Date: 201706
Local time of day: 0601-1200
Location: ZZZ.Airport, US
Light: Daylight
Aircraft: Medium Transport; Low Wing; 2 Turbojet Eng
Operator: Air Carrier
Operating under: Part 121
Flight plan: IFR
Mission: Passenger
Flight phase: Cruise
Airspace: Class A ZZZ
ATC / advisory: Center ZZZ
Aircraft component: First Aid Equipment; with Medical Kit & Defibrillator
Component problem: Design
Reporter organization: Air Carrier
Reporter function: Flight Attendant In Charge
Reporter qualification: Flight Attendant Current
Human factors: Time Pressure; Physiological - Other; Confusion; Workload; Troubleshooting
Second reporter function: Flight Attendant (On Duty)
Anomaly: Aircraft Equipment Problem Less Severe; Deviation / Discrepancy - Procedural Published Material / Policy; Flight Deck / Cabin / Aircraft Event Illness / Injury
Detector: Person Flight Attendant
When detected: In-flight
Result: Flight Crew Landed in Emergency Condition
Contributing factors: Equipment / Tooling; Procedure; Human Factors
Primary problem: Human Factors

Narrative: Passenger X rang her call button. I responded to her as I was working the First Class cabin. She stated she felt nauseous and asked for a cold cloth; which I brought; along with a vomit bag. Passenger X was traveling with a POC (Personal Oxygen Container). She mentioned it was her first time flying while having to use it and wondered if it was working properly. At that point I offered to bring the forward POB (Personal Oxygen Bottle) for her to use. I notified FA-B; of the situation and asked her to come [up] front to help me assess the passenger. Upon returning with the POB; FA-B asked me to page for medical assistance as Passenger X had lost consciousness and then came to. Prior to her loss of consciousness FA-B was able to find out that the passenger had COPD; Diabetes (had taken insulin the night prior but hadn't eaten) and had 2 prior open heart surgeries. I paged for medical assistance. Two passengers responded; a doctor and nurse. FA-B updated the women on the situation as they assess the passenger. I was instructed to retrieve orange juice and then notified the flight deck and told the CA I would report back. The doctor increased the personal oxygen container (POC) setting from 3 liters to 5 liters for the passenger. Two cups of juice seemed to help perk up Passenger X and she started to feel better. I notified the CA she had stabilized for now and I would keep him updated. The doctor then instructed me to get food preferably protein for the passenger to eat. FA-B then instructed the passenger to ring her call button at the slightest chance of not feeling well.Upon returning with a snack basket; Passenger X mentioned she was feeling nauseous and dizzy again. I notified the doctor; nurse and FA-B. We all came to her aid. She then fell unconscious. I retrieved the EEMK (emergency medical kit) and AED then notified the flight deck we had a medical emergency and requested MedAire and paramedics upon arrival along with a wheelchair. I also turned off the wifi. An ABP (Able Body Person ramper non-rev) assisted in getting Passenger X out of her seat and onto the floor. The POB was placed on her only to find out it wasn't working properly. I then retrieved a POB from the aft cabin. I also retrieved several sugar packets while the team was placing the AED pads to her chest. The AED analyzed her heart rhythm and a shock was not given. The passenger began to seize unconsciously. Several sugar packets were placed under her tongue while the doctor was going through the EEMK looking for supplies. She continued to seize intermittently. I notified the CA the situation was declining. The Captain notified me that ZZZ was the closest airport and he had already [advised ATC]. The doctor then administered injections of Dextrose intramuscularly. Passenger X began to regain consciousness; but was still malaise and not very coherent. By now we were in 'double chime; sterile '. All of the proper announcements were made by me. I also asked the passengers to remain seated upon arrival to allow paramedics to board the plane. Passenger X was too ill to be moved for landing. The three assisting us seats were moved; all of them would reach down and make sure Passenger X was safe and secure (not moving) upon landing. The ABP; was also in charge of making sure the medical equipment stayed secure (the POB was belted to the chair and secure). FA-B and I agreed that when we heard the landing gear go down we would all take our seats. As they finalized the medical details I ran to secure the aft and forward galleys. We were notified by a non rev pilot touchdown was in less than 30 seconds. I demanded everyone take their seats immediately. Unfortunately FA-B didn't make it to her seat and fell in the aisle upon touchdown. She jumped up and secured herself in the closest open seat. Once safe; she returned to her jump seat to perform her normal FA duties. Paramedics arrived and the aisle chair requested did not. FA-B retrieved the onboard aisle chairbut it got stuck. A paramedic had to slam it open for use. FA-B and the doctor briefed the paramedics and our passenger; Passenger X was removed from the aircraft.The EEMK is not user friendly in a very urgent situation. The doctor expected us to know the exact location of its contents. We had the contents list but didn't know where to look for the supplies. FAs should be able to see an open EEMK and location of contents. Time is precious and too much time was spent fumbling through it looking for the proper equipment. There needs to be medical glucose gel and a glucometer for quick use by a doctor as well as an automatic blood pressure cuff. Then general noise inside the plane is too loud to hear the volume on the AED for prompts. We were unable to hear any prompts over the general noise of the aircraft. The onboard aisle chairs need to be worked in so they don't jam upon trying to use. We need better syringe disposal. Two of the smaller syringes used were placed inside a water bottle but I had no way to dispose of the large 18 gauge attached to the dextrose. This is very dangerous as it was contaminated. I placed several napkins around the needle then placed several plastic cups over it. Then I placed the water bottle with the two smaller syringes and the larger one in a biohazard bag with a note on the bag 'caution contaminated syringes.' I was uncomfortable leaving the plane with those there. There should be a mandatory 'wait period' (30 minutes) to decompress and assess if one is fit to fly emotionally immediately after an emergency. We had to do a plane swap and board in 10 minutes after we finished the ZZZ flight. The Captain did ask if we were OK and of course we said yes but it was the adrenaline talking. We had not a moment to breathe. It was very intense in the main cabin. FAs were unaware the landing gear comes down very early in an emergency landing situation. We were waiting to hear it to take our seats (for safety of passengers in need). This is why we were scrambling in the cabin last minute. Also; FAs were waiting to hear back from MedAire but didn't realize it can't be communicated with during sterile flight deck. This should be conveyed to FAs during training events (initial/recurrent).


