Narrative:

Enrt sju to bwi we had a medical emergency -- elderly lady with suspected heart attack. Intern on board termed condition very serious and deteriorating. I picked orf as best close option. ATC cleared us for a high speed cruise descent. Did not religiously obey the 250 KTS below 10000 ft speed restr and advised approach of the fact. Patient condition was considered critical at this point. Slowed to more politically correct speeds at around 5000 ft and completed a normal landing. Cooperation by ATC was excellent, particularly by orf approach (WX was 500 ft overcast 1 mi visibility. Lady was taken off aircraft by advanced life support medical team still alive. Comment: great difficulty in establishing HF communication fsr rerte due to frequency congestion. It is nothing short of criminal that in this day of satellite communication we are running these over water rtes with such an anticipated system as ssb HF. It wasn't great when I was in the navy 35 yrs ago and it sure as hell is outmoded now. Direct aircraft to ATC communication technology is available now and it should be mandated.

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Original NASA ASRS Text

Title: EMER DECLARED -- ACR CREW WITH AN ILL PAX DIVERTS TO ALTERNATE AND KEEPS THE SPD HIGH BELOW 10000 FT. SPD DEV.

Narrative: ENRT SJU TO BWI WE HAD A MEDICAL EMER -- ELDERLY LADY WITH SUSPECTED HEART ATTACK. INTERN ON BOARD TERMED CONDITION VERY SERIOUS AND DETERIORATING. I PICKED ORF AS BEST CLOSE OPTION. ATC CLRED US FOR A HIGH SPD CRUISE DSCNT. DID NOT RELIGIOUSLY OBEY THE 250 KTS BELOW 10000 FT SPD RESTR AND ADVISED APCH OF THE FACT. PATIENT CONDITION WAS CONSIDERED CRITICAL AT THIS POINT. SLOWED TO MORE POLITICALLY CORRECT SPDS AT AROUND 5000 FT AND COMPLETED A NORMAL LNDG. COOPERATION BY ATC WAS EXCELLENT, PARTICULARLY BY ORF APCH (WX WAS 500 FT OVCST 1 MI VISIBILITY. LADY WAS TAKEN OFF ACFT BY ADVANCED LIFE SUPPORT MEDICAL TEAM STILL ALIVE. COMMENT: GREAT DIFFICULTY IN ESTABLISHING HF COM FSR RERTE DUE TO FREQ CONGESTION. IT IS NOTHING SHORT OF CRIMINAL THAT IN THIS DAY OF SATELLITE COM WE ARE RUNNING THESE OVER WATER RTES WITH SUCH AN ANTICIPATED SYS AS SSB HF. IT WASN'T GREAT WHEN I WAS IN THE NAVY 35 YRS AGO AND IT SURE AS HELL IS OUTMODED NOW. DIRECT ACFT TO ATC COM TECHNOLOGY IS AVAILABLE NOW AND IT SHOULD BE MANDATED.

Data retrieved from NASA's ASRS site as of July 2007 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.