Minimum Medical Kit

Air Safety Week, April 23, 2001

By April 12, 2004, all airplanes operating with one or more flight attendants must be equipped with automated external defibrillators (AEDs) for immediate treatment of sudden cardiac arrest, and they also must be equipped with upgraded emergency medical kits (EMKs). The Federal Aviation Administration's (FAA) April 12 final rule (Docket No. FAA-2000-7119) mandates what many carriers already are doing.

Intravenous (IV) kits and saline solution must be included as part of the on-board EMK. An IV capability is not part of the current requirement, the absence of which was criticized recently concerning a passenger suffering from a bleeding ulcer (see ASW, April 9). However, the new requirement for an IV capability may have overlooked a critical component. During the comment period, Arizona-based MedAire Inc., a company that provides medical support to many airlines, urged that an IV catheter must be an essential element of the IV kit.

Not to worry, the FAA replied, saying in its final ruling, "The FAA intends to require an 'IV administration kit', which would include one or more IV catheters."

However, the itemization of required items in the final ruling does not include IV catheters. "We're not going to be administering any of that fluid without catheters," declared MedAire President Joan Sullivan Garrett. She maintains that at least two catheters must be included. One is reminded of the aphorism about the horse lost for want of a shoe.

The FAA ruling followed an extended period in which public comments were solicited, and during which a number of suggestions were received. Many of them went well beyond AEDs and EMKs to include:

* Staff flights with medical personnel ready to respond to medical events.

* Limit alcoholic beverages consumed on flights.

* Have passengers inform air carriers about particular physical status and/or special dietary needs.

* Deny air passage to pregnant women.

* Maintain oxygen with a flow regulator adequate for at least 4 hours on overwater flights.

* Require two separate blood borne pathogen kits (a response kit and a cleanup kit).

The FAA responded dryly that these ideas were "beyond the scope" of its proposal. >TK