Narrative:

Approx 6.5 hours into flight; aft cabin called to advise of a possible passenger medical emergency. Pax was initially unresponsive; then not waking appropriately; and unable to move left arm or leg. A physician seated across the aisle from pax and an emergency rn did initial assessment; while I contacted dispatch via satcom to establish a phone patch with physician on call. First officer began preparations for a possible divert. On-board physician initially suspected glycemic emergency and requested a glucometer. Our in-flight medical kit does not contain a glucometer. Additionally; both blood pressure cuffs were not operating properly; and temperature measuring strips were not serviceable. I instructed the purser to make a passenger announcement asking if anyone had a personal glucometer; with negative results. After the announcement; two additional physicians identified themselves and offered assistance. One of these suspected an ischemic condition (stroke or tia). Two conference calls between dispatch; physician on call; cockpit; purser and on-board physicians were held; with differing medical opinions and diversion recommendations (approx 1.5 hours to ppt or continue 5.5 hours to destination). I advised the parties that our geographic location permitted us to delay diversion decision for approx 45 min with minimal impact. A consensus was reached to monitor passenger; who was by then on O2 and iv drip; for improvement. Pax showed signs of improvement then subsequently became fully responsive; with normalized vital signs and mobility. The decision was then made to continue flight to destination. EMS met pax on arrival and transported her to a medical facility for additional assessment/treatment.long haul flights are unique environments in which to provide medical care. Coordination between in-flight medical volunteers; on-ground resources; and crew is necessary to ensure a successful outcome. Further; composition of the on board medical kit should be periodically reviewed; and additional items such as glucometers; considered for inclusion. Inspection of medical kit contents must also include operability and serviceability of items; not just their presence. Information about in-flight medical incidents is limited by the lack of a central registry with standardized data collection. Such a registry would inform development of medical kits; best practices for in-flight medical volunteers; flight crew training; and passenger screening protocols.

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Original NASA ASRS Text

Title: Air carrier Captain reported a medical situation on an oceanic flight during which short comings of the onboard Emergency Medical Kit were revealed. The reporter suggested the contents of the EMK should be enhanced for long haul flights and that the items should be tested for serviceability and not just their physical presence.

Narrative: Approx 6.5 hours into flight; aft cabin called to advise of a possible passenger medical emergency. Pax was initially unresponsive; then not waking appropriately; and unable to move left arm or leg. A physician seated across the aisle from pax and an emergency RN did initial assessment; while I contacted dispatch via SATCOM to establish a phone patch with Physician on Call. FO began preparations for a possible divert. On-board physician initially suspected glycemic emergency and requested a glucometer. Our in-flight medical kit does not contain a glucometer. Additionally; both blood pressure cuffs were not operating properly; and temperature measuring strips were not serviceable. I instructed the purser to make a passenger announcement asking if anyone had a personal glucometer; with negative results. After the announcement; two additional physicians identified themselves and offered assistance. One of these suspected an ischemic condition (stroke or TIA). Two conference calls between dispatch; Physician on Call; cockpit; purser and on-board physicians were held; with differing medical opinions and diversion recommendations (approx 1.5 hours to PPT or continue 5.5 hours to destination). I advised the parties that our geographic location permitted us to delay diversion decision for approx 45 min with minimal impact. A consensus was reached to monitor passenger; who was by then on O2 and IV drip; for improvement. Pax showed signs of improvement then subsequently became fully responsive; with normalized vital signs and mobility. The decision was then made to continue flight to destination. EMS met pax on arrival and transported her to a medical facility for additional assessment/treatment.Long haul flights are unique environments in which to provide medical care. Coordination between in-flight medical volunteers; on-ground resources; and crew is necessary to ensure a successful outcome. Further; composition of the on board medical kit should be periodically reviewed; and additional items such as glucometers; considered for inclusion. Inspection of medical kit contents must also include operability and serviceability of items; not just their presence. Information about in-flight medical incidents is limited by the lack of a central registry with standardized data collection. Such a registry would inform development of medical kits; best practices for in-flight medical volunteers; flight crew training; and passenger screening protocols.

Data retrieved from NASA's ASRS site and automatically converted to unabbreviated mixed upper/lowercase text. This report is for informational purposes with no guarantee of accuracy. See NASA's ASRS site for official report.