Page R L, Joglar J A, Kowal R C, Zagrodzky J D, Nelson L L, Ramaswamy K, Barbera S J, Hamdan M H, McKenas D K
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas 75390-9047, USA.
N Engl J Med. 2000 Oct 26;343(17):1210-6. doi: 10.1056/NEJM200010263431702.
Passengers who have ventricular fibrillation aboard commercial aircraft rarely survive, owing to the delay in obtaining emergency care and defibrillation.
In 1997, a major U.S. airline began equipping its aircraft with automated external defibrillators. Flight attendants were trained in the use of the defibrillator and applied the device when passengers had a lack of consciousness, pulse, or respiration. The automated external defibrillator was also used as a monitor for other medical emergencies, generally at the direction of a passenger who was a physician. The electrocardiogram that was obtained during each use of the device was analyzed by two arrhythmia specialists for appropriateness of use. We analyzed data on all 200 instances in which the defibrillators were used between June 1, 1997, and July 15, 1999.
Automated external defibrillators were used for 200 patients (191 on the aircraft and 9 in the terminal), including 99 with documented loss of consciousness. Electrocardiographic data were available for 185 patients. The administration of shock was advised in all 14 patients who had electrocardiographically documented ventricular fibrillation, and no shock was advised in the remaining patients (sensitivity and specificity of the defibrillator in identifying ventricular fibrillation, 100 percent). The first shock successfully defibrillated the heart in 13 patients (defibrillation was withheld in 1 case at the family's request). The rate of survival to discharge from the hospital after shock with the automated external defibrillator was 40 percent. A total of 36 patients either died or were resuscitated after cardiac arrest. No complications arose from use of the automated external defibrillator as a monitor in conscious passengers.
The use of the automated external defibrillator aboard commercial aircraft is effective, with an excellent rate of survival to discharge from the hospital after conversion of ventricular fibrillation. There are not likely to be complications when the device is used as a monitor in the absence of ventricular fibrillation.
由于获得紧急护理和除颤存在延迟，在商业飞机上发生心室颤动的乘客很少能存活下来。
1997年，美国一家主要航空公司开始在其飞机上配备自动体外除颤器。空乘人员接受了除颤器使用培训，并在乘客失去意识、脉搏或呼吸时使用该设备。自动体外除颤器还通常在身为医生的乘客指导下用作其他医疗紧急情况的监测器。每次使用该设备时获取的心电图由两名心律失常专家分析其使用的适当性。我们分析了1997年6月1日至1999年7月15日期间使用除颤器的所有200例情况的数据。
自动体外除颤器用于200名患者（191名在飞机上，9名在候机楼），其中99名有记录显示失去意识。185名患者有心电图数据。在所有14名心电图记录为心室颤动的患者中均建议进行电击，其余患者则不建议电击（除颤器识别心室颤动的敏感性和特异性为100%）。首次电击使13名患者的心脏成功除颤（1例应家属要求未进行除颤）。使用自动体外除颤器电击后出院存活率为40%。共有36名患者在心脏骤停后死亡或被复苏。在有意识的乘客中使用自动体外除颤器作为监测器未出现并发症。
在商业飞机上使用自动体外除颤器是有效的，心室颤动转复后出院存活率很高。在没有心室颤动的情况下将该设备用作监测器不太可能出现并发症。
