Improving Pilot Response to In-Flight Strokes: A Randomized Controlled Trial

Vol. 19, No. 5, 2005

Free Abstract Article (Fulltext) Article (PDF 103 KB)

Original Paper

Improving Pilot Response to In-Flight Strokes: A Randomized Controlled Trial
Enrique C. Leira^a, Salvador Cruz-Flores^a, Kathleen W. Wyrwich^b, Gary J. Northam^c, Aninda B. Acharya^a, Yi Pan^a, Eve M. Holzemer^a, Sharon B. Womack^a

Departments of
^aNeurology, School of Medicine,
^bResearch Methodology and School of Public Health, and
^cParks College of Engineering and Aviation, Saint Louis University, St. Louis, Mo., USA

Address of Corresponding Author

Cerebrovasc Dis 2005;19:317-322 (DOI: 10.1159/000084500)

Key Words

In-flight stroke
Computer-assisted learning
Aviation

Abstract

Background: When a passenger suffers an in-flight stroke (IFS), the pilot decides when to expedite access to ground care. Pilot pro-activeness towards IFS could improve outcome and should be promoted. Unfortunately, little is known about a pilot's stroke pro-activeness or limiting factors. Methods: Randomized controlled trial of an educational intervention (American Stroke Association, 30-slide stroke awareness lecture) through an internet-based computer system using pilot students and instructors as subjects. Pilots completed pre-intervention and post-intervention tests of 25 simulated in-flight scenarios that describe strokes and other neurological and medical symptoms. Outcomes chosen were the percentage of pilots that would use a medical radio service, declare an emergency on board, or divert to the nearest airport for each scenario. Results: Participant pilots (n = 104) were less likely to respond to IFS than to myocardial infarction (p < 0.001). Fear of retaliation by an employer was the most important modifiable limitation. The educational program increased the simulated rate of emergency declarations for in-flight vertebrobasilar strokes (p < 0.001) and subarachnoid hemorrhage (p < 0.001). Conclusions: Pilot-simulated response to certain IFS improves immediately after this educational intervention, which should be disseminated in schools and airlines. Further studies are needed to determine the long-term benefits of this intervention and the impact on actual diversion rates. Companies should also review their policies to shield pilots from retaliation when altering the flight plan for patients.

Author Contacts

Enrique C. Leira, MD
Division of Cerebrovascular Diseases, Department of Neurology, 2-RCP
University of Iowa, 200 Hawkins Drive
Iowa City, IA 52246 (USA)
Tel. +1 319 356 8755, Fax +1 319 356 4505, E-Mail enrique-leira@uiowa.edu

Article Information

Presented in part at the International Stroke Conference, New Orleans, La., 2005.

Received: November 16, 2004
Accepted: January 4, 2005
Published online: March 17, 2005
Number of Print Pages : 6
Number of Figures : 0, Number of Tables : 5, Number of References : 16

Medline Abstract (ID 15775711)

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