In-Flight Medical Emergencies: What Really Happens at 35,000 Feet
If you’ve ever wondered what happens when someone gets sick on a plane, here’s the honest version: we don’t “guess,” we don’t “Google,” and we definitely don’t hand out medical care like it’s a mint basket.
This topic came up on our Episode 70 transcript after a very real, very unpleasant situation: a crew member tried an unfamiliar bottled “vitamin C” drink while abroad, drank the whole thing, and then spent a long-haul doing the most aggressive cardio known to humankind—sprinting to the lav and trying to function in a job where “taking a break” is not a thing.
And that story lands on the bigger point: in-flight medical emergencies aren’t rare. In the episode, we referenced that roughly 1 out of every 600 commercial flights has a medical emergency. The CDC’s travel medicine guidance puts it at about 1 in every 604 flights, which is basically the same message: this happens all the time.
CDC reference: https://www.cdc.gov/yellow-book/hcp/travel-air-sea/perspectives-responding-to-medical-emergencies-when-flying.html
This post explains what actually happens onboard, why there are rules around medical kits and medications, and what you can do as a passenger to avoid becoming the main character at cruising altitude.
What counts as an “in-flight medical emergency”?
Most people picture a dramatic collapse and a call for a doctor.
Sometimes it’s that. Often it’s not.
The CDC notes that common in-flight emergencies include fainting/presyncope, respiratory symptoms, and nausea/vomiting—which sounds a lot like “travel day as a lifestyle.”
CDC reference: https://www.cdc.gov/yellow-book/hcp/travel-air-sea/perspectives-responding-to-medical-emergencies-when-flying.html
When symptoms are severe enough that someone can’t safely remain seated, can’t keep fluids down, is having trouble breathing, has chest pain, shows signs of stroke, or is having an allergic reaction—now it’s an emergency. And it becomes an operational issue fast.
The flight attendant playbook: what we do (in plain English)
1) We assess and stabilize
We check responsiveness, breathing, and immediate risk. We keep the person safe and seated/positioned appropriately, and we manage the scene (because crowds don’t help anyone breathe).
2) We call for medical professionals onboard
Flight attendants are trained in first aid and emergency response, but we are not licensed medical providers. That matters, because some interventions and meds are governed by protocol and medical direction.
3) We contact ground medical support (“doctor on the ground”)
Many airlines use air-to-ground medical advisory services (the industry knows this category as “MedLink-style” support), where clinicians guide the crew in real time based on what’s happening and what resources are onboard.
Example (industry reference): https://www.medaire.com/products-services/commercial-aviation-products-services/medical-and-aviation-security/medaires-medlink-medical-advisory-service
This is how you get better decision-making than “well, I saw a TikTok about this once.”
4) We decide whether to continue or divert
Most flights continue to destination. The CDC notes that aircraft continue to destination for the majority of medical events, with diversions being the minority and typically tied to higher-risk presentations (cardiac issues, stroke concerns, etc.).
CDC reference: https://www.cdc.gov/yellow-book/hcp/travel-air-sea/perspectives-responding-to-medical-emergencies-when-flying.html
Diversions are not “dramatic for fun.” They’re expensive, disruptive, and done when the medical risk justifies it.
“Why can’t you just give them the medication?” Medical kits, AEDs, and the rules
This is the part that surprises passengers: planes can have serious medical equipment onboard, but that doesn’t automatically mean the crew can administer everything.
In the U.S., the FAA requires certain emergency medical equipment on passenger-carrying aircraft under Part 121—this includes first aid kits, an emergency medical kit (EMK) on aircraft where a flight attendant is required, and an AED under certain conditions.
FAA regulation reference (14 CFR § 121.803): https://www.law.cornell.edu/cfr/text/14/121.803
The CDC also summarizes these requirements at a high level in its aviation medical emergency overview.
CDC reference: https://www.cdc.gov/yellow-book/hcp/travel-air-sea/perspectives-responding-to-medical-emergencies-when-flying.html
What that means in real life:
There are protocols about access to and use of the EMK.
