New Delhi|HL
The unexpected incident happened on Sunday evening when four doctors from AIIMS New Delhi were on-board Vistara airline flight UK-814, from Bangluru to Delhi. The flight took off at 9:00 PM, and around 30 minutes after take-off, a distress announcement was made, to seek help from any doctor available on board the flight.
On hearing the announcement, 4 doctors from AIIMS New Delhi-
Dr Navdeep Kaur (SR, Anesthesiology- JPNATC)
Dr Damandeep Singh (SR, Cardiac Radiology and Endovascular Interventions)
Dr Oishika Chakraborty (SR, Obstetrics and Gynaecology)
Dr Avichala Taxak (SR, Cardiac Radiology and Endovascular Interventions)
And one doctor- Dr Rishabh Jain who is presently enrolled in ILBS, New Delhi
All doctors responded to the call and initiated immediate medical care.
There was ~1.5 year old female who had underwent open intracardiac repair surgery in Bangalore three weeks ago, for complex congenital heart disease (Dextrocardia, situs inversus and total anomalous pulmonary venous connection). The parents of child were in distress saying their baby was not responding.
The child was safely taken to the rear zone of aeroplane and carefully assessed, and child was found to be cyanotic, not breathing and pulses were absent. The heartbeat was not palpable. Immediately according to pediatrics resuscitation protocol, CPR was started. The airway was maintained using three maneuvers- head tilt, jaw thrust and chin lift and positive pressure ventilation was initiated using on board available face mask ( adult size) attached to ambu bag and pediatric oropharyngeal airway. Chest compressions were given according to pediatric life support protocol.
To connect oxygen cylinder to the AMBU bag, tubing which was required was harvested from on-board available emergency oxygen mask.
In the extreme harsh circumstances with limited availability, an I.V line was secured in first attempt and emergency drugs (Adrenaline) as per weight of child every 3-5 mins. On board available AED was skillfully utilized to deliver cardiac shock, and further CPR was continued.
ROSC- return of spontaneous circulation was achieved after ~45 minutes of CPR in the form of palpable brachial pulse.
No ECG/Oxygen saturation probe was available to monitor heart rate and saturation on board.
The pilot was requested to immediately land at nearest airport, and Nagpur was nearest available option with estimate time of landing ~20 minutes.
The flight was landed to Nagpur airport, and child was successfully handed over with stable hemodynamic parameters to the pediatrician in Nagpur who arrived in ambulance.
