Aircraft Cabin Hypoxia and Adverse Medical Events—Reply

In Reply In our review, we recommended supplemental oxygen for patients with dyspnea or another symptom of distress; we did not seek to restrict use of oxygen to only patients with dyspnea or hypoxia. Pulse oximetry is not commonly available aboard commercial aircraft, nor is it a required component of the emergency medical kit mandated by the Federal Aviation Administration, making clear identification of this finding infrequent. Because commercial airlines are not required to have oxygen stores to maintain passenger need for an entire flight, decision making led by the ground-based expert command physician allows the best use of any resources. Also, preflight screening to identify and plan for selected patients is wise, the latter often resulting in bringing on board an oxygen-concentrating device.