Dr. Andrea Merrill, a Delta Air Lines passenger on a flight to Portugal earlier in the month, heard a call from a fellow passenger for help. The red bag was given to her as she approached the scene.
Merrill stated, “They said it was the medical kits and I opened it to see what it contained because I’ve never been in an in-flight medical emergency.”
Surprised at what was inside the kit, she was astonished. For example, the blood pressure cuff was not like one found in hospitals. It was a manual one that had to be assembled and used to listen for pulses with a less than optimal stethoscope.
Merrill stated that it was difficult enough to hear anything in a regular doctor’s office. But, if you’re flying at 30,000 feet, it can be very loud. It was impossible to hear and it took some time to put together the blood pressure cuff, then try to listen.
Merrill, a Boston Medical Center surgical oncologist, found out later that her experience was not an isolated one. This was just one of many experiences that medical professionals had, and it highlighted the long-standing need to increase the number of emergency supplies.
While she waited in the customs line to get into Lisbon, she took to Twitter to share her experiences with the airline. Her tweet was met with many replies.
Dear @Delta: I just helped in a medical emergency on the ground. You need to have a glucometer and epi pen in your medical kit. ItaEUR(tm),s impossible to hear the sounds of an airborne disposable stethoscope. This is important for passenger safety.
According to regulations set forth by the Federal Aviation Administration (FAA), airlines pack emergency medical kits. Although they can include more than necessary, some airlines may not have enough to meet the requirements of medical professionals.
Merrill found it difficult to use a manual blood pressure monitor. She was also surprised that no glucometer was available to measure blood sugar. Merrill said this would have been a great help.
While there was epinephrine available to treat allergic reactions as per the FAA’s requirements, there wasn’t an Epi-Pen to facilitate administration.
Merrill’s tweet was retweeted by other medical professionals who shared similar stories of treating emergency situations on the air. To combat drug overdoses and to use pulse oximeters to measure oxygen, they suggested that all emergency kits include naloxone.
Last summer, I was also able to assist with a medical emergency at @delta. The patient was concerned about possible stroke sx- there wasn’t a glucometer. There was a case for one but no suppliesaEUR
I have been involved in many emergency situations involving in-flight passengers over the years and agree that auscultation is almost impossible due to ambient noise. A cheap pulse oximeter (around $20) and an automated BP cuff could provide valuable clinical information to triage.
Dr. Paulo Alves at MedAire, the global medical director of aviation health, didn’t be surprised by Merrill’s reaction.
His company provides assistance from the ground during inflight medical emergencies. He’s also treated several emergencies so he knows the contents of the kit.
Alves stated that the last time the kit had been modified was 2004. It’s been a while, right? It is quite understandable that regulation doesn’t develop at the same rate as medicine.
A committee from the Aerospace Medical Association made recommendations to the FAA several years ago to upgrade the kits aEUR.” This included adding drugs such as naloxone and an EpiPen.
The FAA released a statement saying it was “reviewing medical kit requirements” and that in the interim, it had issued guidance to airlines regarding additional items they could include in their kits. The Congress has the power to make changes to the kits.
Alves stated that travelers can still trust there is a system to help them in flight medical emergencies. These are rare.
Support is available to medical professionals who are willing to help with these emergencies, regardless of whether they are a doctor, nurse, veterinarian, or dentist.
“A message to the volunteer medical professional is, “Hey, you’re never alone.” He said, “You know, you can always call for expert advice.”
Alves asked that people avoid travel when they feel sick or anticipate a medical problem. He said that even the best hospital advice and emergency kit are not as effective as getting treated in a hospital.
Merrill, for her part, said that a Delta Air Lines nurse called Merrill a few days after treating the emergency on the flight. This was part of company protocol and she used the opportunity to share her story.
She said that they had discussed the possibility of having a medical kit at the gate that could be added to their safety checklist. He said that he would bring it up with them. It was a constructive phone call.
A Delta Air Lines spokesperson stated that the company would be adding medical items to its medical kit this summer.
Merrill assured the patient that everything was fine on that flight to Portugal.
