Protocols for use of inhaled nitric oxide (iNO) during air transfers
| iNO cylinders | Must be clearly marked with necessary hazard labels |
| Must not be changed during a flight or its delivery system dismantled | |
| iNO may only be carried when there is a real medical likelihood of being required | |
| If iNO is not required, the cylinder should not be taken on the return sector | |
| NO/NO2 detectors | Both NO and NO2 detectors must be carried on every flight with iNO |
| They must be fully functional and tested before departure | |
| In the event of an alarm the medical crew must immediately alert the flight crew of a gas leak. In such an event the flight crew will initiate an adverse event | |
| Adverse events | The aircrew will divert to an airport closest to a hospital with iNO facilities |
| Once the aircraft has landed, the doors will be opened allowing residual gases to be vented from the aircraft | |
| Arrangements will be made for the mandatory medical examination of the air crew | |
| Continuation of the flight is at the discretion of the air crew and dependent on any symptoms experienced by the crew | |
| If there is a clinical issue about deterioration of the infant and the need for an urgent onward journey, a request should be made for the services of a Search and Rescue (SAR) asset | |
| If a SAR asset is used, it has to be on the basis that no other option for transport is available and the condition is life or death |