20/08/2026
Anaphylaxis can be fast, unpredictable and fatal. On an aircraft, every second counts, so why are airlines still relying on adrenaline that has to be drawn up from a vial or glass ampoule?
Most major airlines carry adrenaline in their emergency medical kits. But it is often supplied in a vial or ampoule that requires a syringe, dose calculation and preparation before it can be given.
That may be manageable in a hospital, but on a moving aircraft, potentially in turbulence, low light and under extreme pressure, it’s a very different situation.
Different adrenaline concentrations can add further risk. Even doctors who understand how adrenaline works may be unfamiliar or uncomfortable drawing up an emergency dose from an ampoule or vial outside a controlled hospital environment.
When Natasha experienced anaphylaxis on a flight in 2016, 2 EpiPens were administered, but her reaction remained severe. A doctor onboard found adrenaline in a vial in the aircraft’s emergency kit, but was not confident drawing up the correct dose because giving too much adrenaline can also be life-threatening.
This is why all airlines should carry ready-to-use adrenaline options, including auto-injectors (AAIs), such as EpiPen and Jext, or nasal adrenaline such as EURneffy, in their emergency medical kits.
This is currently a major issue in the US, where food allergy organisations are challenging proposed FAA changes that could continue to rely on cheaper vials and ampoules rather than requiring ready-to-use adrenaline options.
The standard for emergency care in the sky should be the same everywhere. When anaphylaxis strikes at 35,000 feet, passengers should not have to depend on whether someone onboard feels confident enough to draw up a dose.
This is a global aviation problem and it needs a global solution. We need airlines and aviation regulators worldwide to make ready-to-use adrenaline a standard part of emergency medical kits onboard.
In the UK, Civil Aviation Authority guidance also allows adrenaline in airline emergency medical kits to be supplied in vials and ampoules.
We fully support US organisations such as No Nut Traveler traveller, Allergy Research & Education and Red Sneakers for Oakley in calling for safer, faster access to emergency adrenaline on US flights.
When every second counts, emergency adrenaline should be ready when passengers need it.
Read Natasha’s Foundation’s Flying with a Food Allergy Report and our recommendations for safer air travel: https://www.narf.org.uk/flying-with-food-allergies