In-flight cardiac arrest and in-flight cardiopulmonary resuscitation during commercial air travel: consensus statement and supplementary treatment guideline from the German Society of Aerospace Medicine (DGLRM)

Abstract

By the end of the year 2016, approximately 3 billion people worldwide travelled by commercial air transport. Between 1 out of 14,000 and 1 out of 50,000 passengers will experience acute medical problems/emergencies during a flight (i.e., in-flight medical emergency). Cardiac arrest accounts for 0.3% of all in-flight medical emergencies. So far, no specific guideline exists for the management and treatment of in-flight cardiac arrest (IFCA). A task force with clinical and investigational expertise in aviation, aviation medicine, and emergency medicine was created to develop a consensus based on scientific evidence and compiled a guideline for the management and treatment of in-flight cardiac arrests. Using the GRADE, RAND, and DELPHI methods, a systematic literature search was performed in PubMed. Specific recommendations have been developed for the treatment of IFCA. A total of 29 specific recommendations for the treatment and management of in-flight cardiac arrests were generated. The main recommendations included emergency equipments as well as communication of the emergency. Training of the crew is of utmost importance, and should ideally have a focus on CPR in aircraft. The decision for a diversion should be considered very carefully.

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Acknowledgements

The manuscript was prepared by the working group “guidelines, recommendations, and statements” of the German Society of Aerospace Medicine and reviewed by the board of the German Society of Aerospace Medicine (DGLRM). The authors thank Prof. Douglas Boyd (University of Texas) sincerely for his critical comments, language editing, and improving the quality of this manuscript.

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Correspondence to Jochen Hinkelbein.

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Conflict of interest

C.N. is the Treasurer of the German Society for Aviation and Space Medicine (DGLRM). E.D.R. received honorarium from MSD. E.G. is the CEO of the German Academy for Aviation and Travel Medicine (DAFR). H.G. received travel reimbursement for presentations from Ambu and VBM, Germany. J.H. is the President of the German Society for Aviation and Space Medicine (DGLRM) and Treasurer of the European Society of Aerospace Medicine (ESAM) as well as Chairman of the ESAM Space Medicine Group; J.S. is employed at Lufthansa. C.A., A.H., M.B., S.J., J.A., P.K., F.C., I.J., and M.K. have no conflicts of interest.

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Jochen Hinkelbein is the Chairman of the task force.

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Hinkelbein, J., Böhm, L., Braunecker, S. et al. In-flight cardiac arrest and in-flight cardiopulmonary resuscitation during commercial air travel: consensus statement and supplementary treatment guideline from the German Society of Aerospace Medicine (DGLRM). Intern Emerg Med 13, 1305–1322 (2018). https://doi.org/10.1007/s11739-018-1856-4

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Keywords

  • CPR
  • Cardiopulmonary resuscitation
  • Cardiac arrest
  • Airplane
  • In-flight medical emergencies
  • BLS
  • AED