The claustrophobic patient:
check the patient first...
I would not give o2 via NRB prophylactically just because they have a Hx of claustrophobia. Many anxiety disorder patients exhibit hyperventilation as a symptom leading up to and during an episode. Giving 02 to an already hyperventilating pt via a nonrebreather would be counter-productive. So check your patient for this before this Tx.
When hyperventilating, Patients tend to breathe by using the upper thorax rather than the diaphragm, which results in chronic over inflated lungs. When the stress induces a need to take a deep breath, the deep breathing is perceived as dyspnea. The sensation of dyspnea creates anxiety, which encourages more deep breathing, and a vicious cycle is created.
To treat, instruct the patient to breathe abdominally, using the diaphragm more than the chest wall. This often leads to improvement in 'subjective' or patient perceived dyspnea and eventually corrects many of the associated symptoms.
Otherwise, I would calm the patient, put in a comfortable position, tell the FA to see about activating her protocol for giving the passenger a sedative ( short acting benzo if available). I would imagine major airlines have a med kit on teh plane with sedatives as well as a protocol for their use. I would not put my Butt on the line prescribing or telling a FA to give a medication, especially in a non emergency case such as this. No caffeine or other stimulants for the patient during the flight.
The asthma patient:
My guess is that the plane's med kit has an inhaler ( probably albuterol). Tell the FA to go and visually check for its existence. If available, give patient prophylactic dose to inhale after quick med hx. Again, place pt in low stress environment ( as low as possible)... oxygen is good to calm patient if feeling symptoms of dyspnea. Usually want to place patient in a comfortable environment avoiding HOT/MOIST air and Cold/dry air environments. Also have patient avoid caffeine, as it is a common trigger for asthma attacks.
If an asthma attack actually would have occurred-
02 immediately. If no inhaler available, ask patient to notify of any oncoming attack asap ( if they can tell, they usually can) and in an emergency the planes epi pen can be used to bronchodilate to stop the attack. During a severe attack, I would have asked the FA to announce over the PA to see if a passenger on board had an inhaler with them.
That’s my .02....
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