Second narrative: I have underlined the emergency equipment that we had issues with:1. Medair - We need to know that Medair is unavailable during the last 25 min of flight during initial descent. 2. Stethoscope - very poor quality; unable to auscultate anything while flying3. Manual blood pressure cuff - maybe an automatic one. This would have to be a part of recurrent training as all automatic BP cuffs operate slightly different.4. Glucometer - good tool to have in the EEMK to be operated by medical staff5. Glucose gel - quick acting; also good to have in the EEMK; 6. AED - could not hear the voice commands at all while in flight! Someone needs [to] check all the AEDs for the audible voice and that it is set on the loudest setting.7. EEMK - unfamiliarity of listed items; needles were bound in a plain white paper; nothing to distinguish them. Also no rubber tourniquet was found. This kit is very user unfriendly in an emergency. I think in initial/recurrent every FA needs to open the kit and look at the contents and remove the syringes from the boxes to see what they are dealing with. The medical staff assume we know what is in the kit and how it operates. The complete unfamiliarization of the content of the kit is a huge delay in administering emergency care.8. Aisle Chair - jammed. Once it was opened and reopened several times by the ramp agents; I was able to open it. This needs to be part of the maintenance checks monthly9. No aisle chair brought to gate by [company] personnel10. A mandatory 30 minute debrief/break before the next flight not including crossing seat belts; emptying trash or preflight then next flight; Also a phone call or better yet a supervisor visit to check on the staff.


Synopsis: EMB-175 Flight Attendants reported a passenger became ill during flight. Issues with multiple onboard medical devices were noted.