Your first day as a doctor

First things first, I get that this is a very pressing emergency, but I'd make it very clear to everyone present (including Japanese man, but fortunately I can speak some Japanese!) that I'm not a licenced doctor yet.

I would carry out basic first aid tasks such as supporting him against a wall with his knees drawn up to his chest (iirc) and then do as many observations such as resp rate, pulse rate that I could without any equipment while I wait for the real doctors to arrive and take over.

You make your way to the back of the cabin and introduce yourself to the staff. Looking relieved, they rush you over to where a man is sitting. He is Japanese, in his 50's and dressed in a sharp suit. He is clutching his chest and complaining of crushing pain. He looks terrible - pale, sweaty, clammy, breathless.

Now what?

The cabin crew acknowledge that you're not a fully qualified doctor yet, but unfortunately you are the only person on board who can help. Thankfully, the patient speaks English. You take a history from him and do some observations. To cut a long story short, it is clear that he is having a heart attack. You are 40,000 feet over the atlantic ocean - it will be several hours before medical help can take over.

Now what?

Ok, since he's sweaty and breathless does this suggest it is cardiac related?

And the patient speaks perfect English and he's a hedge fund manager who works between NY/Lon/Tokyo.

The cabin crew acknowledge that you're not a fully qualified doctor yet, but unfortunately you are the only person on board who can help. Thankfully, the patient speaks English. You take a history from him and do some observations. To cut a long story short, it is clear that he is having a heart attack. You are 40,000 feet over the atlantic ocean - it will be several hours before medical help can take over.

Now what?

Give him aspirin?

Or maybe the patient has his own GTN spray?

You ask the cabin crew for some aspirin and GTN spray. They don't know what you're talking about, but hand you the on-board medical pack. Looking through it, you find a stethoscope and sphygmomanometer (BP monitor) and a load of drugs, half of which you haven't heard of ever, as it is a US flight and so most of the medicines aren't UK standard. Nevertheless, you find some aspirin and sublingual GTN tablets. It's quite a budget airline though - you check the expiry date - it reads 2006. Still give it?

The cabin crew acknowledge that you're not a fully qualified doctor yet, but unfortunately you are the only person on board who can help. Thankfully, the patient speaks English. You take a history from him and do some observations. To cut a long story short, it is clear that he is having a heart attack. You are 40,000 feet over the atlantic ocean - it will be several hours before medical help can take over.

Now what?

You ask the cabin crew for some aspirin and GTN spray. They don't know what you're talking about, but hand you the on-board medical pack. Looking through it, you find a stethoscope and sphygmomanometer (BP monitor) and a load of drugs, half of which you haven't heard of ever, as it is a US flight and so most of the medicines aren't UK standard. Nevertheless, you find some aspirin and sublingual GTN tablets. It's quite a budget airline though - you check the expiry date - it reads 2006. Still give it?

You ask the cabin crew for some aspirin and GTN spray. They don't know what you're talking about, but hand you the on-board medical pack. Looking through it, you find a stethoscope and sphygmomanometer (BP monitor) and a load of drugs, half of which you haven't heard of ever, as it is a US flight and so most of the medicines aren't UK standard. Nevertheless, you find some aspirin and sublingual GTN tablets. It's quite a budget airline though - you check the expiry date - it reads 2006. Still give it?

You ask the cabin crew for some aspirin and GTN spray. They don't know what you're talking about, but hand you the on-board medical pack. Looking through it, you find a stethoscope and sphygmomanometer (BP monitor) and a load of drugs, half of which you haven't heard of ever, as it is a US flight and so most of the medicines aren't UK standard. Nevertheless, you find some aspirin and sublingual GTN tablets. It's quite a budget airline though - you check the expiry date - it reads 2006. Still give it?

I have no idea. I'd like to open a line of communication quickly with a more qualified doctor on the ground to find out. At a guess, the aspirin could be toxic due to decomposition into it's constituant acids but I've no idea about the GTN.

I'm no pharmacist but I wouldn't be too bothered about expiry dates. I doubt it's going to poison him and the potential benefits certainly outweigh the risks. Someone correct me if I'm wrong though. Tannoying the rest of the passengers for in-date aspirin and GTN is a brilliant idea though.

I'm no pharmacist but I wouldn't be too bothered about expiry dates. I doubt it's going to poison him and the potential benefits certainly outweigh the risks. Someone correct me if I'm wrong though. Tannoying the rest of the passengers for in-date aspirin and GTN is a brilliant idea though.

I'm also guessing that someone is legally obliged, or will have, to phone the airport(s) to inform the right people about the current situation? And if possible, get communication going between a much more qualified, experienced airport doctor who could help in the scenario.

Give him the aspirin and check his BP?