In-flight automated external defibrillator use and consultation patterns

Area of Science:

• Aviation Medicine
• Emergency Medical Services
• Cardiology

Background:

• Limited data exists on the use and outcomes of automated external defibrillators (AEDs) during commercial airline flights.
• Understanding in-flight AED application is crucial for improving emergency cardiac care in the unique environment of air travel.

Purpose of the Study:

• To characterize the use of AEDs during in-flight medical emergencies.
• To determine the outcomes of automated external defibrillator (AED) application in patients experiencing cardiac arrest on commercial flights.
• To analyze patterns of ground medical consultation associated with in-flight AED use.

Main Methods:

• A retrospective review of 169 automated external defibrillator (AED) applications reported to an airline consultation service across three U.S. airlines (May 2004-March 2009).
• Data collected included patient demographics, initial cardiac rhythm, shock delivery and success, survival to admission, and use of ground medical consultation.
• Cardiac rhythms were classified, and success was defined as return of a perfusing rhythm.

Main Results:

• Of 169 AED applications, 40 involved cardiac arrest. Survival was 15% overall (6/40), with 50% survival (5/10) for patients with initial ventricular fibrillation/ventricular tachycardia (VF/VT).
• AEDs were used for monitoring in 129 cases (76%). Fourteen patients received defibrillation, primarily for VF/VT.
• Ground medical consultation was obtained in only 33-35% of AED use cases and cardiac arrests.

Conclusions:

• In-flight AED use achieved a 50% survival rate for ventricular fibrillation/ventricular tachycardia (VF/VT) cardiac arrest, highlighting the device's potential.
• Overall survival for in-flight cardiac arrest remains poor (15%), particularly for non-shockable rhythms.
• The study underscores the need for increased utilization of ground medical consultation during in-flight medical emergencies involving AEDs.