Cardiopulmonary resuscitation in commercial aircraft - evidence -based recommendations of the DGLRM guideline

Approximately 3 billion people worldwide travel by commercial air transport annually. A calculation based on the number of passengers transported shows that between 1 out of 14,000 to 1 out of 50,000 transported passengers will experience acute medical problems during a flight. Cardiac arrest accounts for 0.3% of all in-flight medical emergencies. However, it is responsible for 86% of in-flight events resulting in death. So far, no guideline for inflight cardiac arrest (IFCA) does exist to provide specific treatment recommendations. A task force was created to develop a guideline for the treatment of in-flight cardiac arrest based on clinical and investigational expertise in this area. By using a systematic literature search including Grade, Rand and Delphi methods, specific recommendations for the treatment of IFCA have been created. Several main recommendations have been developed: emergency equipment location as well as content should be mentioned in the preflight safety announcement; ECG should be available for patients with cardiac arrest, it is very important to request help by an on -board announcement after identification of a patient with cardiac arrest; two -person CPR is considered optimum and should be performed if possible; the crew should be trained regularly in basic life support - ideally with a focus on CPR in aircraft; a diversion should immediately be performed if the patient has a return of spontaneous circulation.