Removal of Burn Compound From First-Aid Kits; Final Rule DEPARTMENT OF TRANSPORTATION

SUMMARY: This amendment revises the regulations concerning first aid

kits required on board air carrier, air taxi, and commercial aircraft

to remove the burn compound from the list of items required for the

kits. This amendment responds to a petition from Air Transport

Association, supported by the American Red Cross, that the burn

compound be removed from the kits since the use of ice or cold water is

the preferred treatment for minor burns. This amendment will relieve

affected operators from the expense of having to periodically replace

an item in the first aid kits that is not needed.

DATES: Effective date: January 12, 1994. Comments must be received on

or before March 14, 1994.

ADDRESSES: Send or deliver comments on the rule in duplicate to:

Federal Aviation Administration, Office of the Chief Counsel, Attn:

Rules Docket (AGC-204), room 916, 800 Independence Avenue, SW.,

Washington, DC 20591. Comments may be examined in the Rules Docket

weekdays, except Federal holidays, between 8:30 a.m. and 5 p.m.

FOR FURTHER INFORMATION CONTACT:

Gary Davis, Regulatory Branch, Air Transportation Division, Flight

Standards Service, Federal Aviation Administration, 800 Independence

Avenue, SW., Washington, DC 20591, telephone: (202) 267-8096.

SUPPLEMENTARY INFORMATION:

Background

On December 5, 1986, the Air Transport Association (ATA) submitted

a petition to delete burn compound (burn ointment) from the first-aid

kits required to be carried on each aircraft operated under part 121 of

the Federal Aviation Regulations. In the petition ATA noted that the

application of ice or cold water is the preferred treatment for minor

burns. As part of its supporting data, the petition included a request

from Western Airlines to delete burn ointment from their first aid

kits. Also included in the petition were copies of instructions from

flight manuals for several other airlines in which flight attendants

were advised to use ice compresses for the treatment of burns and not

to use the burn ointment unless it is requested by the passenger. In

addition, ATA stated that burn ointment normally has an expiration

date, which requires replacement, inspection, and record-keeping.

On January 21, 1987, ATA submitted a second letter to the docket

that transmitted an American Red Cross statement confirming their

position that burn ointment retains heat within the wound, causing the

wound to actually worsen in some cases. In addition, information

provided by the Red Cross indicated that burn ointment must be removed

before any other treatment can be applied.

ATA submitted additional information on April 9, 1987, in which it

cited the March 1987 ATA Cabin Safety Panel meeting where the subject

of first-aid for minor burns was discussed. At that meeting, each panel

member present stated that their flight attendants were trained to use

cold water or ice rather than burn ointment, unless burn ointment was

specifically requested by the passenger. Representatives of most of the

major airlines were included in this group, constituting over 80

percent of all the seat miles flown by the major airlines.

By letter dated July 6, 1987, ATA submitted a comment from the

School of Nursing at the University of Miami as an additional medical

opinion. That letter, from an associate professor, stated that

emergency care for burns should begin with stopping the burning process

by applying cool water to stop the pain and slow the process of heat

damage. This medical opinion also noted that application of ointments,

oils, etc., should be avoided.

The petition of ATA was published in the Federal Register on

February 20, 1987 (52 FR 5309). The comment period closed April 20,

1987. The only comments received on the petition are those cited above.

By letter dated July 6, 1993, ATA petitioned on behalf of its

member airlines and similarly situated operators for an exemption from

the requirement to carry burn ointment in first aid kits as required by

appendix A to part 121. A summary of that petition was published in the

Federal Register on August 11, 1993, and the comment period closed

August 31, 1993 (58FR42752). Two comments were received. The Air Line

Pilots Association supports the removal of the ointment from first aid

kits and notes that this removal would facilitate maintenance by

eliminating the need for purchasing, stocking, record keeping,

replacing, and disposing of the ointment. The Association of Flight

Attendants (AFA) agrees that the removal of the ointment from first aid

kits is an appropriate action; however, the AFA also suggests that the

FAA should require an equivalent amount of an antibiotic ointment in

its place. AFA adds that more recent information from the American Red

Cross suggests that cool water or wet cloths is the first step in

treatment, but that ice is not recommended except for minor burns.

The FAA's Analysis of the Petition

The FAA agrees with industry practice. Serious burns can be

properly treated only by professionals in a medical facility. Neither

burn ointment nor cold water is, by itself, an adequate response to a

major burn injury. The intent of the burn ointment requirement has

always been to provide relief from minor burns caused by cigarettes or

hot beverages.

In the limited situation of treating minor burns aboard an

aircraft, cold water is the preferred treatment. This treatment avoids

the heat retentive properties of burn ointment. Moreover, if the wound

requires further medical treatment, the use of ice or cold water

eliminates the need to scrape the wound to remove burn ointment.

Therefore, the FAA has determined that burn ointment should be

deleted from the list of items required for first aid kits in parts

121, 125, and 135. Ice or cold water is carried on aircraft operated

under part 121 and on aircraft with 20 or more passenger seats operated

under parts 125 and 135 to which aircraft the burn ointment requirement

applies. This will spare air carriers the unnecessary expense of having

to maintain an unneeded item.

