The United States Federal Aviation Administration has proposed easing airline requirements for emergency medical kits on board commercial flights in a move that would give carriers more flexibility over the resources needed for nine emergency medical scenarios.
Current rules stipulate that medical kits on aircraft must provide the basic equipment and treatment for flyers experiencing health problems until emergency medics arrive at the scene.
Airlines must at present carry a 64-item first aid kit, alongside specified units of other items such as a blood pressure cuff, a stethoscope, sterile gloves, four syringes, six needles, a 50% dextrose injection (for hypoglycaemic events), two doses of epinephrine (used in anaphylactic and septic shock cases, and cardiac emergencies), plus 10 nitroglycerin tablets (again used in cardiac emergencies).
Sometimes aircraft are unable to take off and fulfil schedules due to a lack of supplies, although carriers can apply for exemptions when there are known shortages of certain medications, as happened in 2013, Reuters reports, during a dextrose supply chain crisis caused by a sudden surge in demand. The increased flexibility the FAA is now proposing would have seen airlines able to replace their dextrose supplies with an equivalent alternative, instead of having to ask for an exemption.
The newly proposed rules would be based on standards-driven performance criteria and put the onus on airlines to decide which items to supply, and in what quantities, as long as they cover nine scenarios: allergies, bleeding, cardiac emergencies, gastrointestinal emergencies, respiratory emergencies, labour, low blood glucose, opioid overdoses and seizures.
The shift follows research undertaken by the FAA and a team from Duke University who reviewed 3.1 billion passenger boardings and 77,000 in-flight medical emergencies across 84 airlines operating across six continents, between January 2022 and December 2023. Their analysis revealed an average of one medical emergency for every 212 flights, with 8%of passengers hospitalised after landing. Less than 2% of the incidents resulted in the plane having to divert from its course.
Arguments in favour of the new system include the economic benefits of allowing airlines to continue to fly despite a lack of specific medications, as long as they have a suitable alternative and have assessed the risks. The approach would mean the lack of a solitary first aid kit ingredient would no longer undermine carriers’ operational resilience. Instead, airlines “would adopt a flexible, performance-based standard that allows airline operators to tailor kit contents and crew training to evolve with modern medical science,” the FAA said.
