Is there a standard medical kit on board?

DOCTORS responding to in-flight medical emergencies may have to wait another year before standards regarding the provision of medical kits on planes are in place.

There is currently no Australian legislation requiring airlines to have a medical kit, or to standardise the contents of the kits. Instead, individual airlines have discretion about the medical equipment they provide, according to the Civil Aviation and Safety Authority (CASA).

Proposed regulation of mile-high medical kits has been under way for more than 3 years, but industry consultation is ongoing and implementation is not expected until 2012.

Under the new rules, there will be mandatory requirements for planes to carry first aid kits and emergency medical kits, with inclusions recommended by CASA. However, the specific contents will not be legislated due to the speed of medical advances and the difficulty in changing regulations.

A CASA spokesman said the new medical kit rules were a small part of a large piece of regulatory reform, which had been delayed due to the huge consultative process and legislative drafting issues.

“But we understand that the better the equipment on board, the better the doctors can do what they need to do,” he said.

JAMA has raised concerns about the quality of in-flight medical care and equipment, with the release of a four-step proposal to improve in-flight medical care, written by two American doctors. (1)

Doctors in America who responded to in-flight emergencies faced challenges such as inconsistent or ill-equipped medical kits, inadequate support from flight attendants and cramped physical conditions, the authors said.

The proposal calls for mandatory reporting of all in-flight medical emergencies and systematic debriefing of anyone involved in the incident. “Collecting these records and disseminating lessons learned may help improve the care given”, they said.

A standardised first aid kit should be available on all flights, the authors said. The optimal contents of this kit would be based on expert consultation and the results of the mandatory incident reporting.

The proposal also recommends standardised access to on-the-ground medical support and improved training of flight attendants. In Australia, all flight attendants are required to have first aid training.

The JAMA authors said that key concepts in the quality health care movement, such as root cause analysis, actually originated in the aviation industry and helped improve flight safety. However, these approaches had not been applied to the medical care provided to airline passengers.

- Sophie McNamara

1. JAMA 6 May 2011 (Online first)

Posted 9 May 2011