Use of automated external defibrillators in a major Latin America airline: 5 years' experience

Background

Passengers who have ventricular fibrillation, the most common mechanism, aboard commercial aircraft rarely survive, and can be treated effectively only with prompt defibrillation. The objective of this study was to assess the impact of making automatic external defibrillators (AEDs) available for use on a major Latin Ameica airline for passengers with cardiac arrest.

Methods

In 1998, Varig Brazilian Airlines began the onboard defibrillation program with AEDs. Flight attendants were trained in the use of the defibrillator and applied the device when passengers had a lack of consciousness, pulse, or respiration. A portable monitor (Biolog 3000; Micromedical) was added and an electrocardiogram that was obtained during each use of the device. We analyzed data on all 18 instances in which the defibrillators were used between May 1998, and October 2002.

Results

AEDs were used for 18 patients. The administration of shock was advised in nine patients who had electrocardiographically documented ventricular fibrillation, and no shock was advised in the remaining patients (sensitivity and specificity of the defibrillator in identifying ventricular fibrillation, 100%), 50% of the rhythm was pulseless electrical activity (probably the 'silent dead'). The first shock successfully defibrillated the heart in nine patients (100%).

Conclusions

The expansion of the knowledge of the AEDs and the corrected implantation of the chain of survival 'on board' will increase the extense of recovery of cardiopulmonary arrest victims in aircrafts.