It is estimated that thousands of air travelers around the world suffer cardiac arrest each year, with nearly a quarter of them occurring on an airplane on average.
The new study, published Tuesday in the Journal of the American Heart Association, comes at the end of a summer when travelers were returning en masse to airports and planes after pandemic lockdowns.
Because cardiac arrests are relatively rare on commercial flights, few studies have looked at their frequency, use of lifesaving measures, and outcomes. Researchers in the new study wanted to assess the impact of a 2004 Federal Aviation Administration requirement that all US commercial airlines be equipped with automated external defibrillators, or AEDs.
They looked at the Seattle-Tacoma International Airport records of every adult who was treated by emergency services for a cardiac arrest in which the heart suddenly stops beating due to an electrical malfunction. A heart attack can cause cardiac arrest, as well as other heart and non-heart problems.
Over a 16-year period, from 2004 to 2019, they tracked 143 cardiac arrests that occurred before the ambulance arrived, with 34 (24%) occurring on an airplane and 109 (76%) occurring outside of the airplane. People who had cardiac arrest at the airport survived hospital discharge 44% of the time, compared with 15% of those who had cardiac arrest on an airplane.
That’s still higher than the nationwide average survival rate of less than 11% in out-of-hospital cardiac arrest, indicating the importance of CPR and AEDs, said lead study author Dr. Neal Chatterjee. For example, he found that all cardiac arrest survivors on the plane were treated with an AED.
“Our study has shown that cardiac arrest is rare, but it can certainly survive if we can intervene early on. Flight attendants and airport staff should be trained to intervene, but there are also things we can do as spectators on the plane or on board. Plane to improve results. “
Bystanders who see someone break down or stop responding should alert a flight attendant or airport employee immediately, Chatterjee said. If you are in an airport and are comfortable doing CPR until help arrives, that’s fine. But when you are on an airplane, you should alert the flight crew quickly and follow their cues.
“It is incredibly important that there is a calm, organized environment in which there is a responsible person. Trust the flight crew to make these decisions and wait to volunteer when they ask for help with resuscitation, ”said Chatterjee, cardiologist and cardiologist electrophysiologist at the University of Washington Medical Center in Seattle.
Around 5 billion people fly commercially every year around the world. When the researchers applied the results of their study to these numbers, they estimated that 2,000 travel-related cardiac arrests occur worldwide each year, including 350 in the United States
“I think the study offers a strong message of the importance of CPR training to viewers and also that the aviation industry is working with federal agencies to improve training in cardiac arrest management, and AED use in particular,” said Chatterjee. who is also an assistant professor of medicine at the University of Washington.
Dr. Benjamin Abella, director of the University of Pennsylvania’s Center for Resuscitation Science at Philadelphia and professor of emergency medicine, said the study was limited by the small sample size.
Still, Abella, who was not involved in the research, applauded the authors for showing that above-average survival rates can be achieved when a cardiac arrest is observed on an airplane or at an airport and CPR and AEDs are used immediately.
“The study is reassuring for both air travelers,” he said, “and a challenge for all of us to dramatically improve survival rates in other environments.”
He also wanted studies on passenger train traffic, “this is a completely unexplored area with a much broader population”.
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