Defibrillators save lives aboard American's jets

Thursday, October 26th 2000, 12:00 am
By: News On 6

40% of heart attack victims recovered during study

By Katherine Yung / The Dallas Morning News

Thousands of feet in the air, flight attendants on American Airlines planes are saving heart attack victims at rates surpassing those of even emergency medical personnel, according to a study examining use of the medical devices over a two-year period.

Forty percent of passengers recovered after being treated with a defibrillator aboard an American plane during the period, compared with rates of 30 percent or lower for firefighters or paramedics, the study reported. The airline attributed the difference to trained flight crews with easy access to the defibrillators.

"We believe that these devices should become standard equipment for all commercial aircraft," the study's authors wrote in Thursday's issue of The New England Journal of Medicine.

They have a good chance of getting their wish. Early next year, the Federal Aviation Administration is expected to issue a rule that would require all airlines to install defibrillators on their aircraft.

"Technology has brought us to where they are small enough to be put on aircraft, and they are easy enough to use that you can quickly train someone," said American spokesman John Hotard.

A defibrillator sends electrical shocks to a person's heart when it begins beating abnormally. The shocks can return the heart to its normal pattern, preventing a heart attack from causing death.

Although costly, the devices have made a difference on American planes, the airline and researchers said. Since March 1997, when American started to equip some planes with them, flight attendants have hooked the defibrillators to passengers 409 times.

In most instances, the passenger had some type of heart trouble but wasn't experiencing a heart attack, and the device was used to monitor the person's condition.

However, in 32 instances, the defibrillators were used to shock a passenger's heart. In half of the 32 cases, the passenger died aboard the aircraft. Of the other 16 cases, 11 passengers are still alive and five were alive when they left the plane but subsequently died. These figures, provided Wednesday by American, contain more recent data not included in the study.

"By and large, the experience has been very positive," said Emily Carter, national health coordinator for the Association of Professional Flight Attendants, the union representing American's 23,000 flight attendants. "These things are going to become as common as fire extinguishers."

The Association of Flight Attendants, which represents more than 49,000 other attendants at 27 carriers, isn't opposed to the use of defibrillators and thinks it is a good lifesaving device, said Candace Kolander, the union's coordinator of air safety and health. However, the union wants airlines to ensure that flight attendants receive adequate training, she said.

Under the Aviation Medical Assistance Act of 1998, flight attendants and passengers who assist in administering defibrillators cannot be sued except in cases of "gross negligence or willful misconduct." Ms. Carter said that she knows of no incidents where American flight attendants made any mistakes using the devices.

As of May, when the FAA issued a notice of a proposed rule requiring all commercial airlines to equip their planes with defibrillators, eight major and six regional airlines either carried the devices or planned to do so, the agency said.

All planes owned by Dallas-based Southwest Airlines Co. will contain the equipment by the beginning of next year, said Kathy Pettit, one of the airline's managers of inflight training.

Over 10 years' time, the FAA has estimated, it will cost the industry $138 million to install defibrillators, add certain drugs to onboard medical kits and train flight crews. Defibrillators normally cost between $2,000 and $3,000 each, but airlines can negotiate discounts.

American estimates that it has spent several million dollars to buy the devices and train flight attendants to use them. It now carries defibrillators on each of its 720 planes, and its regional affiliate, American Eagle, is currently adding them to its jets and turboprop planes.

Airlines aren't the only ones adding defibrillators. On Wednesday, Dallas/Fort Worth International Airport announced it will install 30 of the devices around its facilities, particularly in baggage claim areas, where many cardiac arrests occur. The public can access the defibrillators in clearly marked cabinets that will also contain instructions and pictures to guide users.

The study was conducted by a group of eight physicans and one nurse. One physician, Richard Page, has served as a consultant to Hewlett-Packard's Agilent Technologies, which manufactured the defibrillators used in the study and has worked as a consultant to American on its defibrillator program. In addition, another physician, David McKenas, is American's corporate medical director.

According to the report, if defibrillators were used on all commercial planes worldwide, the devices would be used 2,975 times for 452 patients experiencing cardiac arrest aboard an aircraft, saving 93 lives each year. It cited data showing that 108 people died on 15 major U.S. airlines from July 1, 1998, through June 30, 1999.