CPR on a plane

[snocrazee]

First Post,

I have followed this forum for many years because I have always been interested in flying. I am sure the many flight crews here have stories of CPR and medical emergencies on a plane. Please share what the flight crew experiences are. I will share my first experience and my thoughts running through my head of doing CPR on a airplane.

First off, I am a Respiratory Therapist at a hospital with over 25 years of experience. My wife is a Physician's Assistant at a clinic here in our town. We both see patients every day at our jobs.

We took a trip to see my parents in Texas very recently which was the worst trip of our lives. Diverted to Waco, TX to spend the night due to wind shear at DFW which honestly was scary descending into DFW but our pilot handled it well. Ubered from Waco, TX to Fort Worth, TX the next day to see my parents on our anniversary.

Long story short, on our return trip to Spokane, WA the flight attendant asked if any passengers were medical professionals. I hit the call button while my wife gave me the stink eye. Flight attendant was pretty shook up but asked if we had business cards. I said yes, and she said come with me. An older gentleman was slumped against the right airplane exit door past the bathroom. I actually saw him getting on the plane before we took off and thought to myself that he didn't look too good. Needless to say, I lifted his head to only see his eyes and told my wife we need to drag him out and put him flat on the floor. I checked his pulse after looking and seeing that he had agonal breathing. No pulse. Wife did mouth to mask breathing while I did chest compressions for the last thirty minutes of the flight.

My thoughts: This older gentleman was not going to make it (I have done CPR about 500 times at work the last 25 years). If we were in a hospital with a doctor they would have said stop a long time ago. But basic CPR class says keep going until you are physically exhausted or help arrives or you are in danger (we have all the CPR cards more advanced than basic).

Another note: It was my wife's first real time doing CPR and I did not know that. She told me she was losing it 15 minutes into it while doing the breathing. Her father passed away recently. I made her switch with me a bit. It bothers you looking into open eyes while giving breaths. The main flight attendant was shook up quite a bit but brought us everything they had on the plane. I did my best to explain to her what was happening and what we were doing to help calm her a bit. The AED is your friend. The gentleman did not need any shocks but also remember that the beeps it gives us are not his pulse but a tempo for us to keep while doing CPR (flight attendant thought it was his pulse on the AED). The oxygen tank is of no use unless someone is spontaneously breathing.

We arrived in Spokane, WA while doing CPR. The cockpit crew expedited to the gate where we physically picked the passenger up and took him up the jet way with the EMS crew to lay him in the terminal and continue CPR. Unfortunately the gentleman did not make it and they stopped CPR in the terminal.

Last thoughts: Coping skills. My wife is still shook up but it's my job to help her. Me: I learned to cope with death a long time ago. I am not hardened but told my wife that when he slipped away he was closer to heaven. I also told her that if it was our family member on that plane that we were the best two people on that plane to give him a chance. That makes us feel better about it. I have no idea what the pilots are thinking when the flight attendant says someone is doing CPR on a passenger. I suppose they are thinking get the plane on the ground. Not looking for a thanks at all. We wished it was a happy ending but it wasn't. Anyone have any thoughts or experiences? What do pilots think when this happens?

[Pilot DAR]

Though I am a [non airline] pilot, my only experience with doing CPR has been in my capacity as a volunteer firefighter for 27 years. I've had to start solo CPR four times. I did not ever make a save. However, a number of my fellow firefighters did, so I know it could be done. The most memorable thing I was told over the many years of recurrent CPR training was: "If you, as a trained CPR provider, have decided to initiate CPR, you have determined that the patient lacks vital signed - they are dead. You cannot make that worse by beginning CPR.". That was reassuring, as I know I have broken ribs.

Only once, was CPR not terribly stressful. A wife knew it had been time, when I arrived. Otherwise, there is incredible stress, and someone screaming. Worse yet will be two conflicting family members, one screaming "save him!!!", the other saying that there is a Don Not Resuscitate order, but they don't have it with them. Then you're starting CPR with two people screaming at you for totally different reasons.

In summary, starting CPR is the final courtesy one person offers to another who has passed away. If you save them, it wasn't the final courtesy, but instead and awesome courtesy - either is good.

A jet airliner in cruise flight cannot be suddenly pointed down to the nearest regional airport, for a number of reasons, which, for the first part of the flight probably includes landing weight. Pilots much more conversant with that than I will be along shortly with more wisdom on those factors.

By the way... Good Job! Thank You!

[Capt Scribble]

I have had two deaths on board over the years. It happens, I have no emotional connection with the passengers and will use common sense and medical advice to guide my actions. Death is part of the human condition and if you carry millions of people by air each year, a few will have serious medical issues. So long as you have tried your best, your efforts should not be seen as a failure. As an observation from the charter market, passengers outside school holiday times are often old with complex health needs, so its amazing that there are not more people taken seriously ill. Listening to the symptoms collected for Medlink, it strikes me that some individuals should be nowhere near an aircraft and most unlikely to have insurance to cover medical needs.

[Imagegear]

Outside of school holidays, only the well heeled businessman, occasional A lister, and pensioners are the only ones keeping the airline afloat.

IG

[obgraham]

Snocrazee that was a very thoughtful post. I think you exhibited the highest of professional standards. You have the skills, and you used them to the best of your ability. Well done.

But objectively, you and I both know that the survival odds in that scenario are extremely low, even though the public often has different expectations. That does not exclude you, and especially your spouse, from feelings of sadness sbout the outcome after the fact.

I spent my 40 years dealing with the other end of life's spectrum. Largely because happy outcomes vastly outnumbered sad ones. But every stillbirth, neonatal death, or complication that didn't resolve the way I or my patients wished was a cause for sadness and reflection. Along with resolve to try better next time. Isn't that what professionalism is all about?

In our current messy state of affairs in health care in this country, I am glad there are people like you around and would have been pleased to work with you.