Physician Urges FAA to Change Epinephrine Auto-Injector Policy After Mid-Flight Anaphylactic Reaction

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Dr Lindsey Ulin, a resident physician in the Department of Internal Medicine at Brigham and Women’s Hospital, was flying from Phoenix to Austin on Southwest when she realized she was starting to feel the telltale signs of an anaphylactic reaction for the first time.

Anaphylaxis is a severe, life-threatening reaction to a food, drug, insect venom, or environmental substance.

“I developed hives all over my face and my chest, then I suddenly felt short of breath, which quickly got worse, and I could feel my throat closing,” she said.

With time running out, she called the flight attendant to request the onboard epinephrine auto-injector only to learn the plane’s emergency medical kit did not carry an auto-injector, only a vial of epinephrine and a syringe.

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According to Ulin, the process of filling and administering a syringe with the proper dose of epinephrine requires many steps.

“When it’s in that form, there’s no instructions, there’s no way to know. So, all of these steps which the average passenger — unless they’ve had medical training — is probably not going to know,” she said.

Luckily, another physician from Texas was aboard the flight who was able to draw and administer enough of the drug to stabilize her condition. She was met by EMS upon landing some 30 minutes later.

“When that physician showed up, just the sense of relief that came over me,” she said.

Ulin said her story could have ended with tragic consequences and is urging the FAA to mandate that all airlines carry epinephrine auto-injectors on board.

“Having to depend on a medical professional being on your flight or crowd-sourcing for life-saving supplies is not an emergency preparedness strategy,” she said. “I was lucky with how my story ended, but somebody else won’t be.”

Here follows a WCVB-TV report on the incident:


We at SnackSafely.com are happy tragedy was averted in this case and that Dr Ulin is well and advocating for change.

Epinephrine is the only drug that can halt and reverse the progression of anaphylaxis but must be administered in a timely fashion to be effective. When seconds count, having to scramble for, load, and administer epinephrine from a vial requires time and expertise that may not be available on every flight or in every circumstance. Having stock epinephrine auto-injectors onboard and training staff to administer them would ensure better outcomes.

We urge the FAA to mandate the devices aboard all flights and to ensure that at least one staff member trained to administer them is aboard at all times.

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Dave Bloom
Dave Bloom
Dave Bloom is CEO and "Blogger in Chief" of SnackSafely.com.

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