Coffee, tea … or Narcan? – Local health experts call for upgraded airline medical kits

WISE — Teresa Tyson was returning from vacation last fall on a flight from Florida back to Knoxville when she was part of an in-flight emergency."About 30 minutes into the flight they called for any medical personnel to come forward," said the nurse practitioner and CEO of nonprofit regional health services group The Health Wagon.Tyson and three other nurses on that flight were confronted with a woman showing no pulse or respiration."She was actually blue," Tyson said. "It was a miracle because she lived."Part of Tyson's medical training included assessing a patient for a possible drug overdose under certain conditions. Little medical information was available on the woman, meaning that Tyson and the others had to consider an overdose situation."At first her daughter was with her but had limited information," said Tyson. "One of the things you think of is a possible drug overdose but, in her case, it ended up not being a drug overdose.""One of the first things I asked was for Narcan when the flight attendants brought forth their medical bag but there was no Narcan in it," said Tyson. "That was on my list of differentials because she was so blue. When I called for Narcan, the attendants said they didn't have any onboard. I asked if anybody on the plane had Narcan and nobody did. If it had been an overdose, you're 30,000 feet in the air and you're at the mercy of what's in that bag."The nurses and Tyson started CPR, but the emergency defibrillator on the plane ended up not delivering a shock. They managed to start an IV, the pilot turned the plane back to a Florida airport, and emergency medical crews met the plane at the tarmac.Tyson said the incident got her checking on any government requirements for having Narcan among medical supplies on commercial flights. She found that the Federal Aviation Administration had started accepting public comments on a possible requirement."There's a bill proposed in the House of Representatives, HR 3616, that came out in 2023 and referred to the House Transportation and Infrastructure Committee," said Health Wagon Clinical Director Paula Hill-Collins, "but it was to direct the Federal Aviation Administration to include medications for treatment of an opioid overdose in an aircraft emergency. Now Congress is looking for public comment, but it's not yet been passed."Tyson said the bill would require other emergency supplies to help treat anaphylactic shock and cardiac emergencies too.While the bill was introduced by Maryland Democratic Congressman David Trone before he left Congress in 2025 and sponsored by 22 other legislators including three Republicans, Hill-Collins said, HR 3616 still sits in committee."Having Narcan available for use on a flight should be nonpartisan," Tyson said of the delay of action on HR 3616. "It was shocking that Narcan was not available on that flight."Tyson said training airline flight attendants and crews in Narcan use is not hard, adding that the Health Wagon and health organizations across the country have offered training to emergency and law enforcement personnel and the general public for several years."It may not necessarily be a drug overdose situation when you need Narcan," Tyson said. "A passenger might be exposed unknowingly to an opioid under a variety of situations.""There's a stigma attached to Narcan that shouldn't be there," Hill-Collins added. "In 2019 there was a guidance document sent to the FAA by the Aerospace Medical Association recommending including it in onboard medical kits."Narcan inhalers require no special refrigeration or handling to be stocked on aircraft, Tyson added."Narcan is highly effective, but it wouldn't have hurt anyone who wasn't suffering from a drug overdose either," Tyson said. "Having a couple of doses on a plane would be great. Overdoses just are so prevalent."Anyone wanting to send their comments on Narcan onboard commercial flights can go to: https://www.regulations.gov/commenton/FAA-2026-9178-0001. The proposed regulation is also identified by:-&emsp;&emsp;Docket No. FAA-2026-9178-&emsp;&emsp;Notice No. 26-13-&emsp;&emsp;RIN 2120-AM18-&emsp;&emsp;Title: Improving Emergency Medical Kit Efficacy and Flexibility in Commercial Airline OperationsUsing the public comment link at the webpage, Tyson said commenters can enter their comments of support for Narcan as part of an inflight medical kit. She also offered a sample comment that supporters can use to write their own comment."I respectfully urge the Federal Aviation Administration to require intranasal naloxone/Narcan on all commercial passenger aircraft as a mandatory item in emergency medical kits."Opioid overdose is a time-sensitive, life-threatening medical emergency. During a flight, emergency medical services are delayed until the aircraft lands and ground responders arrive. In those critical minutes, passengers, flight crews, and onboard medical volunteers need access to lifesaving tools."Narcan is safe, easy to administer, non-addictive, and widely used by first responders, law enforcement, schools, libraries, churches and public organizations. It has minimal downside if administered when opioids are not the cause, but it can save a life when opioids are involved."Not every in-flight emergency is an overdose. However, during the initial assessment of an unresponsive passenger with respiratory failure or cardiac arrest, opioid overdose may need to be considered as part of the differential diagnosis. In that moment, the medication must be immediately available."Aircraft already carry emergency medical kits and AEDs because some emergencies cannot wait. Opioid overdose reversal should be treated with the same urgency."I ask the FAA to require that every Part 121 commercial passenger aircraft carry at least two doses of intranasal naloxone/Narcan, include clear instructions for use, and require flight crew training on recognition and response to suspected opioid overdose."A preventable death in flight is unacceptable. Narcan should be on every commercial flight."