“MacGyver the friendly skies”: what’s in a commercial airline medical kit

Fly long enough and eventually you will hear the flight attendant over the plane PA system announce mid-flight, “if there is a doctor on board please press your call light.”  [if you don’t believe me, just ask OB Doctor Mom].

As an eager pre-medical student a few (ok, many) years ago, I thought this would be the highlight of my career.  I imagined I would jump into action as a cool & confident lifesaver that would use my mad MacGyver medical skills to save a life (or lives) midflight before informing the captain that there was no need to make an emergency diversion as I fully solved the life-threatening issue.   

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My childhood hero.

The reality–as all trained medical professionals are aware–is far less glamorous.  I have only been called upon once during a flight (Toronto to Copenhagen).   This 2-beers-deep subspecialty surgeon happily deferred to the three internists, nephrologist, and one critical care doc who also responded to manage the case of “back pain and anxiety” that was plaguing the forty-year-old gentleman in 38F.   Given that my best medical use during an inflight emergency would be to quickly obtain a surgical airway it is highly unlikely that I will ever be the jack-of-all-trades, life-saving MacGyver physician that my younger self imagined I would be.   

Nonetheless, I like to be aware of the tools available and keep up on the possible conditions which may require treatment on a typical commercial flight. A review of medical issues during flights found that there was 1 medical emergency in every 604 flights. Syncope, respiratory issues, and nausea/vomiting  are the most common complaints.  Of these issues, 7.3% result in aircraft diversion.  An unfortunate 0.3% of passenger issues result in death.  A physician is present to respond approximately 50% of the time.

The FAA requires all commercial carriers to maintain a medical kit as well as an AED onboard.  Here are the contents:

 

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FAA mandated medical kit contents (note: AED also present on flights)

 

 

Noticeably lacking from this kit is any ability to obtain a definitive airway (no endotracheal tube or laryngoscope). There is also no suction machine, anti-emetic , hemostat, or scalpel (for obvious reasons, I suppose).  Even before I discovered this medical kit list I always travelled with a headlight, hemostat, and endotracheal tube.  Given the lack of these on flights I will continue to do so (of course, if I ever have to use these then it would mean the patient is critically ill and my efforts may very likely be in vain if suction, O2, and definitive care are not soon available).  I am considering adding an epi-pen (easier to dose than vial epi) and Zofran (noticeably lacking from onboard kit given the frequency of vomiting) to my kit as well.

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The airway kit we brought on the first flight with our then 3 month old infant (note: we have since increased the size of the Endotracheal tube slightly from 2.5!)

Other articles go into the details, but as medical professionals acting in good faith, we are usually protected by Good Samaritan laws. I am also a firm believer of trying to stay up on the basics of medical care in case your services are ever needed regardless of your specialty.  I would also recommend travelling with some form of identification with your credentials (be it a copy of your medical license or hospital ID) as this may be required to access the medical kit.

Here’s  to uneventful and boring flights!

-M

 

 

[Disclaimer: this article is opinion only and is not intended to provide medical advice to diagnose or treat any medical condition]

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7 thoughts on ““MacGyver the friendly skies”: what’s in a commercial airline medical kit

  1. As a radiologist, I nudge my pediatrician wife if there is ever a call for a doctor on a plane.

    Once, while flying to Argentina, she went to examine a woman experiencing heavy bleeding (i’ll let you imagine where). I remember my wife was dismayed how little IV fluids were available. She, along with an internist on the plane, had to decide whether to land the plane before we crossed the Amazon rainforest, or try to make to Buenos Aires. In the end we continued on and everyone was fine.

  2. Yikes! I’d be tapping out of that one as well! I was surprised to see that 500ml is all that’s available. Glad everyone made it safely and on time. Was your wife given any vouchers or miles for her help (or an extra peanut packet at least)?

  3. I recently answered a call on a flight. I had to show my medical license before they would allow me to render aid. The passenger was hyperventilating and then passed out in front of me. Woke up a few seconds later and was perfectly fine. The stethoscope was broken. The engine noise was so loud I couldn’t hear anything anyways. They really need a digital BP monitor. I wrote the airline and never heard back. (United by the way). I’m just glad I didn’t get beaten up and dragged off the plane. Do planes have an AED aboard? Should be ok to shock even if the plane isn’t grounded right?
    Not that I expected anything but I didn’t get any acknowledgment from United afterwards. Just an extra can of soda.

    1. That is quite the story. It seems that united isn’t showing much love for any docs these days! The AED should be on every commercial flight and all medical equipment should be functioning per FAA guidelines (although I couldn’t find a requirement for testing the kits). Here is an interesting case report about AED use during a flight https://www.ncbi.nlm.nih.gov/m/pubmed/19378914/

      I’m glad your passenger/patient was fine…I’m really surprised you didn’t even get a free beer for your services!

      1. Thanks for the link. The pilot did say that O2 was available. Not sure from where- maybe the overhead oxygen masks?
        Funny, after the episode, two nurses on the same flight came up to thank me. Where were you guys?!?!
        BTW MacGyver rocks. Murdoc on Widowmaker was the best.

  4. I’ve answered that call. An anxious and dehydrated man had a vasovagal episode and fainted. I was one of 3 who answered the call. We used the AED to analyze his rhythm (sinus brady) and he was coming to by the time we got to him.

    I did use the kit to start an IV and we gave him a liter of NS. He did well, and we had an uneventful rest of the flight to Alaska to start our honeymoon. My wife and I were both upgraded to first class for the remainder of the flight, and we were given travel vouchers for future flights. It was a pretty cool experience all around.

    Cheers!
    -PoF

    1. That’s some serious onboard medical kit utilization! Strong work! Certainly that was a well deserved upgrade and voucher. I was surprised to see that there are no airway supplies required by the FAA. Do you ever pack your own ETT/laryngoscope during your travels?

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