Incidence, Mechanism, and Outcomes of On‐Plane Versus Off‐Plane Cardiac Arrest in Air Travelers

Background Air travel affords an opportunity to evaluate resuscitation performance and outcome in a setting where automated external defibrillators (AEDs) are readily available. Methods and Results The study cohort included people aged ≥18 years with out of hospital cardiac arrest (OHCA) traveling t...

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Autores principales: Neal A. Chatterjee, Kosuke Kume, Christopher Drucker, Peter J. Kudenchuk, Thomas D. Rea
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Publicado: Wiley 2021
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Acceso en línea:https://doaj.org/article/cc152bc43c7a46eb8c93e363dbb57ca9
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spelling oai:doaj.org-article:cc152bc43c7a46eb8c93e363dbb57ca92021-11-23T11:36:35ZIncidence, Mechanism, and Outcomes of On‐Plane Versus Off‐Plane Cardiac Arrest in Air Travelers10.1161/JAHA.120.0213602047-9980https://doaj.org/article/cc152bc43c7a46eb8c93e363dbb57ca92021-09-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.120.021360https://doaj.org/toc/2047-9980Background Air travel affords an opportunity to evaluate resuscitation performance and outcome in a setting where automated external defibrillators (AEDs) are readily available. Methods and Results The study cohort included people aged ≥18 years with out of hospital cardiac arrest (OHCA) traveling through Seattle‐Tacoma International Airport between January 1, 2004 and December 31, 2019 treated by emergency medical services (EMS). The primary outcomes were pre‐EMS therapies (cardiopulmonary resuscitation, application of AED), return of spontaneous circulation, and survival to hospital discharge. Over the 16‐year study period, there were 143 OHCA occurring before EMS arrival, 34 (24%) on‐plane and 109 (76%) off‐plane. Cardiac etiology (81%) was the most common mechanism of arrest. The majority of arrests were bystander‐witnessed and presented with a shockable rhythm; these characteristics were more common in off‐plane OHCA compared with on‐plane (witnessed: 89% versus 74% and shockable: 72% versus 50%). Pre‐EMS therapies including cardiopulmonary resuscitation and AED application were common regardless of arrest location. Compared with on‐plane OHCA, off‐plane OHCA was associated with greater rates of return of spontaneous circulation (68% versus 44%) and 3‐fold higher rate of survival to hospital discharge (44% versus 15%). All survivors of on‐plane OHCA had AED application with defibrillation before EMS arrival. Conclusions When applied to air travel volumes, we estimate 350 air travel‐associated OHCA occur in the United States and 2000 OHCA worldwide each year, nearly a quarter of which happen on‐plane. These events are survivable when early arrest interventions including rapid arrest recognition, AED application, and CPR are deployed.Neal A. ChatterjeeKosuke KumeChristopher DruckerPeter J. KudenchukThomas D. ReaWileyarticleautomatic external defibrillatorcardiac arrestcardiopulmonary resuscitationDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 18 (2021)
institution DOAJ
collection DOAJ
language EN
topic automatic external defibrillator
cardiac arrest
cardiopulmonary resuscitation
Diseases of the circulatory (Cardiovascular) system
RC666-701
spellingShingle automatic external defibrillator
cardiac arrest
cardiopulmonary resuscitation
Diseases of the circulatory (Cardiovascular) system
RC666-701
Neal A. Chatterjee
Kosuke Kume
Christopher Drucker
Peter J. Kudenchuk
Thomas D. Rea
Incidence, Mechanism, and Outcomes of On‐Plane Versus Off‐Plane Cardiac Arrest in Air Travelers
description Background Air travel affords an opportunity to evaluate resuscitation performance and outcome in a setting where automated external defibrillators (AEDs) are readily available. Methods and Results The study cohort included people aged ≥18 years with out of hospital cardiac arrest (OHCA) traveling through Seattle‐Tacoma International Airport between January 1, 2004 and December 31, 2019 treated by emergency medical services (EMS). The primary outcomes were pre‐EMS therapies (cardiopulmonary resuscitation, application of AED), return of spontaneous circulation, and survival to hospital discharge. Over the 16‐year study period, there were 143 OHCA occurring before EMS arrival, 34 (24%) on‐plane and 109 (76%) off‐plane. Cardiac etiology (81%) was the most common mechanism of arrest. The majority of arrests were bystander‐witnessed and presented with a shockable rhythm; these characteristics were more common in off‐plane OHCA compared with on‐plane (witnessed: 89% versus 74% and shockable: 72% versus 50%). Pre‐EMS therapies including cardiopulmonary resuscitation and AED application were common regardless of arrest location. Compared with on‐plane OHCA, off‐plane OHCA was associated with greater rates of return of spontaneous circulation (68% versus 44%) and 3‐fold higher rate of survival to hospital discharge (44% versus 15%). All survivors of on‐plane OHCA had AED application with defibrillation before EMS arrival. Conclusions When applied to air travel volumes, we estimate 350 air travel‐associated OHCA occur in the United States and 2000 OHCA worldwide each year, nearly a quarter of which happen on‐plane. These events are survivable when early arrest interventions including rapid arrest recognition, AED application, and CPR are deployed.
format article
author Neal A. Chatterjee
Kosuke Kume
Christopher Drucker
Peter J. Kudenchuk
Thomas D. Rea
author_facet Neal A. Chatterjee
Kosuke Kume
Christopher Drucker
Peter J. Kudenchuk
Thomas D. Rea
author_sort Neal A. Chatterjee
title Incidence, Mechanism, and Outcomes of On‐Plane Versus Off‐Plane Cardiac Arrest in Air Travelers
title_short Incidence, Mechanism, and Outcomes of On‐Plane Versus Off‐Plane Cardiac Arrest in Air Travelers
title_full Incidence, Mechanism, and Outcomes of On‐Plane Versus Off‐Plane Cardiac Arrest in Air Travelers
title_fullStr Incidence, Mechanism, and Outcomes of On‐Plane Versus Off‐Plane Cardiac Arrest in Air Travelers
title_full_unstemmed Incidence, Mechanism, and Outcomes of On‐Plane Versus Off‐Plane Cardiac Arrest in Air Travelers
title_sort incidence, mechanism, and outcomes of on‐plane versus off‐plane cardiac arrest in air travelers
publisher Wiley
publishDate 2021
url https://doaj.org/article/cc152bc43c7a46eb8c93e363dbb57ca9
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AT kosukekume incidencemechanismandoutcomesofonplaneversusoffplanecardiacarrestinairtravelers
AT christopherdrucker incidencemechanismandoutcomesofonplaneversusoffplanecardiacarrestinairtravelers
AT peterjkudenchuk incidencemechanismandoutcomesofonplaneversusoffplanecardiacarrestinairtravelers
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