To the Editor

Dr. Phoebe Leith’s letter published in the Spring 1996 issue of the Newsletter, reminds me that “the more things change, the more they remain the same.” Some twenty years ago, I participated in the resuscitation of passengers on two TWA flights. Neither involved cardiac arrest, but as an anesthesiologist, I felt handicapped in my efforts to aid them by a lack of equipment.

As Dr. Leith noted, the emergency oxygen masks on commercial passenger aircraft can not be used as a source of supplemental oxygen. I asked for oxygen on both occasions. It was too long in coming and it came with no positive pressure device. After each of these events, I was asked by the attendant to fill out an “incident report,” and subsequently received letters of thanks from the medical department of TWA. I was asked for suggestions as to how to improve emergency medical care on aircraft and recommended that a generic self-inflating resuscitator (e.g. “Ambu”) bag and oxygen source be in each kit and immediately available. Some time later there was a note in the J.A.M.A. asking physicians who had helped with emergency care on aircraft to relate their experiences, and to make suggestions for improving such care. Once more I suggested the resuscitator bag. The cost of such a device is miniscule compared to that of a commercial airliner, so I believe that it is still not provided because the airlines fear increased liability from its presence. I hesitated to recommend a defibrillator because the airlines would believe that the presence of this might also expose them to a greater liability risk. Today, I believe it would be difficult to find an airliner passenger list that did not contain someone trained in CPR. Therefore, I still feel that a resuscitator bag and easily available supplemental oxygen source should be required on each commercial airliner. I hope that we as both physicians and anesthesiologists would back such a recommendation.

Solomon H. Statman, M.D. Long Beach, CA