The crew may need medical direction (and in some cases a qualified medical professional onboard) for certain medications or interventions.
The goal is safe care within training, authorization, and documented procedures—not improvisation.
If you’ve ever wondered why the crew is asking for a doctor while there’s a medical kit onboard, this is why.
The “mystery vitamin C” problem: don’t experiment right before (or during) travel
Let’s talk about the mistake that started the whole conversation: trying a new supplement drink abroad and chugging it like it’s a hydration hack.
Even plain vitamin C, at high supplemental doses, can cause digestive side effects—diarrhea, upset stomach, vomiting, and more.
Mayo Clinic reference: https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/vitamin-c/faq-20058030
Now combine that with:
jet lag,
dehydration,
unfamiliar ingredients/labeling,
anxiety,
and a long flight with limited “quiet recovery” options.
It’s not a wellness routine. It’s a speedrun.
Practical rule:
Do not trial new supplements, “immune shots,” detox products, or mystery beverages within 24–48 hours of flying—especially long-haul. If you wouldn’t test it right before a job interview, don’t test it right before you’re sealed in an aluminum tube for 10 hours.
What you should do before you fly (so we don’t meet under worst-case circumstances)
Important note: This is travel guidance and common-sense prep, not medical advice. If you have specific conditions or questions, talk to your clinician before traveling.
Keep medications in your carry-on (not checked)
If you need it to function, it should stay with you. Bags get delayed. Your body does not care.
TSA guidance for traveling with medications:
Liquid medications: https://www.tsa.gov/travel/security-screening/whatcanibring/items/liquid-medications
TSA medical items list: https://www.tsa.gov/travel/security-screening/whatcanibring/medical
Tell the crew early if something is trending badly
Don’t wait until it’s a full event. Early notice allows the crew to:
reposition you,
assess you calmly,
contact ground medical support sooner,
and avoid the “sudden emergency in the aisle” situation.
If you have severe allergies or known risks, don’t assume the plane is your backup plan
Carry your prescribed emergency meds and know where they are. The inflight environment is controlled, but it’s not a hospital, and time matters in allergic reactions.
Don’t stack dehydration + alcohol + “new supplement”
If your travel plan includes champagne, airport snacks, and experimental wellness products, you are building a three-part documentary called Regret: The Series.
What happens if you get sick onboard?
Here’s what to expect:
The crew will assess you and keep you safe.
We’ll ask if there are medical professionals onboard.
We may contact ground medical support for guidance.
If symptoms suggest high risk, diversion may be considered.
The key variable is severity and risk—not whether the flight is “almost there,” not whether someone has a connection, and not whether it’s inconvenient. (It’s always inconvenient. That’s not the deciding factor.)
Final Cabin Pressure takeaway
Medical emergencies happen more often than most travelers realize—and most of them don’t look like a movie scene. The best outcomes usually come from two things:
Preparation (carry what you need, don’t experiment with your body right before a flight), and
Early communication (tell the crew before it becomes critical).
Question for you (drop it in the comments)
What’s your go-to “I always travel with this” item for staying healthy on the road—and have you ever tried a travel supplement or “airport wellness” product that immediately backfired?
✍️ Written by Shawn Smith, a working flight attendant and co-host of Cabin Pressure with Shawn & G.
References
CDC Yellow Book – Responding to Medical Emergencies When Flying
FAA Regulation – 14 CFR § 121.803 Emergency medical equipment (Legal Information Institute)
https://www.law.cornell.edu/cfr/text/14/121.803
Mayo Clinic – Too much vitamin C: Is it harmful?
TSA – Traveling with medication FAQ
TSA – Liquid Medications (What Can I Bring?)
https://www.tsa.gov/travel/security-screening/whatcanibring/items/liquid-medications
TSA – Medical items (What Can I Bring?)
https://www.tsa.gov/travel/security-screening/whatcanibring/medical
MedAire – MedLink Medical Advisory Service (industry example of air-to-ground support)