Good Cause Justification

In consideration of the fact that burn ointment is not the

preferred treatment for minor burns, the requirement to carry burn

ointment aboard aircraft is inappropriate. Most types of burn ointment

have expiration dates, thus new ointment must be purchased, kits must

be opened, the ointment replaced, kit resealed and re-installed, and a

record of the action must be made. The cost of this process, with labor

being far more expensive than the ointment itself, represents a

significant nuisance burden for air carriers and commercial operators.

ATA carriers are required to maintain over 10,000 kits. This is an

unnecessary cost to the industry for which the consumer derives no

benefit. It is clearly in the public interest to delete the

requirement.

Since this is a minor amendment in which there is not expected to

be any public comment or disagreement from the medical community, the

FAA finds that public notice and comment on this amendment is

unnecessary. Moreover, because this amendment relieves a requirement,

it should be made effective upon publication in the Federal Register.

Interested persons, however, are invited to submit such comments as

they may desire regarding this amendment. Correspondence should

identify the docket number and be submitted in duplicate to the address

provided above. All communications received on or before the close of

the comment period will be considered by the Administrator, and this

amendment may be changed in light of comments received. All comments

will be available for public review, both before and after the closing

date for comments, in the rules docket.

Trade Impact Statement

The FAA finds that this amendment will have no impact on

international trade.

Economic Assessment

Because the amendment imposes no cost to operators, the only impact

of this amendment is expected to be that carriers will experience some

cost savings. Accordingly, the FAA has determined that the impact of

this amendment is so minimal that a full regulatory evaluation is not

warranted.

Federalism Implications

The regulation adopted herein would not have substantial direct

effects on the states, on the relationship between the states, or on

the distribution of power and responsibilities among the various levels

of government. Therefore, in accordance with Executive Order 12612, it

is determined that this regulation would not have sufficient federalism

implications to warrant the preparation of the Federalism Assessment.

Paperwork Reduction

This final rule is expected to produce a minor reduction in the

record keeping requirements under parts 121, 125, and 135. The

paperwork estimation for those parts will be revised accordingly.

Conclusion

To the extent that this amendment will have an economic effect on

the airlines and the general public, it will only be a minor, positive

one. Therefore, the FAA has determined that this amendment involves a

regulation that is not a significant regulatory action under Executive

Order 12866 or significant under the Department of Transportation

Regulatory Policies and Procedures (44 FR 11034; February 26, 1979).

Since no small entities would be affected by the rule, the FAA has

determined, and it is certified that under the criteria of the

Regulatory Flexibility Act, the rule will not have a significant

economic impact, positive or negative, on a substantial number of small

entities. The economic impact is so minimal that it does not warrant a

full regulatory evaluation.

List of Subjects in 14 CFR Parts 121, 125, 135

Air safety, Air transportation, Aviation safety, Safety,

Transportation, Cabin safety, First-aid kits.

The Amendment

Accordingly, parts 121, 125, and 135 of the Federal Aviation

Regulations (14 CFR part 121) are amended as follows:

PART 121--CERTIFICATION AND OPERATIONS: DOMESTIC, FLAG, AND

SUPPLEMENTAL AIR CARRIERS AND COMMERCIAL OPERATORS OF LARGE

AIRCRAFT

1. The authority citation for part 121 continues to read as

follows:

Authority: 49 U.S.C. App. 1354(a), 1355, 1356, 1357, 1401, 1421-

1430, 1472, 1485, and 1502; 49 U.S.C. 106(g) (revised, Pub. L. 97-

449, January 12, 1983).

2. In Appendix A to part 121, paragraph (5) is amended by removing

the item ``Burn compound, \1/8\ ounce or an equivalent of other burn

remedy, quantity 6'' and by moving the remaining six items in the list

to the end of the list in paragraph (4).

PART 125--CERTIFICATION AND OPERATIONS: AIRPLANES HAVING A SEATING

CAPACITY OF 20 OR MORE PASSENGERS OR A MAXIMUM PAYLOAD CAPACITY OF

6,000 POUNDS OR MORE

3. The authority citation for part 125 continues to read as

follows:

Authority: 49 U.S.C. App. 1354(a), 1421 through 1430, and 1502;

49 U.S.C. 106(g) (Revised Pub. L. 97-449, January 12, 1983.)

Sec. 125.207 [Amended]

4. Section 125.207(a)(1)(iii) is amended by removing the item: Burn

compound, \1/8\ oz or an equivalent of other burn remedy, quantity 6.

PART 135--AIR TAXI OPERATORS AND COMMERCIAL OPERATORS

5. The authority citation for part 135 continues to read as

follows:

Authority: 49 U.S.C. App. 1354(a), 1355(a), 1421 through 1431,

and 49 U.S.C. 106(g) (Revised Pub. L. 97-449, January 12, 1983).

Sec. 135.177 [Amended]

6. Section 135.177(a)(1)(iii) is amended by removing the item: Burn

compound, \1/8\ oz or an equivalent of other burn remedy, quantity 6.

Issued in Washington, DC on January 5, 1994.

David R. Hinson,

Administrator.

[FR Doc. 94-626 Filed 1-11-94; 8:45 am]

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