When AEDs are Required
Commercial airplanes are generally equipped with Automated External Defibrillators (AEDs). An AED is a portable electronic device capable of assessing a person’s heart rhythm and delivering an electrical shock to treat life-threatening arrhythmias, such as ventricular fibrillation, during a sudden cardiac arrest event.
The presence of an AED is a regulatory mandate imposed by aviation authorities worldwide, not a voluntary choice for major carriers. In the United States, Federal Aviation Administration (FAA) regulations require all large commercial passenger aircraft operating under 14 CFR Part 121 to carry at least one approved AED. This mandate applies to airplanes that require at least one flight attendant and have a maximum payload capacity exceeding 7,500 pounds, typically including aircraft configured for 30 or more passengers.
International bodies establish similar requirements, setting the global standard for in-flight medical preparedness. The International Civil Aviation Organization (ICAO) recommends or requires AEDs on aircraft with a seating capacity of more than 19 passengers. Similarly, the European Union Aviation Safety Agency (EASA) recommends their carriage on aircraft with a capacity of 30 or more passengers when flying more than 60 minutes from a suitable airport. These rules ensure that on most commercial jetliners, the device is considered a “no-go” item, meaning the flight cannot depart without a functional AED on board.
Crew Training and Emergency Deployment
The availability of an AED is supported by the mandatory training flight attendants receive. Cabin crew members are designated as the primary first responders and are required to receive initial and recurrent training in Cardiopulmonary Resuscitation (CPR) and AED operation. This recurrent training must be completed at least once every 24 months to maintain proficiency in these life-saving techniques.
During a suspected cardiac emergency, the crew follows a specific, coordinated protocol. This begins with alerting the flight deck, which then initiates contact with specialized medical support on the ground. Simultaneously, the cabin crew retrieves the AED, which is stored in an accessible location, and may make a formal announcement, known as a Medical Volunteer Request, to find a licensed medical professional among the passengers.
Aviation AEDs are typically semi-automatic models designed for use by non-medical personnel. These devices feature clear visual and voice instructions that guide the operator through applying the electrode pads, analyzing the patient’s heart rhythm, and administering a shock if a “shockable rhythm” is detected. Immediate defibrillation is paramount, as survival rates for ventricular fibrillation—the most common form of treatable cardiac arrest—decrease rapidly, by up to 10 percent per minute.
Comprehensive In-Flight Medical Support
The AED is part of a comprehensive system designed to manage various medical events during a flight. This system includes the Enhanced Emergency Medical Kit (EEMK), which contains supplies beyond a standard first-aid kit. The EEMK is a secured container providing diagnostic tools and prescription medications for use by a medical professional or under the direction of ground support.
Enhanced Emergency Medical Kit (EEMK)
The EEMK contents allow for detailed assessment and stabilization of a patient until the aircraft can land. The ability to administer these specific medications and diagnostic checks complements the AED’s function, addressing the broader needs of an in-flight medical crisis. Typical contents include:
- A sphygmomanometer (blood pressure cuff)
- A stethoscope
- Aspirin for cardiac events
- Antihistamines for allergic reactions
- Prescription drugs for severe pain or nausea
Ground-Based Medical Consultation
The entire emergency response is guided by specialized, ground-based services like MedLink or MedAire, which provide real-time medical consultation via satellite communication. These services are staffed 24/7 by emergency physicians experienced in aviation medicine who have access to the airline’s specific protocols and equipment inventories.
The doctors on the ground advise the crew or an onboard medical volunteer on the appropriate course of treatment, including the administration of EEMK medications or the continued use of the AED. If the patient’s condition is severe and cannot be managed with onboard resources, the Captain has the authority to divert the flight. This decision is made in consultation with the ground medical team and the airline’s dispatch.