American Airlines honored for pioneering role in saving lives

By Janice Youngwith
Wednesday, February 6, 2008

All 18,000 current members of American Airlines flight attendant crews are fully trained to administer the onboard automated external defibrillator.

After nearly a decade of heart-saving mid-air success, American Airlines will be honored this spring for their pioneering role in recognizing the benefits of and using onboard automated external defibrillator (AED) technology to save lives and hearts.

Presented by the American Heart Association's Metro Chicago chapter at April's Heart Ball, American will receive the organization's prestigious Coeur d'Or, Heart of Gold Award for a decade of heart-saving success. In 1997, American Airlines became the first U.S. airline to equip its aircraft fleet with AEDs and since that time 80 passengers have been saved.

All 18,000 current members of flight attendant crews that fly with American are fully trained to administer the lifesaving treatment, increasing the odds of heart attack survival for travelers while in the air, says Mary Frances Fagan, an American Airlines spokesperson.

"The defibrillator program was launched May 1, 1997 and just months later, Robert Griggy, 53, of Roxboro, N.C., became the first passenger to be saved by a defibrillator on American Airlines after suffering a heart attack during a Feb. 18, 1998 flight at Dallas Fort Worth Airport," Fagan says. "He collapsed on board an aircraft after rushing to catch a connecting flight to Mexico and later went on to become a champion for getting defibrillators installed in a variety of public places in his home state."

Taking a closer look at emergencies

A review of existing flight attendant training, an increase usage of in-flight medical kits and input from captain and flight attendant medical incident reports were factors that triggered the airline's medical staff to take a closer look at top inflight medical emergencies and their causes, says Linda Campbell, a registered occupational nurse and retired manager of aeromedical services at American.

"We found syncope (fainting spells), respiratory distress, cardiac/chest pain and nausea/vomiting all played major roles in our mid-air emergencies," she recalls. "Medical kit usage with cardiac issues led the list of reasons causing an airplane to divert and land. Post-incident interviews with our crew and medical personnel who often lent a hand pointed out that even though CPR was performed, it didn't do much good on its own."

It was at a nursing conference in San Antonio that Campbell first viewed a prototype of defibrillator technology during initial developmental stages.

"I remember speaking with Dr. David McKenas, who was the American Airlines corporate medical director at the time, and sharing our excitement for the new technology," she says. "We vowed to keep our eyes on the developing technology to see if it might one day be able to be used onboard our aircraft."

AEDs save lives

According to American Heart Association experts, in most cases when sudden cardiac arrest occurs, the victim's heart quivers in uncontrolled rhythm and causes the person to collapse, become unresponsive to gentle shaking and stop breathing normally. Death typically follows within minutes, with some 1,000 American deaths each day attributed to sudden cardiac arrest.

"Patients rarely survive if cardiopulmonary resuscitation and lifesaving defibrillation aren't delivered within minutes," explains Campbell. "AEDs can provide treatment within that window of opportunity and jump-start hearts that have stopped beating."

American Heart Association experts recommend defibrillation in three to five minutes or sooner to help save lives. For each minute that defibrillation is delayed, the victim's chance of survival decreases by seven to 10 percent.

They estimate that 95 percent of sudden cardiac arrest victims die before reaching the hospital, but that when defibrillation is provided within five to seven minutes, the survival rates rise to 49 percent. Since equipping its aircraft with AEDs, American has achieved a survival rate of 63 percent.

"Seconds do count," Campbell says. "We found that even if our aircraft was directly over the airport when the cardiac emergency happened, it still would take 20 minutes to land the plane. Surviving a sudden cardiac arrest is largely dependent on how quickly a victim is defibrillated."

‘We mounted a massive training program'

Campbell says she recalls reading in the USA Today newspaper about a company, Heartstream, with plans to make and manufacture automated portable defibrillators for non-medical people and made the initial contact. The Food and Drug Administration (FDA) granted approval for inflight use of the HeartStream AED in October 1996 and by the following spring, the first AEDs were installed aboard the airline's international flights.

"We mounted a massive training program which eventually encompassed more than 27,000 flight attendants," she reports.

"Local paramedics and medical personnel were invited to our road show training classes across the country and the enthusiasm hasn't died down since that time."

In November 1998, Michael Tiggue, a passenger flying from Boston to Denver, suffered a mid-air heart attack and was saved using an onboard defibrillator installed just two days earlier. He was American's first in-flight save.

By December 1999, the lifesaving technology was onboard 732 American Airlines aircraft and by 2002, an additional 272 American Eagle planes. The first passenger was saved just months later, in May 2000, aboard an American Eagle flight.

In April 2004, the FAA required AEDs on all commercial passenger aircraft of a certain size. American's established program for defibrillator use and training, at the vanguard of technology, served as a model for other airlines and agencies seeking defibrillator information, training materials and protocols.

"We were at the forefront of the wave endorsing public access defibrillation, encouraging the installation of defibrillators in airport terminals, grocery stores, community centers and more," she reports. "Our Dallas-Fort Worth American Airlines Training Center became the first such location for defibrillator installation and public access in Texas."

Easy to use and automated so they won't deliver a shock unless detecting that the heart has actually stopped beating, most units provide clear verbal instructions to users when activated.

According to the American Heart Association, about 340,000 people a year die annually of coronary heart disease in an emergency department or before ever reaching a hospital, with most of these deaths being caused by sudden cardiac arrest.

The most common cause of cardiac arrest is an abnormal heart rhythm called ventricular fibrillation, causing the heart to quiver and rendering it unable to pump blood efficiently.

The AEDs are designed to deliver an electric shock through the chest wall directly to the heart with special built-in computers assessing patient heart rhythm, the need for a shock to restart stopped hearts and shock administration. Audio and visual prompts help guide trained and even novice users through the lifesaving process.

"As the world's largest commercial airline, we realize our responsibility to ensure the safety and security of our passengers," says Dr. Thomas Bettes, current American Airlines medical director. "By placing AEDs on all our aircraft well in advance of any FAA requirement to do so makes us proud, knowing we have paved the way for other air travelers. Knowing that people's lives actually have been saved and getting to meet some of those individuals makes us happy to be associated with a great company like American."

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