Emergency at altitude: exploring physicians’ knowledge, preparedness, and perspectives on in-flight medical emergencies in Saudi Arabia

<b>BACKGROUND:</b> In-flight medical emergencies (IMEs) present significant challenges to healthcare professionals, particularly those with limited training or experience in managing such situations. The objective of this study was to evaluate the level of knowledge, attitudes, and behaviors of licensed doctors in Saudi Arabia concerning IMEs, and to identify the demographic factors influencing their preparedness. <b>METHODS:</b> A cross-sectional study was conducted with a sample of 383 licensed physicians across five regions of Saudi Arabia. Participants completed a self-administered questionnaire assessing demographics, knowledge of IMEs, attitudes towards providing assistance, and previous experience with in-flight emergencies. Data were analyzed using SPSS 26, with statistical significance set at <i>P</i><0.05. <b>RESULTS:</b> The results revealed a predominantly young (75.8% aged 25-34 years) and male (69.6%) participant pool. While 76.6% of respondents recognized the impact of cabin pressure on oxygen, only 45.4% correctly identified air travel risks for asthmatic patients. Although 66.8% felt confident assisting in IMEs, 20.9% cited medicolegal concerns. Moreover, area of working within Saudi Arabia (<i>P</i>=0.020), year of experience (<i>P</i>=0.041), prior experience with IMEs (<i>P</i>=0.021), and IMEs training (<i>P</i><0.001) had a significant association with levels of knowledge. <b>CONCLUSION:</b> The study highlights a critical need for enhanced training programs with a focus on the management of IMEs among healthcare practitioners in Saudi Arabia.