As a resident physician, I love my job but residency is an incredibly busy time and I was really looking forward to a family vacation in Scottsdale, Arizona. We had a great trip but things took a nearly deadly turn flying home. At the beginning of my Southwest flight, I felt nauseated but thought it was probably indigestion from the lunch I just ate at the airport and that it would go away on its own soon. Later into the flight I suddenly felt itchy and had hives all over my face and chest. I took a Benadryl I happened to have in my work bag, because you never know what you or a coworker may need during a twenty-eight-hour shift, but it did not help. Suddenly I was short of breath, which quickly worsened as I felt my throat closing.
Although I had never had anaphylaxis before, I immediately recognized that was what was happening and knew I needed an epinephrine auto-injector (or EpiPen) to save my life. After pushing the call button for help, I with what little voice I had left at this point, asked the flight attendant to get me an EpiPen from the emergency medical kit. It was terrifying to find out at 30,000 feet that Southwest does not carry EpiPens in their emergency medical kits and that no other passengers had an EpiPen on the plane either. Time was running out as my family had to helplessly watch me struggle to breathe, and we were still thirty minutes away from landing.
The flight attendant handed me a glass ampoule of epinephrine from the emergency medical kit and nothing else. As I tried to smash it open against my tray table, someone appeared and let me know they were a doctor and were there to help. The other physician was able to safely open the ampule, put together the two syringes required to give it in this form, and safely administer it to me. Every second counts in treating anaphylaxis as it can quickly turn deadly. Epinephrine is the only treatment that can save someone’s life from anaphylaxis. The multiple steps to give this form of epinephrine require precious time even for medically trained professionals, and are not something a flight crew or the general public will likely know how to do. If the other physician had not been on my flight I would not be here today. EMS met us at the gate and immediately gave me an additional dose of epinephrine, of which I needed a total of three for me to be stabilized before making it to the hospital.
I got lucky with having another physician onboard and that this happened towards the end of my flight, but someone else won’t. We cannot depend on having a healthcare provider onboard or someone on the flight having an epinephrine auto-injector with them as an emergency preparedness strategy. The Federal Aviation Administration must require epinephrine auto-injectors to be included in airlines’ emergency medical kits to save passengers’ lives.