In-Flight First Aid Training Program
for Cabin Crew
Sung Hee Ahn, MD
Aviation Medical Center, Korean Air
2013.05.15
I have the following financial relationships to disclose:
• Employee of : Koreanair, Seoul, South Korea
I will not discuss off-label use and/or investigational use
in my presentation
Disclosure Information83rd AsMA Annual Scientific Meeting
Sunghee Ahn, MD, FAM
Contents
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Increase in air
Travelers
Aging of the
Passengers
Increase in invalid
Passengers
Increasing the Number of In-Flight Medical Emergency
The Importance of In-Flight First Aid
The Current Status of In–Flight First Aid Training
In-flight First Aid Training Program for Cabin Crews
The role of Cabin Crew in In-flight Medical Emergency Cases
EmergencyPatient
Crew who finds the patientCrew who finds the patient
Assesses the patient and get medical information
Provides first aid Calls for help
Crew who is asked to helpCrew who is asked to help
Reports to captain and page a medical doctor
provides medical kits Assists the crew member who
found the patient with providing first aid and
getting medical information Records the actions taken in
time sequence
Medical Doctor
First Aid Assistance
Provide medical kits on board
Assist the medical doctor
EMCS(Emergency Medical Call System) Request for Medical Assistancethe Emergency Medical
Call System
YES
No
Korean Air Cabin Crews
In-flightFirst Aid Training program
for Cabin crews
The Number of cabin
Crews : 6,363
(~2013.03.31)
First Aid Training curriculum Specified by Target Crews
In-flightfirst aid training program
for flight attendants
InitialFirst Aid Training
InitialFirst Aid Training
1
RecurrentFirst Aid Training
RecurrentFirst Aid Training
2
Team leaders’First Aid TrainingTeam leaders’
First Aid Training
3
First Aid Training curriculum Specified by Target Crews
Category Initial Recurrent Team leaders’
Who New EmployeeCabin crew who has
completed Initial TrainingTeam leader
When Upon employment Every year Every 2years
Duration Off-line : 3daysOn-line : 2hrsOff-line : 2hrs
On-line : 3hrsOff-line : 3hrs
Test Written + Practice Practice Written + Practice
Certificate Yes Not applicable Yes
First Aid Training Contents (Basic)
Aviation physiology CPR & AEDFirst Aid
(1, 2)
Air Transportation for Invalid Passengers
Inflight Medical kits Vital Sign
Lumbago PreventionAnnual Emphasis on
In-flight first aid
Aviation physiology CPR & AEDFirst Aid
(1, 2)
Air Transportation for Invalid Passengers
Inflight Medical Kits Vital Sign
Lumbago PreventionAnnual Emphasis on
In-flight first aid
Key Highlights by Years
Year Subject
2008 How to assess Passenger’s health conditions
2009 CPR & AED (New guideline)
2010 How to use inflight medical kits (mainly with new items)
2011 How to use glucometers
2012 How to handle in-flight medical emergency
2013 How to properly perform emergency first aid in flight
In-Flight First Aid Training for Team leaders
Training Content Examples of
actual in-flight
emergencies
Training Methods Discussion between
instructors and trainees
Role Playing of actual emergency scenarios
Emphasis onTests
to strengthen
decision-making
skills
Team Leaders
First Aid Certification System
Eligibility
: Employees taking the Initial First Aid Training and those taking the Team
Leaders’ First Aid Training Issuance Criteria
: At least 80 points on the written test and passing the practice test Certification validity period : 2 year from date of issuance
Excellence and Professionalism of In-Flight First Aid Training
In-flight First Aid Training program for cabin crews
First Aid Training Instructor
20 BLS Instructors
(Including Emergency medicine specialist) 11 BLS Providers
Aviation medical personnel in charge of
invalid passenger’s air transportation management of in-flight medical kits
First Aid Instructor
Complete KAL Instructor Training Course
Monthly First Aid Training for Cases
Performing pertinent training which is basically focused on First Aid through the on-line
monthly analysis of cases involving in-flight emergencies
Korean Airlines Medical Information System(KALMED)
