The prognosis is not encouraging. Not that you're actively planning such things, but try not to get very sick while flying on a U.S. airline. Chances are very good that the airline does not carry a comprehensive medical kit, and, depending upon when and where you get sick, you might be in for a very rough flight indeed.
And the airlines are not exactly rushing to correct the problem. Many of them have been lobbying against moves to require them to carry such kits.
"We've been opposed to it," says Chuck Novak, spokesman for United. "After all, who would administer the treatment? And," Novak argues, "even if a doctor was on board when a medical emergency happened, he has no medical history on the patient and the possibility of a wrong diagnosis is great."
United isn't alone in its opposition. Every major U.S. carrier has come out against the carrying of such kits. They argue that the kits are expensive, burdensome and could lead to misuse, or abuse.
AMA Against It, Too
The airlines aren't the only ones opposed to the concept of improved medical equipment on airplanes. The American Medical Assn. is against it. The AMA's Commission on Emergency Medical Services has said that only "certain minimum diagnostic and therapeutic equipment should be on board commercial aircraft."
This includes the basics: a stethoscope, sphygmomanometer (measures blood pressure), splints, tongue blades and a flashlight.
"Aircraft technology has zoomed in recent years," says one flight attendant who wants better medical equipment on board. "But our first-aid kits have remained the same--much too simple."
To be sure, medical kits carried aboard U.S. jetliners have changed little from the ones put together in 1924 by Johnson & Johnson for the first round-the-world flight: bandages, gauze, ammonia, ointment and a splint.
"It's barely minimum for a troop of Boy Scouts," says Sen. Barry Goldwater, who has introduced a bill to force U.S. airlines to carry medical kits that would be more useful to treat heart attacks, allergic reactions, seizures, diabetic comas, choking and bleeding.
The Goldwater bill is just one of recent moves to update medical equipment on commercial airliners.
The Federal Aviation Administration has been involved, reluctantly, in the issue since 1981. That's the year the Public Citizen Health Research Group of Ralph Nader's Aviation Consumer Action Project petitioned them to require airlines to carry better medical kits.
In their quest for a change in FAA rules, the consumer group charged that "every day, an unknown number of airline passengers develop serious medical problems, some of which may be life-threatening if not properly treated."
The FAA denied the petition in 1982, citing an American Medical Assn. report that stated the addition of potent drugs and instruments could create a "possible situation of misuse by unqualified personnel."
Nader's group then tried unsuccessfully to appeal the FAA decision.
Although almost every major foreign airline, including carriers such as Air New Zealand, Air France and Japan Air Lines, carries substantial medical kits, U.S. lines still fight the idea.
Tough Place for Diagnosis
"It sounds like a good idea on the surface," says Thomas Tripp, Manager of Technical Information for the Air Transport Assn. "But an airplane flying at 35,000 feet is an extremely tough place to perform an accurate diagnosis. It's hard to even hear an accurate heartbeat with all of the wind noise outside the airplane that the stethoscope picks up.
"There's also a problem with having drugs such as Valium and morphine on board," says Tripp. "One half of all people are allergic to morphine. A person can die from an allergic reaction."
But Goldwater wants medical kits on planes. So does Ralph Nader. And the Assn. of Flight Attendants is pushing hard for the kits.
"We want those medical kits," says Noreen Koan, chairman of the National Air Safety Committee of the Assn. of Flight Attendants. "There's a consistent need for them because quite often in an emergency a doctor is on board but he doesn't have the proper equipment. But the airlines don't want to spend the money."
In a majority of cases, a passenger who gets sick on a plane and receives medical treatment after landing is essentially treated in city and state record books as if he got sick at the airport where he was ultimately treated, not in the air.
The same recording philosophy applies if the passenger dies in flight. He or she is not officially declared dead until after the plane lands and the body is removed from the plane.
Air Canada is an exception when it comes to record keeping, and its figures seem to indicate that the incidence of passenger sickness in flight on all other airlines could be significant.