A junior doctor is calling for lifesaving adrenaline auto-injectors to be carried on Eurostar after caring for a young child who suffered an allergic reaction on the service.
Dr Raphaelle Debray, 26, who is French and works for the NHS, was en route to Paris when she responded to an appeal for a doctor. She requested the onboard medical kit and found it contained only some plasters and a defibrillator. In contrast, international guidelines state that commercial airlines should carry emergency medical kits, with equipment and medication including adrenaline. British Airways and easyJet said they carried adrenaline auto-injectors (AAIs) on all flights.
Debray said: “This is not like a regular train where you can get an ambulance to come very quickly because of the time that you are underground.” She said the Eurostar medical kits should also include other medical items such as a resuscitation mask and airway stents to prevent obstructions in the upper airway.
Debray has written to Eurostar urging it to upgrade its first aid kits to include an AAI, available under the brands EpiPen, Jext and Emerade. Fortunately, the child did not suffer an anaphylactic reaction during the episode caused by chocolate containing egg, and quickly recovered after the incident on 11 April.
In the letter sent to Eurostar, Debray wrote that it was “shocking” that an onboard medical kit on an international service carried only plasters and a defibrillator. “A more complete medical kit in your trains could prevent deaths or severe injuries.”
Eurostar said this weekend it would review its medical kits, but that it was prevented by government regulations from including prescription medicines, which would include AAIs. A spokesperson said: “The safety and wellbeing of our customers and colleagues is always our number one priority. We carry first-aid kits as well as defibrillators on each of our trains, and our onboard crew are trained in first aid.”
The spokesperson said there were exemptions to the Human Medicines Regulations 2012 that permit aircraft, ships, offshore installations and schools to hold and supply some prescription medicines for emergency medical aid, but none applied to rail services. “We will be liaising with the relevant authorities about this,” the spokesperson said.
The risk to some people from severe allergies was highlighted by the case of Natasha Ednan-Laperouse, 15, who died in July 2016 after suffering a severe allergic reaction on a BA flight to a baguette bought from Pret a Manger at Heathrow airport.
Natasha’s father, Nadim Ednan-Laperouse, co-founder of the charity the Natasha Allergy Research Foundation, said: “Access to adrenaline auto-injectors can be a matter of life or death.
‘Given the exploding numbers of severe allergic reactions among children and young people, it is obvious that first-aid kits on planes, trains, ferries and cruise liners should contain AAIs. Ministers need to reform the regulations around AAIs.”
Simon Williams, chief executive of Anaphylaxis UK, said it was vital that people who were prescribed AAIs carry them at all times. He said the charity would support a wider availability of AAIs. “Staff will need full and proper training on dealing with an emergency and administering an AAI, and legislation may need to change.”
