In June 1995, physicians Angus Wallace and Tom Wong were waiting for their flight to depart Hong Kong to London when they were asked to examine a woman complaining of arm pain caused by a "fall." After takeoff, the doctors returned to the woman to put a splint on her arm but they quickly realized that her injuries were much more serious than she had first reported. Not only did the woman have arm and rib fractures, her lung was punctured and air leaking between her lung and chest wall had caused a pneumothorax. The condition is life threatening if not treated and Wallace believed the change in air pressure upon landing would kill her. So Wallace and Wong had to improvise. From Wikipedia:
The medical kit had lidocaine – a local anaesthetic – but the catheter in the kit was designed only for urinary catheterisation and was too soft for use as a chest tube. The doctors fashioned a trocar from a metal clothes hanger to stiffen the catheter, and a check valve from a bottle of water with holes poked in the cap. They sterilised their equipment in Courvoisier cognac, and began surgery by making an incision in the patient's chest, but with no surgical clamps available, Wong had to hold the incision open with a knife and fork while Wallace inserted the catheter. The whole surgery lasted about ten minutes; the doctors successfully released the trapped air from the patient's chest, and she passed the rest of the flight uneventfully, eating and watching in-flight movies.
In the aftermath, Wallace and Wong published a brief article in the British Medical Journal about the incident. Wallace also testified before a Parliamentary committee investigating British airlines' alleged lack of investment in on-board medical equipment. He was even more critical of US airlines in this regard, noting that his efforts would have been impossible with typical US airline medical kits not even containing aspirin, and stated that "There needs to be a major change in attitudes in the U.S., both from the government and from the airlines."