Every year, millions of travelers board flights to celebrate the holiday season with friends and family. While most passengers worry about flight delays, emergency room physician Dr. Tushara Surapaneni has a more pressing concern: the lack of adequate medical supplies when faced with in-flight emergencies.
In-flight medical incidents, although rare, occur more frequently than many people might assume. A recent analysis of data from 84 airlines reveals that such emergencies happen on approximately 1 out of every 212 flights, a stark contrast to earlier estimates of 1 in 604 flights. Given that the Federal Aviation Administration (FAA) manages around 44,000 flights daily, this translates to roughly 70 to 200 medical emergencies occurring every day over U.S. airspace.
Flight attendants, trained in CPR and basic first aid, are the first responders in these situations. They may contact ground-based medical teams or request assistance from any medical professionals on board. During two long-haul international flights, Dr. Surapaneni volunteered to help with emergencies only to discover that he was the only physician present. One of those flights ultimately required a diversion to transport a sick passenger to a hospital.
Reflecting on his experiences, Dr. Surapaneni notes several challenges: the noise of the aircraft makes it difficult to hear heartbeats, and administering intravenous fluids is complicated at cruising altitudes. He emphasizes the urgent need for the FAA to enhance its requirements for emergency medical kits.
The current medical kits on airlines contain minimal supplies, including a stethoscope, manual blood pressure cuff, IV catheters, vials of epinephrine and lidocaine for cardiac arrest, and a defibrillator. Dr. Surapaneni expressed surprise at how sparse these kits are, especially considering the FAA has not updated its basic requirements for emergency medical kits since 2004.
In March 2024, Congress passed a reauthorization bill directing the FAA to review the potential benefits of expanding emergency medical kits. This review includes evaluating whether the kits can adequately address opioid overdoses and anaphylaxis, both life-threatening conditions. If the FAA implements changes as suggested, airlines will be required to carry naloxone for opioid overdose treatment and appropriately dosed epinephrine for anaphylaxis.
While these measures would be beneficial, Dr. Surapaneni believes additional essential equipment and medications should be included as standard. He proposes a list of items that could significantly improve passenger safety:
– Pulse oximeters for measuring oxygen levels
– Glucometers for checking blood sugar
– Automated blood pressure cuffs
– Pediatric airway equipment
– Injectable benzodiazepines for treating prolonged seizures
– Naloxone nasal spray for opioid overdoses
– Epinephrine auto-injectors in both adult and pediatric dosages
– Oral glucose gel and glucagon for treating low blood sugar
Some U.S. airlines, including Southwest Airlines and Delta Airlines, do carry certain advanced medical supplies, but the specific contents of their medical kits are not consistently disclosed. Official statements from several major carriers regarding their medical kits have been vague, leaving medical professionals unsure of the resources available if an emergency arises.
Enhancing transparency and standardizing medical kit contents not only benefits passengers but could also minimize flight diversions, which can cost airlines between $70,000 and $230,000. Although in-flight medical emergencies are infrequent, the FAA’s core mission prioritizes safety, even in rare situations.
It is time for the FAA to act on Congress’s call to update its policies regarding in-flight medical kits. By expanding the basic requirements for emergency medical supplies, airlines can ensure standardized, improved safety measures for all passengers.
