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Medical Guidelines for Airline Travel: Management of In-Flight Cardiac Arrest
Aerospace Medicine and Human Performance
|July 19, 2018
Summary
Carry automated external defibrillators (AEDs) on all flights to improve survival from in-flight cardiac arrest. Prompt treatment for shockable rhythms is crucial, but diversion decisions require careful consideration of operational factors.
Area of Science:
- Aerospace Medicine
- Emergency Medicine
- Cardiology
Background:
- In-flight cardiac arrest presents unique challenges due to limited resources and variable medical volunteer skills.
- Survival rates for out-of-hospital cardiac arrest (OHCA) improve with witnessed arrests, shockable rhythms, and prompt defibrillation using automated external defibrillators (AEDs).
- Not all in-flight cardiac arrests are recognized, as victims may be mistaken for sleeping passengers.
Purpose of the Study:
- To recommend the carriage of AEDs on all commercial airline flights.
- To provide guidelines for managing in-flight cardiac arrest, including decisions regarding aircraft diversion.
- To address the challenges of resuscitation in the unique environment of commercial air travel.
Main Methods:
- Literature review on resuscitation after out-of-hospital cardiac arrest (OHCA).
- Development of recommendations by the Air Transport Medicine and Aerospace Human Performance Committees.
- Approval of recommendations by the Council of the Aerospace Medical Association.
Main Results:
- Patients with a shockable rhythm (ventricular fibrillation or unstable ventricular tachycardia) have the best prognosis.
- Prompt treatment with AEDs and cardiopulmonary resuscitation (CPR) can improve survival rates.
- Aircraft diversion for advanced cardiac life support (ACLS) is often necessary for shockable rhythms but requires careful consideration.
Conclusions:
- Automated external defibrillators (AEDs) should be carried on all commercial airline flights, irrespective of flight duration.
- Decisions to divert aircraft for patients with non-shockable rhythms must involve a discussion of outcomes and operational factors among rescuers, crew, and medical support.
- Standardized medical guidelines are essential for managing in-flight cardiac emergencies effectively.
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