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

1

2

3

4

5

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