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by tgokh 3583 days ago
Are you in the US? The FAA has a strict set of minimum medical equipment for each flight with a flight attendant. [1][2]. European regulations require a lot more but don't actually apply to most flights in Europe as they only require an EMK for flights going more than 60 minutes from any airport. Even then, it seems like many European airlines carry a lot more than their American counterparts, though less than the ICAO recomendations [3]

[1] https://www.law.cornell.edu/cfr/text/14/part-121/appendix-A

[2] http://www.faa.gov/documentLibrary/media/Advisory_Circular/A...

[3] http://www.sciencedirect.com/science/article/pii/S1477893910...

1 comments

I'm in Canada.

That being said, I've review your first link, and I'm not impressed.

* Sphygmonanometer = useless. You can't hear fuck. Just taking the pulse is accurate enough in life or death circumstances.

* Stethoscope = almost useless. You can't hear fuck. Might want to use to confirm a suspicion of pneumothorax.

* Airways, oropharyngeal. Most people don't know how to use those. Might be useful, though

* CPR mask. If he's coding in the plane, he's dead.

* Saline solution, 500 cc. As good as two glasses of (holy) water by mouth.

* Protective nonpermeable gloves or equivalent. Good ! Should have at least four of those.

* Analgesic, non-narcotic, tablets, 325 mg = Tylenol. Who cares

* Antihistamine injectable, 50 mg. Why ??? Not more potent than any cheap oral antihistamine.

* Bronchodilator. Good

* Epi. Good. But they should not have two different concentrations to confuse people.

* Lidocaine. Have no idea why anyone would want that.

> Sphygmonanometer = useless. You can't hear fuck.

A systolic pressure is still a useful datapoint. If you want to get a diastolic pressure, see if you can't track down a paramedic (a modern widebody jet isn't much louder than the back of a rig).

> Stethoscope = almost useless. You can't hear fuck.

See above...

> Airways, oropharyngeal. Most people don't know how to use those. Might be useful, though

Most people don't know how to use any of this stuff... That's why they page for a doctor...

> Saline solution, 500 cc. As good as two glasses of (holy) water by mouth.

That's enough to make a difference for a preload sensitive heart failure pt.

> Analgesic, non-narcotic, tablets, 325 mg = Tylenol. Who cares

Someone in pain?

> Lidocaine. Have no idea why anyone would want that.

As an antiarrhythmic, I'm sure. A "hail mary pass" at best, but worth a shot, I guess.

>> Airways, oropharyngeal. Most people don't know how to use those. Might be useful, though

> Most people don't know how to use any of this stuff... That's why they page for a doctor...

In Australia we teach OPAs in Advanced First Aid (not the first aid certification that most people get, but it's a component of the training that workplace first aid officers at any large business must undertake). I'm not sure whether flight attendants are required to undergo that training but it would not be unreasonable to make them.

Of course, as you say, when you can page for a doctor...

> Sphygmonanometer = useless. You can't hear fuck. Just taking the pulse is accurate enough in life or death circumstances.

Seems like a digital blood one would be fine?

> Antihistamine injectable, 50 mg. Why ??? Not more potent than any cheap oral antihistamine.

No more potent, but faster acting, no? Seems like a good idea for anaphylactic shock?

> but faster acting, no?

Not really. Even regular tablets begin to act in 20 min, even faster with the sublingual ones.

> Seems like a good idea for anaphylactic shock?

A very bad one, actually. Some people might want to give an antihistamine first (completely useless in anaphylaxis, by the way), and see what happens, instead of going straight to epi.

When you cannot know the provider's experience, its better to assume for the worse, and give one, and one only choice = EPI.

Antihistamines will not reverse anaphylaxis. If the patient has progressed to anaphylactic shock, they need epinephrine (and you might as well give them the half liter of fluid in the kit as well).
I don't quite trust a digital BP cuff. Airplanes aren't really loud at all. I've done vitals in the middle of louder crowds or in the back of a rig.

Anaphylaxis is only treatable with epi and fluids.