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Crewed Talk

The Crucial Lifesaving Medicine That Almost No Airline Carries

The Crucial Lifesaving Medicine That Almost No Airline Carries
Amanda Pleva

The moment dreaded by all cabin crew, one that we unfortunately all experience at some point in our careers, is the panicked ringing of a call button along with the shouts of passengers seeking help for someone slumped over in a seat or lying in the aisle. Medical emergencies are never easy to deal with, especially since the days have long since passed when flight attendants were required to be registered nurses. But when the issue is related to drugs, matters tend to get much more complicated.

Understandably, few people want to admit to us that they’d taken drugs, especially if they are illegal or abused prescriptions. When someone is in the thick of an overdose, responding to our queries naturally becomes difficult or impossible. Helplessly watching someone in the throes of something unstoppable is the worst feeling imaginable. And these situations are only on the rise, thanks to a growing global drug crisis.

The opioid epidemic has undeniably dug its claws into the world – so much so that, in the US alone, it is now the leading cause of injury death – more than that of traffic accidents.

Onboard an aircraft, there are different reasons why we might see a passenger on opioids – some because they have existing addictions, some because a friend might give them some prescription painkillers to help calm their nerves or to sleep through a long flight. Others may still be drug mules, which can lead to packaging rupturing internally. All of these scenarios have caused the deaths of passengers onboard flights my friends have worked.

Our emergency medical kits contain a vast array of supplies, but one tool not supplied by most is Naxalone, widely known as Narcan. Available in an injectible form but also as an easily administered nasal spray, it can quickly reverse the sedative effects of opioids, which can return a victim’s breathing to a normal rate, saving lives in minutes. It is relied upon as a key weapon for first-responders in a seemingly unwinnable war on drugs.

Overdoses are not a frequent issue for airlines, thankfully, but are on the rise. Unlike on the ground, it takes much more time for an overdose victim to receive the care they need, and Narcan could be the difference between life or death for a rapidly growing demographic of opioid addicts. Sara Nelson, spokesperson for flight attendant union AFA-CWA, says of the resistance of air carriers to the inclusion of the medicine onboard, “We are first responders and we’re the only first responders that don’t have access to Narcan to be able to save peoples’ lives when they are in a drug overdose caused by an opioid.” If having, say, an AED (automated external defibrillator) onboard is a requirement to save people who are suffering the effects of a heart attack, when moments count, it should also be a necessity to carry a powerful antidote which is much easier to administer and requires little training to use, and for people to whom seconds are no less valuable.

Perhaps the reason for the reluctance of airlines to equip their crews with this medicine is, predictably, the almighty dollar. As the demand for opioids has increased, so too has the demand for Narcan, and this isn’t lost on pharmaceutical companies, who are currently charging approximately $30 per dose for the drug. But when such an effective life-saving option is deemed essential for first-responders on the ground, who can also take a patient immediately to a hospital, it seems to be a no-brainer to supply those of us without that ability with the same tools, regardless of the cost.

Besides being a potential lifesaver for people who have intentionally taken drugs, the possibility also exists for accidental intake; it’s not unheard of for crews to accidentally get stuck with an improperly discarded used syringe. While it is unlikely for someone on board to overdose in this manner, police, firefighters and EMTs all carry Narcan for this reason as well.

We live in a time that has normalized prescription drug abuse – I’ve seen them gleefully traded between elderly women, whose hands were weighed down with gemstones worth more money than I will ever earn in my lifetime, and I have also seen them taken by middle-aged people in a place of despair. I have seen their use referenced as casually as having a glass of pinot noir at happy hour. Few people seem to regard them with any sense of caution anymore, which is terrifying because it is this comfort that is causing this widespread problem. When people regularly take others’ prescriptions just to get through a flight, overdose is certainly not out of the question. It is our job as flight attendants to save lives when we can, and airlines should be required to carry Narcan, just as they’re required to carry other medical equipment.

My friends watched people die in their care, and that feeling is unimaginable. The passengers in those cases were all young, otherwise healthy people. Could Narcan have saved them? Sadly, there’s no way to know that now. But if we could prevent just a handful of passengers from arriving at their own funerals, wouldn’t it be worth any cost?

[Photo: Shutterstock]

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1 Comment

  1. leighjohnwi

    October 4, 2017 at 9:12 am

    Amanda, excellent article to incorporate yet another aspect of the current Opioid Epidemic in the US. This also raises an issue that I’ve personally experienced as a medical and health research professional in-flight, and having to access an aircraft’s medical kit. From my personal experience, these kits are spartan at best, and unfortunately the best recourse for a patient in urgent need is an emergency landing at the nearest airport with medical services nearby. Not only are these kits stocked with minimal medical equipment (trying to assess a passenger’s blood pressure with an old stethoscope and arm cuff in-flight is next to impossible…an automated/digital cuff would do wonders), but they are not meant to be periodically checked and updated with more current supplies/medications. Unfortunately, most medications that should be included to temporarily treat a critical patient (Naloxone[note the correct spelling here], Insulin, Epinephrine, etc.) have shelf lives between 12 and 24 months. The expense in supplies and staff hours to consistently check and replace these items is likely not worth it for airlines. Case in point, the insulin vial that was in the onboard medical kit I accessed to attempt to treat a passenger was almost a year expired.

    While I agree that having even an expired dose of these critical medications is better than nothing, this is a bigger issue that certainly would benefit from a larger discussion. In any case, I commend you for your efforts to bring attention to this issue.

    Be well,

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