Hello.
I have no aviation knowledge specifically. I have dropped in as a doctor, doing a repat flight yesterday, to see if there was anything to cause the go around and hold at DUB yesterday due to a blocked runway.!!
If I may just make a few points.
1) The real thing is very different from 'training' No matter how well you train..you are never completely prepared, though to think through what you need to do will help you work more efficiently and safely through the situation. Though of course in the aviation industry, lots of your training is for situations that you hope will not occur in real life.
2) If the pilot has arrested, his chance of survival outside a hospital setting is very small. Effective management and treatment will increase his survival odds, but they are still small.
It is therefore imperative that the other healthy individuals on the plane are not jeapordised by trying to extracate from the seat. Do not underestimate how awkward heavy and difficult corpses/unconscious people are to move. You will need one person to protect the head/neck, and others to move the trunk. They will need lying somewhere eg the galley.If there is any risk whatsoever of risking the safety of the others on the plane DO NOT DO IT!!!
I have never had to do rescussitation on a plane, but my impression is that it would be very difficult because of the cramped conditions and noise.They would need lying down on a firm surface, I suppose in the galley.
3) You need to get effective cpr (cardiac massage ) as soon as possible, and if you have an automatic defib on the plane get it connected, and get a reading as quickly as possible to see if there is something that would benefit from a shock. These things are really good and idiot proof these days, and you cannot do any damage with them!!
worth a couple of mins of your time having a look at it if you havnt.
4) \You are right that the guidelines have changed recently...or they are doing in 2011..
http://www.resus.org.uk/pages/guidesum.pdf
5) In the resuscitation council guidelines, 'call for help' is number one on the list...even for people who supposedly know what they are doing....so you should too.
Nurse doctor paramedic, ask for them all. An ER nurse is going to be more use than an ophthalmologist, but find out who you have on board. You might have someone like me going to do a medical retrieval, with a defib in my hand luggage!!!! If you dont ask you may never know.
6) Speed in getting effective cpr under way is crucial.
We had a lady in the er a couple of weeks ago all monitored, with something completely different , when all of a sudden she had a cardiac arrest!!!! Defibbed within 10 seconds, and virtually carried on with the conversation where she left off!!!
I was at a concert, and an old guy became ill and was led outside, I and a collegue, a consultant anaesthetist administered effective cpr for half an hour from the moment he collapsed. By the time the ambulance appeared 45 mins later, he had come round. Though we will never know what happened for sure, the likelihood is that the guy must have developed an abnormal heart rhythm that did not give him a pulse. we kept him going till his heart clicked back into a rhythm with a pulse. ...so it is worth giving it a good go, but he was lucky to be right by two experienced docs.
7) I wouldnt get too involved in discussions about pupil size any more than I would get involved in discussions about wind shear!!
I hope this is useful, and I hope it never happens!!