• Kyle R Danielson, Anna Condino, Andrew J Latimer, Andrew M McCoy, and Richard B Utarnachitt.
• Airlift Northwest, University of Washington, Seattle, WA. Electronic address: kyledan@uw.edu.
• Air Med. J. 2021 May 1; 40 (3): 159-163.

ObjectiveThe purpose of this study was to describe the incidence, characteristics, and outcomes of cardiac arrest in the air medical environment so that we can begin to understand predictors of in-flight cardiac arrest and identify opportunities to improve care.MethodsThis retrospective observational study was undertaken at Airlift Northwest from 2013 to 2017. Descriptive statistics of adult patients with medical and traumatic etiologies of cardiac arrest were analyzed and compared.ResultsOf the 13,915 adult patients transported during the study period, fewer than 1% (N = 92) had a cardiac arrest during transport. Of those, 42% in the overall cohort had return of spontaneous circulation on arrival at the destination hospital. Medical etiologies of cardiac arrest were more common than traumatic (65% vs. 35%), more likely to have an initial shockable rhythm (30% vs. 3%, P = .004), and more frequently arrived at the receiving hospital with return of spontaneous circulation (57% vs. 31%, P = .03). Rearrest in transport occurred frequently (39%). Most patients were hypotensive before cardiac arrest, and peri-intubation cardiac arrest occurred in 12% of patients.ConclusionCardiac arrest during air medical transport is a rare event that requires a high level of critical care to treat refractory cardiac arrests, hemodynamic instability, and airway compromise.Copyright © 2021 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

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