical assistance.”

The consultants on the ground can help assess a situation and have the proper medical teams ready to meet a plane. They can also help decide if the flight should be diverted.

Airlines are ready — you should be, too
While it may be comforting to know that airlines are prepared for in-flight medical emergencies you should do whatever you can to avoid being the in-flight emergency. However, according to Dr. McMullen and the folks at MedAire, some travelers unwittingly put themselves at risk. For starters, while most healthy passengers can tolerate the cabin pressure onboard airplanes, it can cause problems for people with borderline heart and lung conditions.

And just getting to the airport and on the plane can set some people up for disaster. As Dr. Paulo Magalhães Alves points out in a MedAire advisory: “A great number of air travelers have to walk longer distances and carry more weight throughout the airport than they are accustomed to doing in their ordinary lives. Passengers may also be in a hurry, adding stress to the situation. [P]assengers could easily cross their safety limit if they already have, knowingly or not, a ... heart condition.”

Now isn’t that the best argument you’ve heard yet for packing light, getting to the airport with plenty of time to spare and staying relaxed no matter what happens?

Airport assistance for what ails you
If you do feel sick at the airport, don’t wait until you’ve boarded to do something about it.Lydia Kellogg, senior manager for public safety and security at Airports Council International-North America, said most airports have plenty of AEDs, as well as firefighters, EMTs and other staff who can respond quickly to a medical emergency.

Kellogg should know. She had an asthma attack last year at Reagan National Airport in Washington, D.C. “I couldn’t breathe. I was dizzy and I felt faint,” she said, “so I flagged down the nearest guy with a safety vest. He was able to summon the fire department and they arrived within two minutes.”

Flagging down an airport employee or the nearest guy in a safety vest, asking someone to go get help or just opening up your cell phone and dialing 911 is what Dr. John Zautcke prescribes for anyone who gets ill at an airport. Zautcke is the medical director at the University of Illinois Medical Clinic at O’Hare International Airport, and says if you’re at the “right” airport, you could also pop in and see a doctor. In addition to O’Hare, there are on-site medical clinics in San Francisco, Denver, Atlanta, Newark, Honolulu and several other cities.

At some airports, including Los Angeles International and Boston’s Logan Airport, there are medical clinics close by. “Airport clinics can assess your problem and can often save you a trip to the emergency room, and if need be, we can provide a note you can give to the airline if we think you should not fly,” Zautcke said.

The bottom line: when you get sick on the road, get medical attention as soon as possible. “Don’t be shy,” says Dr. McMullen. “If you feel ill in the airport, speak up. If you feel ill on an airplane, tell the flight attendant.”

And don’t forget that there are emergency call buttons in airplane bathrooms.

Harriet Baskas writes msnbc.com's popular weekly column, The Well-Mannered Traveler. She is the author of the “Stuck at the Airport” blog, a contributor to National Public Radio and a columnist for USATODAY.com.

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