First aid concerns raised after mid-flight misdiagnosis

Colin - I dont think Tracey was suggesting that every "plane" in the sky had a paramedic but they should have somebody, at least one member in the crew who has some first aid training and who can at least do what is taught on a normal 4 day course. That at least gives somebody a chance whilst a call goes out for a doctor or other trained medical help on the plane which is normally found.
BA is very well equipped and staffed but I suppose when you talk about budget airlines not only are you not going to get what is known as a full service airline but you are not going to get the calibre of staff either. You pays your money , you takes your chances!!

oh and yes we do the yearly refresher training as well.....

well it has been two years since I last trained and the new resuscitation rules had not yet come in, altho due a few months after I qualified (for a 3rd time) I was told to stick to the method I was trained in........which was still blow, compression.....

Lisa / Mel

Those songs are no longer useful as the rate is now quicker. I am a member of SJA and "Nellie the elephant" was frowned upon even before the change. Especially if you sing it out loud!!!!

The changes to the guidelines from the Resuscitation council and the details I mentioed above regarding AED use can be found on their website http://www.resus.org.uk/pages/guide.htm

Personally I dont think every 3 years is enough for requalification for first aid at work. In SJA we refresh our qualifications it at least annually and yet we practice a lot more in between.

Tracey Paramedics train for 2 years full time, 3 for a BSc Hons. They experiance a full range of shift patterns. They are authourised to perform some minor surgical procedures, and administer up to 40 different drugs. They are paid the same as nurses, more if they are emergency responders. To train someone to that standard for every plain in the sky is frankly unfeasible.

or Nellie the elephant as St Johns taught us !!

I did hear somewhere that if you peform chest compressions to the tune of the BeeJees hit "Staying Alive", gives you approximately the correct number (100-120 chest compressions) per minute. Morbidly appropriate. But does at least stay in the memory.

I was actually very concerned when I travelled with BMI Baby 18 months ago and a young man 2 seats away from me keeled over his seat, into the aisle. The cabin crew were totally out of their depth in knowing what to do with him and didn't even carry out any checks on his pulse, etc until I asked them if they were going to! I wouldn't normally interfere outside of my own work situation, but I was so disgusted at the lack of care for him.

When in the air, they cannot call for a paramedic or ambulance, so I would have expected that there should be at least 1 member of staff on every flight who is trained to paramedic standard & was totally shocked to discover that this is not the case. It's a case of our lives in their hands!

No first aider slapped the patient on the chest, his daughter who was a trained NURSE did this.............

But anyway, yes I am quite shocked at no defibs on ryan air or lack of trained 1st aiders.......however they would perhaps charge you for the use of one if you needed attention anyhow!

Hi Steve,
FYI resuscitation guidelines changed back in March 2011. It is now 100 to 120 chest compressions per minute. You should be aiming for about 2 per second.

The resuscitation council found that people were not pushing hard enough or going fast enough so they changed the guidelines. The 9th edition "revised" of the FA handbook has the updated information.

Also its one handed compressions for children and two fingers for babies.
I got an SJA trainer in to run demonstrations on infant and child first aid for our well being week last year and we got a good turnout and feedback.
They did it for free but I gave them a small donation for their time.

Clearly an AED needs to be carried on all planes - long and short haul. If lives are to be saved a defib needs to be applied immediately. Waiting for a plane to divert is not an option. Every minute counts.

As to striking someone on the chest, my understanding is that non-professionals are encouraged to use hands-only CPR, applying repeated downward two-handed presses on the chest at the rate of about 100 per minute.

Strictly speaking as a member of the public you do not need training to use an AED (Automated External Defibrillator). But training should be given to any staff that are expected to use it at work. However if you see someone on the street who's heart is in fibrillation, you have an AED, but have not been trained you can (and should) still use it.

To use you just open it up and do what it tells you to do, it wont shock until you push the button and even then it wont do it if the casualty doesn't need it.
The real issue is "SAFETY", both to yourself and others i.e make sure nobody is touching the casualty when you shock them, you are not kneeling in water, you have removed a wire bra or any jewellery around the neck, and put the pads on the other side of the chest if they have a pacemaker e.t.c.

Striking someone in the chest is not taught to first aiders and if my memory holds is not in the official First Aid Handbook "9th edition revised" either. It rarely works and can be misconstrued as assault.

My understanding was that flight crew had to learn how to use the equipment on the aircraft they work on as part of their 6 monthly training. Dependant on the aircraft type, what equipment is carried on the plane, which is why sometimes its difficult to replace crew at short notice - they have to have been trained on that type of aircraft. You could not put somebody in a 747 who has only flown on a 737 for example. I dont know what plane was involved on the Ryanair incident or if they carried difibs. Some short haul planes may not carry them because they dont fly over large expanses of water for long periods and therefore can divert quickly to an emergency landing. All long haul BA flights have a defib and although not a requirement just a recommendation I am pretty sure all short haul do too. I dont think this is the case for many of the no frills however.

I was under the impression Neil that most airlines had!!! These machines are very easy to use... top clear, middle clear, bottom clear - everyone clear "shock" (grin) but on a serious note, they will not shock the patient if it is not needed. The instructions tell you where to put the tracers and the machine will tell you that it is taking a reading. If it detects that the heart needs defibbing then it will tell you and then you follow the procedure as stated.
My concern is Ryanair staff feeling they have the right to assume a patients diagnosis. My training has always been, assume the worst and work back from there - time is of the essence. As for slapping on the chest? hmm! the only time i would slap would be on the back, with the heel of my hand in an upward motion if someone was visibly chocking! I know there was a huge campaign a few years ago and from this I believe Boots the chemist has them, and some of the major supermarkets for use in case of emergencies so I will be more than surprised if all airlines do not have them on planes.

I cannot speak for Ryan Air but my daughter works for BA and their planes have them and the cabin crew are trained. Therefore I am not sure if all planes are supposed to have them or not.

Quite agree Neil. My life was saved by a Network Rail employee on London Bridge Station using a defibrillator. It requires some training and expenditure but I gather the machine tells the operator what to do. All planes should have one.

To be fair to first aiders, slapping a patient in the chest is not part of First Aid training even for heart attack. It is not normal practice and often achieves no benefit to a difribilating heart.

Hindsight is a great thing, albeit after the event. But in the case of an airline carrying so many passengers per flight of a certain age or range of health complications. Would it be pertinent to suggest with the level of footfall in passengers, a risk assessment should recommend a defib pack be installed in every plane with all hosts/hostesses trained to use them along with first aid and fire training. There is no argument of cost implication to not supply this as it is good enough for our fire service engineers on every appliance vehicle and that is a not for profit organisation. Can not having defib on planes be morally disputed? I think not!

Risk assessment is there to ensure controls are in place to remove or reduce risk from hazards. Ryanair should be ashamed from what I've read.