Date: 201902
Aircraft: Large Transport
Operator: Air Carrier
Operating under: Part 121
Flight plan: IFR
Mission: Passenger
Flight phase: Cruise
Reporter organization: Air Carrier
Reporter function: Pilot Not Flying; Captain
Reporter qualification: Flight Crew Instrument; Flight Crew Air Transport Pilot (ATP); Flight Crew Multiengine
Human factors: Communication Breakdown; Time Pressure; Workload; Situational Awareness; Distraction
Anomaly: Deviation / Discrepancy - Procedural Published Material / Policy; Flight Deck / Cabin / Aircraft Event Illness / Injury
Detector: Person Flight Attendant; Person Flight Crew
When detected: In-flight
Result: General None Reported / Taken
Contributing factors: Procedure; Human Factors; Company Policy
Primary problem: Company Policy

Narrative: In cruise at FL350; I was advised by my Pursor of a possible medical issue. A few moments later; he followed up with: [Passenger X] 56 year old male with heart problem history. Had stints implanted approximately one month ago. Collapsed; lost consciousness and was sweating profusely.  [Passenger Y; who is a doctor]; administered first aid to [Passenger X] and continued monitoring; speaking to me directly several times. [Passenger X] initial vitals [were] bp 84/40; hr 48; o2 SAT 88%. About 20-25 mins later; a conscious [Passenger X] was lying on our floor; breathing 100% o2; attached to AED; and vitals of bp 150/90; hr 60. Discussions were conducted between the cockpit crew; Medlink and diversion. Both LAS (slightly behind us) and PHX (in front of us) were options. The Medlink connection/reception was terrible and beyond difficult to understand. Medlink provided some treatment recommendations which came through garbled. I tried to relay what I thought I heard to [Passenger Y] and he corrected my misunderstanding; knowing what Medlink had said; verses what I heard.  I decided that if [Passenger X's] condition had not improved; we were diverting to PHX; and informed Dispatch of that fact. [Passenger Y] assured me that [Passenger X] was now stable and he did not recommend an immediate landing to get [Passenger X] to a hospital. Virtually every cabin medical kit had been opened and used; AED; sharps kit; o2 bottle; med kit; bp cuff [and] all MRM codes entered into logbook. We continued towards IAH...asked Dispatch to arrange EMTs to meet us at gate. Dispatch said Medlink had made arrangements.  The Medlink option is a wonderful tool to assist us with airborne problems; but if we cannot communicate with that provider; it is virtually useless. [Also]; using the cockpit as a relay station; taking one pilot away from his duties throughout the process; and at time both pilots away from their primary duty of flying the aircraft is dangerous (the reason why I decided to divert to PHX unless [Passenger X] was ok to continue). Talking to ATC; trying to decipher the encryption/static/garbled transmissions on our 2nd radio (Medlink); plus receiving numerous calls from the cabin with answers to questions being posed by Medlink gets very time consuming and confusing. The medical linkup needs to be behind the cockpit door! Possibly; a SATPHON in the cabin for medical issues only. Something; but NOT the cockpit!  Being advised and updated of the situation is perfect. That allows me (the First Officer and I) a chance to formulate a plan and discuss with Dispatch our options. Having me as a link between terrible reception and an ill passenger is ridiculous. We need to make SOMETHING available to the cabin crew!




Synopsis: Air carrier Captain reported a medical issue that caused a large distraction for the pilots.  The reporter recommended that Medlink calls be handled by the cabin crew.