Procedure and effectiveness of Basic Cardiopulmonary Resuscitation during the landing of an airplane: an exploratory study on military flights

Introduction: The incidence of cardiorespiratory arrest (CRA) in aircraft is estimated at one per 5-10 million flights. The early initiation of cardiopulmonary resuscitation (CPR) can double or quadruple survival rates after CRA, and is associated with a better prognosis in terms of decreased brain damage and better quality of life. The aim of the present study is to evaluate the effectiveness of basic CPR procedures carried out by the flight crew in a clinical simulation performed in a real environment, during the landing of a military training flight. Methodology: The clinical simulation was carried out with 20 members, grouped in ten pairs, of the Mendez Parada Military Parachuting School at the Alcantarilla Air Base (Murcia, Spain). At an altitude of approximately 1,100 feet, each pair simulated CPR on a Little Anne (R) manikin fitted with a SimPad (R) PLUS. The results obtained were recorded by SkillReporter (TM). Results: The mean duration of the procedure was approximately five minutes. During the flights, the compression depth achieved with CPR was correct in only six of the ten cases. In only one case was the "patient" checked for consciousness and respiration. In 50% of the simulations, the forehead-chin manoeuvre was not performed (i.e., the airway was not opened). Conclusions: The lack of standard recommendations in current guidelines on CPR during aircraft landing may provoke discrepancies in the management of this critical situation and reduce the quality of the treatment provided.