The five-year reauthorization of the Federal Aviation Administration (FAA) was signed into law on May 16, 2024. In a big win for allergists and allergy advocacy organizations, the law includes a provision that, it is hoped, will require airlines to include epinephrine in a form specifically intended for treating anaphylaxis in all on-board first aid kits on planes.
The American College of Allergy, Asthma and Immunology (ACAAI) and its Advocacy Council have been advocating for this change with Congress for many years.
Within two years, the FAA will be required to issue a proposed rule revising the emergency medical kits based on, among other things, the ability for a non-medical professional to treat anaphylaxis. The FAA also will be required to review and update the EMK content list at least once every five years.
Under current requirements, airliners only carry epinephrine vials which would be administered by syringe. These vials are intended for cardiac emergencies. Administering this epinephrine to a passenger experiencing anaphylaxis requires a trained medical professional who knows the correct dosage and concentration and how to administer the medication via a syringe.
The Advocacy Council has long supported updating the required contents of the emergency medical kits (EMK) to include epinephrine for anaphylaxis that can be administered by someone without advanced medical training (for example, in an auto-injector). Having a doctor on board during a medical emergency is important. But that doctor needs the medicine required to treat a patient. Requiring that epinephrine products designed for anaphylaxis are available on every commercial flight will ensure that doctors (or non-medical professionals such as flight attendants) can quickly address an anaphylactic reaction – where minutes can mean the difference between life and death.
The Advocacy Council will recommend that the epinephrine requirement language is broad enough so that it includes epinephrine autoinjectors and does not inadvertently exclude new devices such as the nasal spray product currently under review by the FDA.
The Advocacy Council sees passage of this provision as a huge win for allergists and allergy patients. More work is ahead to ensure the changes we desire are effectuated. The Advocacy Council will remain engaged in the regulatory process to ensure the FAA review affirmatively adds a requirement for epinephrine for anaphylaxis on airliners.