Computerized data that has been accumulated since 1996
Verify statistical data and reflect them in our training
Circulatory19.4%
Digestive17.7%
Injury/Orthopedic17.1%
Neurologic11.5%
Allergy8.7%
Respiratory8.4%
Psychiatry3.6%
Tumor2.4%
Korean Airlines Medical Information System (KALMED)Utilization (example) : Percentage of in-flight first aid cases based on disease
In-Flight First Aid Case Study
In-flight First Aid Training program for cabin crews
Case 1 – In-flight Medical Emergency
MedicalEvent
When our crew was serving meals, one passenger told
that his chest felt heavy
The crew paid attention to him and only served him water
Just 30 minutes before landing, he walked to the toilet
and in front of the door, he grabbed his chest and fell
down suddenly
PAX : OOO (M/65Yrs) Flight SKD : KE654/07FEB13 BKK/ICN Symptom : Heart Attack
Case
Case 1 - Inflight Medical Emergency
FirstAid
• Our crew immediately checked his consciousness and respiration• Our crew started to do CPR• Our crew called for a medical doctor. None were available and so
they contacted EMCS on the ground.
• Our crew performed CPR for ten minutes and defibrillation four times. After that, the patient’s pulse and consciousness returned.
• Our crew supplied oxygen to him and provided medicine including aspirin as per EMCS instructions.
• The crew contacted the ground staff to ask for an ambulance at ICN Airport to stand by.
• After landing, that passenger was taken to a nearby hospital. He underwent treatments including Coronary Angiography ,
recovered and was eventually discharged from the hospital.
Case 2 – Compliments to Our Cabin Crew for Assisting an In-flight doctor
MedicalEvent
PAX : OOO (F/25Yrs) Flight SKD : KE081/31DEC12 ICN/JFK Symptom : Syncope
Case
FirstAid
our crew immediately checked her consciousness and
measured vital sign and assisted In-flight doctor For around ten hours after that, our crew kept a close eye
on her vital signs and health condition until landing The passenger’s condition stabilized and she arrived at
the airport without further incident
Around one hour after taking off, the passenger was
walking down the aisle when she suddenly lost her
consciousness.
I hope you also acknowledged the dedication and teamwork of the member of the Cabin crew who assisted in taking care of the passenger. They were professional, supportive, focused and made the work we had to do to so efficient. I felt that I was working with “medical assistants” who had been with me for a long time!!
Case 2 – Compliments to Our Cabin Crew for Assisting an In-flight doctor
Case 3 – Utilizing First Aid on Ground : Cabin crew’s CPR Experience
MedicalEvent
Our cabin crew encountered a car accident on the way
home A man in his fifties was unconscious and severely injured.
Flight Attendant : OOO (F/30Yrs) Patient : OOO (M/50Yrs)
Case
FirstAid
• Our cabin crew performed CPR on him immediately. • She continued CPR and, at the same time, she ordered the
bystanders to call 911.
• She continued to perform CPR for around twenty minutes despite her uniform leggings being covered in blood from
the knee down.
Case 3 – Utilizing First Aid on Ground : Cabin crew’s CPR Experience
Flight Attendant : OOO (F/30Yrs) Patient : OOO (M/50 대 )
Case
FirstAid
After that, the 911rescue team arrived but she continued
to give CPR until the patient was sent to the hospital.
The observers applauded her but she answered modestly
stating that she was simply applying her company first
aid training.
One of the bystanders was interviewed by the press and
mentioned the efforts of our crew member including the
injuries she suffered on her knees while applying CPR.
Case 3 – Picture of visiting our Aviation Medical Center
Conclusions and Recommendations
In-flight first aid training program for cabin crew
Medical Diversion Ratio
unit : Number per billion passenger-kilometers flown
Recommendations
STEP 1 Need to develop diverse training courses
STEP 2 Update the training contents including more recent cases of in-flight emergencies
STEP 3 Introducing the first aid training based on the team unit