The Federal Aviation Administration (FAA) five-year reauthorization was signed into law on May 16, 2024. The legislation now includes a provision that mandates airlines to carry epinephrine specifically intended for treating anaphylaxis in all on-board first aid kits. This is a significant victory for allergists and allergy advocacy organizations, such as the American College of Allergy, Asthma and Immunology (ACAAI) and its Advocacy Council, who have been lobbying Congress for this change for many years.
In the next two years, the FAA will be obliged to propose a rule revising the emergency medical kits. This will be based on several factors, including the ability of a non-medical professional to treat anaphylaxis. Additionally, the FAA will need to review and update the Emergency Medical Kit (EMK) content list at least once every five years.
Currently, airlines only carry epinephrine vials meant for cardiac emergencies. These vials require administration by a trained medical professional who understands the correct dosage and concentration and knows how to administer the medication via a syringe.
The Advocacy Council has long advocated for updating the EMK contents to include epinephrine for anaphylaxis that can be administered by someone without advanced medical training. Having a doctor on board during a medical emergency is crucial but they need access to appropriate medicine to treat patients effectively. Ensuring that epinephrine products designed for anaphylaxis are available on every commercial flight will allow doctors or non-medical professionals such as flight attendants to promptly address an anaphylactic reaction – where time can mean life or death.
The Advocacy Council plans to recommend that the language regarding epinephrine requirements is broad enough to include autoinjectors and does not inadvertently exclude new devices like nasal spray products currently under FDA review.
The passage of this provision is seen by the Advocacy Council as a significant win for allergists and allergy patients. However, more work lies ahead to ensure the desired changes are implemented. The Advocacy Council will continue to engage in the regulatory process to ensure the FAA review includes a requirement for epinephrine for anaphylaxis on airliners.
ACAAI is a professional medical organization of over 6,000 allergists-immunologists and allied health professionals based in Arlington Heights, Illinois. The College promotes collaboration and congeniality among its members who work together towards patient care, education, advocacy, and research. ACAAI allergists are board-certified physicians trained to diagnose allergies and asthma, administer immunotherapy, and provide patients with optimal treatment outcomes.
