Dear Editor:
Having followed this file for a few decades, I read with interest the article “The First Use of a Defibrillator on a U.S. Commercial Airline” in the September issue.1
While defibrillators were used for the first time in the United States by American Airlines as claimed by the author, it is incorrect to state that “British Airways in 1999 became the first large European airline to begin carrying portable cardiac defibrillators.”
British Caledonian was the first to equip their DC-10 with semiautomatic defibrillators in 1987.2 Then, in 1991, one of the main Australian international airlines, Qantas, began to carry automatic defibrillators on their Boeing 747.3
Also, to be totally transparent, I believe it is important to mention that out of the 11 resuscitations mentioned in the Page study,4 only one of them was in flight, while the others were in the aircraft but at the gate; that is what the author confirmed to me in a personal communication for an article we wrote in this journal.5 At least one major element is different between in flight and on the ground at the gate: the chances of an event being witnessed on the ground are much higher, as shown in O’Rourke’s article.3 This can make a significant difference in the outcome.
Having said the above, automated external defibrillators are in commercial airlines to stay, and I do not question that. However, regardless of how appropriate the decision was to introduce automated external defibrillators in commercial airlines, it is important to be as transparent as possible when communicating in a scientific journal, especially since at the time, in 1997, American Airlines’ decision was seen by many as a marketing move. While this was categorically denied by the author, the decision did, in fact, result in extensive national and international attention from the media. British Caledonian and Qantas could have claimed ownership of the development of the international public health movement but did not.
In Response:
Dr. Thibeault makes several excellent points. The purpose of this article, however, was only to present a historical vignette of the first known use of a defibrillator that saved a life on board a U.S. commercial air carrier on American Airlines in 1998. Although perceived by some as a marketing move, the executive decision was solely based on epidemiological data of what medical events occurred on board American Airlines flights in the 1990s and how passenger welfare could best be served.
