Eleven people were seriously injured in turbulence on a Hawaiian Airlines flight.
The flight, carrying 278 passengers and 10 crew members, encountered severe turbulence just 30 minutes from Honolulu as it departed Phoenix, USA.
The Airbus A330 landed safely and 36 people were treated for serious head injuries, bruises, lacerations and loss of consciousness, according to Honolulu Emergency Medical Services.
Of the 20 injured, 11 were taken to hospital in serious condition and the other nine were in stable condition.
Sixteen people were treated at the airport.
The youngest patient was only 14 months old.
Passenger Kaylee Reyes told Hawaii News Now that her mother had just returned to her seat when the turbulence hit.
Ms Reyes said she was not given the opportunity to buckle up before she “flew up and hit the ceiling”.
Hawaiian Airlines said 13 passengers and three crew members were taken to the hospital, but it was unclear why their numbers differed from those given by emergency services.
“We are supporting all affected passengers and staff and will continue to monitor the situation,” the airline added.
A powerful cold front is moving across Hawaii, bringing damaging winds, potentially severe thunderstorms, heavy rain and flooding, according to the National Weather Service.
NWS meteorologist Thomas Vaughan said a thunderstorm forecast has been issued for Oahu and areas that would have included the flight path at the time of the incident.