Date: 201605
Location: ZZZ.Airport, US
Aircraft: B747-400
Operator: Air Carrier
Operating under: Part 121
Flight plan: IFR
Mission: Passenger
Flight phase: Cruise
Airspace: Class A ZZZ
ATC / advisory: Center ZZZ
Reporter organization: Air Carrier
Reporter function: Flight Attendant (On Duty)
Human factors: Other / Unknown
Anomaly: Aircraft Equipment Problem Less Severe; Flight Deck / Cabin / Aircraft Event Illness / Injury
Detector: Person Passenger; Person Flight Attendant
When detected: In-flight
Result: Flight Crew Requested ATC Assistance / Clarification
Contributing factors: Aircraft; Human Factors
Primary problem: Human Factors

Narrative: Passenger seated at XXD 72 year old on the manifest as 'Wheelchair' able to walk; assistance needed to/from the aircraft asked for assistance to use the lavatory after the initial meal service. He could not pull his weight to get up from his seat. Another male flight attendant asked me for assistance with the customer. The customer asked me to lift him up by his belt buckle from the back so that he could stand up. The customer was approximately 6'3' and it was physically difficult and ergonomically incorrect for me to assist in this way. I did it; and when he was standing; he said that he was feeling weak did not want medical assistance; but only needed to use the lavatory. He insisted that we use the 'handicapped lavatory' which was across the aisle at 3R. The closest lavatory was located at 3L directly behind his seat. He asked me to support him while he walked; and I agreed; suggesting that he hold my shoulders as we walked slowly. I asked him to ring the flight attendant call button in the lavatory when he was ready to go back to this seat. He rang about 5 minutes later; and I knocked on the door; and then opened it. When I opened the door he was still seated on the toilet; and unclothed from the waist down. He needed help lifting his weight from the toilet. He instructed me to reach under his arm and then I pulled him up; then closed the door so he could compose himself. 5 minutes later he rang the call button again. I opened the door; and there was vomit all over the floor and paper towels stained with what appeared to be food and red wine; I assisted him back to his seat and gave him a small bottle of water. I locked the lavatory off; and put it into the maintenance log. I informed the flight attendants of this customer concern; and directed that he not be served any more alcohol. Intoxication was not at issue; but because he had vomited red wine; I decided it would be best not to serve any more alcohol.I was about to go on my break. I had concerns because all 3 male flight attendants were going on break at the same time. Because of the physical difficulty required to assist this customer; and because it would be inappropriate to ask a female flight attendant to assist the customer inside the lavatory in an unclothed state; at the suggestion of [another] flight attendant; we enlisted the help of a physically strong customer seated [nearby] to assist with the lifting; and the purser consulted the older passenger's wife to insist that she help her husband inside the bathroom to clean up. After my rest break; I was briefed that the volunteer customer had indeed assisted in lifting him out of his seat so that he could use the lavatory. Almost immediately after resuming duty; I lifted him out of his seat once again; took him to the lavatory; waited for him; and then resumed duty without issue. His shirt was still stained with vomit. The medical emergency began approximately 2 hours and 20 minutes before landing when I was preparing my galley for the landing service. Another flight attendant informed me that my (physical) assistance was again needed with the customer. After lifting him from his seat and nearly completing our trip to the lavatory; I felt his weight shift backward. I turned; supported him; and he said that he was 'going down.' There were 2 empty seats in the exit row at 3R. I eased him down in the seat; and informed the cockpit that there was a somewhat incapacitated customer in the exit row there; and called for medical assistance. Several qualified customers volunteered assistance. We asked for the EEMK release and obtained it. We consulted [medical]. 3 doctors and a nurse took over the medical care; while I functioned as a liaison with the cockpit and obtained necessary supplies. The passenger retained consciousness and coherency throughout the emergency; but the doctors insisted that he remain lying down because his pulse was very weak throughout the episode. The doctors had difficulty in introducing the saline IV drip; but eventually it was accomplished. He began vomiting blood and the doctors were very concerned that he would begin aspirating vomit and blood. I assisted in placing the customer in the recovery position on the floor at 3R. It became difficult to contain the vomit and blood. Eventually we obtained priority landing at destination. The customer remained on the floor during landing while I secured an oxygen bottle and one of the doctors held his saline IV drip bag. 3R was completely unusable as an emergency exit. My jumpseat assignment was 4L; but I switched with the flight attendant seated there for landing because I was completely entrenched in caring for this customer. The jumpseat was unusable so I assumed the seat nearest the emergency exit at 3R. Both cabin and cockpit EEMK were used. Doctors expressed frustration with the availability of appropriately sized needles; quantity of needles; and the poor quality of stethoscopes. The secondary EEMK (cockpit) stethoscope was particularly inadequate in quality; but needed to be used because of damage to the somewhat better equipment in the primary EEMK. Both were deemed inadequate due to the noisy situation of an airplane interior. All the medical professionals were unable to determine a blood pressure reading. Also; the medical professionals wanted a way to measure blood sugar. The customer was diabetic; was on medication; but the spouse was unable to provide specific information about what the medications were. The customer also had a pacemaker and a previous history of gastrointestinal bleeding. The doctors stated that GI bleeding was the cause of the customer's bloody vomit; and a main reason why he could not be moved.Lifting 'mobile' customers out of their seats is not a part of normal flight attendant duties. If the customer were identified as immobile and in need of an aisle chair; it would have been helpful. True; the customer's legs worked; but he was ill and weak. This placed an enormous physical and logistical burden on the flight attendant crew whose efforts were already taxed by a situation of persistent light/moderate turbulence and chop. Even if this had not escalated into a medical emergency; we were already in a difficult situation. Customers who need to be lifted from their seats need to travel with a helper capable and trained to do the task. Flight attendants try their best; as we did; but the failure to identify this customer's special needs taxed the flight crew; and ultimately created a situation that compromised the safety of all passengers and crew.




Synopsis: B747 Flight Attendant described an ill passenger who required assistance getting out of his seat and walking to and from the lavatory; beyond the abilities of the female flight attendants to handle. He eventually required the assistance of doctors on board who find the contents of the EEMK to be inadequate and of poor quality.