Guidelines for inflight CPR

[Code Blue]

After a recent occurence over the Atlantic, I was wondering if the experts here could shed some light on the above.

What SoPs or guidance is given to cabin crew on the matter of CPR in the cruise portion of the flight?

It's easy enough to start :eek: , but do you have any guidelines on whether or when to stop?

Rgds
CB

[ditzyboy]

Only the Pilot in Command can allow you to stop.... That includes doing it during final descent and immediately after landing. I cant remember whether or not we can do it DURING landing... I think we can actually!

Having said the above though - if you are too tired and no other crew member can relieve you I think we have the right to stop due to our own danger or risk to health.

Hope that helps.

[stormywx]

Hi Code Blue,

I'm a pilot and can confirm what ditzyboy has said, only the PIC can advise the crew to stop and usually that would only be after he/she has been in contact with the airlines ground medical staff and seeked advise on the situation. If there was a doctor on board however, it would be at their discresion.

It should be noted that NO-ONE crew included are actually legally required to begin CPR or to continue CPR if, at any stage there is a risk to themselves or other crew/pax. This could include, if the aircraft was experiencing turbulance, if the pax being treated was considered high risk or during an instrument approach and landing.

In the last 12 months, most large airlines (QF & DJ included) have linked up with ground medical organisations so they can get advise from trained medical personnel on any medical condition they may encount.

Cheers
stromy

[mainfrog2]

Our rules for CPR are

Stop if:

1 Signs of breathing and circulation resume
2 The scene becomes unsafe
3 CPR has been given for 30 mins with the defib advising No Shock and there being no signs of life.
4 You become too tired
5 Medlink advises you to stop
6 A/C lands and medical services arrive.

There's no requirement for any instruction from the flight deck other than what is passed to them by Medlink.

[flapsforty]

In our mob we are only allowed to stop if:

1 Signs of breathing and circulation resume
2 An MD declares death

Going on an 8 hour defib course this thursday, very happy that we are now allowed by law to use them.
Did CPR for real once, elderly gent who collapsed shovelling the first snow of the season at my kids' school.
Took over an hour for the ambulance to get there, and they were the longest 60 mins of my life. Especially the part after I had heard the umistakeable death rattle and knew that I had to keep at it anyway untill the med folks got there.
Breathing down the throat of a dead body not for the faint hearted.
So if you have any doubts about yourself being able to do that, leaving CPR to another crewmember is nothing to be ashamed about.

[Flighttime]

CAA rules state clearly that cabin crew must be seated for landing and shold stop CPR. the advise given is continue CPR till Captain gives orders for seat for landing. Under CPR conditions (presuming the Captain has been informed will be later than normal). Each airline has it owns procedures as to when you can stop CPR. Check it out with your own trainers as to the companies individual advice.

[ditzyboy]

I asked someone I work with an aparantly in Australia we can be performing CPR during landing.....

[Code Blue]

Thanks for the replies one & all.

The incident I alluded to was a collapse mid Atlantic and the cabin crew did CPR for 2.5 hours (including descent and landing) to CYQX. The unfortunate pax did not survive but the crew did a great job (Czech Air ?). I doubt I could do CPR for that length of time - I managed 35 minutes once and I was knackered!.

According to the autopsy report the pathologist didn't reckon much of his heart was left to work.

Rgds
CB

[stormywx]

Ditzy,

Sorry but that is incorret. Australian CAR's and CAO's are very strict when it comes to pax and crew.

Quoting CAO 20.16.3
3.1
"Each crew member and each passenger shall occupy a seat of an approved type:-
a) during t/o and ldg
b) during an instrument approach
c) when the aircraft is below 1000ft AGL
d) in turbulent conditions

The only exceptions to this are
a) stretcher cases, carried in accordance of CASA requirements
b) package dispatchers
c) parachutists

It should also be noted, that if the aircraft is therefore required to conduct any form of instrument approach due weather or ATC requirements, then the crew must be seated & therefore not be preforming CPR for the entire duration of the approach, which could begin a fair distance (+10 miles) from the airport.

The PIC and cabincrew have no discresion when it comes to the above requirements.

Cheers
stormy

[min]

MedAire/Medlink, who mainfrog has already referred to, provide medical advice to many of the airlines. I read somewhere that they were going to produce an inflight manual/textbook covering Emergency inflight conditions, both medical and traumatic, basic anatomy, aviation medicine etc...I think there was to be info on resuscitation,...not sure if any of the airlines are using it as yet, but I thought it was going to be available in 2001, from memory. Sounds like a good idea, tho.

M.

PS. Just checked their site - the "Manual of Inflight Medical Care" now available.