Narrative:

While working this leg in cruise at FL300 about an hour out from our scheduled landing; me and the captain could clearly hear a scuffle going on in the cabin. We looked at each other and were going to call back to the flight attendant but just before we could she called up to us and informed us that she had a medical emergency with a passenger having a seizure in row 5. The captain (PF) said we will get the plane on the ground and hung up the phone and we got working on an alternate. Captain advised a landing in ZZZ as that was only about 40 miles ahead at 12 o'clock. I gave a quick thought as to whether that would be a suitable alternate and being that we have scheduled service into there and it was nearest practical I agreed and immediately informed ATC; they then immediately issued a descent. On the way down we were very saturated with calls from ATC and from the cabin passing back and forth information regarding the sick passenger and services required upon landing on top of the instructions given to us by ATC in regards to just flying the aircraft. The captain was able to complete a diversion report and I was able to get enough time off frequency to get the ATIS; runway landing; landing speeds; determine that we would be underweight; and attempted to contact operations. In all of this scuffle we had been in a steep descent into ZZZ with the captain unnecessarily taking his attention away from flying the aircraft. This led to us being very fast descending through 10;000 feet which triggered the high speed master warning multiple times. I gave a stern call for correction once and then again I said more abruptly that he needs to slow the plane down again of which he made a less than sufficient correction but we eventually were able to get down to a correct airspeed by about 8;500 feet. It was about this time we had a break and I could read and complete the in range checklist. We were all caught up by about this time although still in a steep descent we did a 360 to help get down with the help of ATC. But calls from the cabin started to come back again from both the flight attendant and a physician who was tending to the passenger when we were entering a very critical phase of flight and also with the sterile light illuminated. Again despite my best attempts to help alleviate workload for the captain he was task saturating himself and taking his attention away from flying the aircraft. I could sense his manic pace that he was attempting to use to get the aircraft on the ground and tried to alert him to slow down and relax but it did not seem to have effect. As we soon approached ZZZ airport I and the captain lost situational awareness due to task saturation and unfortunately marginal conditions at the airport. Which were reported as very VMC but due to a large amount of glare from landing into the sun made it difficult to see the field of which we were attempting a visual approach backed up with and ILS navaid as had been briefed. The approach checklist had been completed but due to us loosing situational awareness we were a lot closer to the airport than we thought and despite the captains attempts at some steep s-turns there was just no way to make that approach happen and we did get a sink rate aural warning on approach. So we broke off to the right and the captain asked me to request a visual approach to runway xx; of which I obliged and the tower advised that it was closed. So I said how about left traffic for runway 9; tower said that's just fine and cleared us to maneuver as necessary and cleared to land runway 9. I checked the winds to make sure the tailwinds were not excessive (which it was a 6 knot tailwind component) and made sure the captain was comfortable with making that maneuver which he said he was. From this point we made a left visual traffic pattern for runway 9 at about 1;000 AGL. I quickly gave the captain a the ILS course and frequency for backup and hoped the approach would work out better forus. Unfortunately the captain again overcome by his emotion to get the aircraft on the ground tried to rush too quickly and cut the turn to base way to short. We rolled final at about 400 feet and received and aural sink rate and bank angle warning on short final. We touched down relatively on speed and in the touchdown zone but the approach was far from stable. We turned off the runway and were met by paramedics who pushed stairs up to the aircraft and tended to the stricken passenger. Both the captain and myself were visibly shaken by the event. The passenger was taken off along with another passenger who had a slight injury while helping the man suffering from the seizure but he was able to get fixed right up and boarded the plane again. We did what we could to try to block out what happened and concentrate for our next leg to continue on to destination which happened without incident. The captain told me later on that he had never had a medical emergency on one of his flights before.there were a lot of threats on this flight but as I see it the overwhelming factor that led to the undesired aircraft state was just the captains inability to slow down and take his time. I tried to explain to him at one point that risking 50 lives is not beneficial to helping one life but it did not seem to take effect. Also the basic division of attention which allowed himself to get far too task saturated and stop flying the aircraft of which I was guilty of as well. Other threats were that: the captain had never had a medical emergency before; the multiple and unnecessary calls coming from the cabin in a critical phase of flight; marginal weather at our airport of intended landing; and lack of leadership in the cockpit. There were a couple undesired aircraft state's that occurred during this emergency diversion due to factors listed above but the most prominent undesired aircraft state that I observed was the airplane landing from a very unstable approach. The go-around was on the tip of my tongue during that whole approach; but being the fashion the aircraft had been operated up to that point I feel it was probably safer that we were on the ground; but landing from an approach like that is something I hope to never do again and I think the captain would agree with me we were both very disappointed in ourselves in how we handled this emergency.in the future I will be much more vocal and assertive in taking our time and making sure there is one level of safety in an event like this to prevent undesired aircraft states like this one. I have had a few of these types of emergencies before and frankly have gotten mixed assessments from pilots in prominent positions in this company some saying to do everything you can to get that aircraft on the ground quickly and some saying the opposite. This may just be a position that is just left up to people and their opinions but after this event I realize just how bad things can go if you do not take your time and lose focus on the bigger picture.

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Original NASA ASRS Text

Title: EMB145 First Officer reported a medical diversion that went poorly due to the Captain trying to rush too much. The first approach resulted in a go around and the second was unstabilized but a landing was achieved.

Narrative: While working this leg in cruise at FL300 about an hour out from our scheduled landing; me and the captain could clearly hear a scuffle going on in the cabin. We looked at each other and were going to call back to the flight attendant but just before we could she called up to us and informed us that she had a medical emergency with a passenger having a seizure in row 5. The captain (PF) said we will get the plane on the ground and hung up the phone and we got working on an alternate. Captain advised a landing in ZZZ as that was only about 40 miles ahead at 12 o'clock. I gave a quick thought as to whether that would be a suitable alternate and being that we have scheduled service into there and it was nearest practical I agreed and immediately informed ATC; they then immediately issued a descent. On the way down we were very saturated with calls from ATC and from the cabin passing back and forth information regarding the sick passenger and services required upon landing on top of the instructions given to us by ATC in regards to just flying the aircraft. The Captain was able to complete a diversion report and I was able to get enough time off frequency to get the ATIS; runway landing; landing speeds; determine that we would be underweight; and attempted to contact operations. In all of this scuffle we had been in a steep descent into ZZZ with the Captain unnecessarily taking his attention away from flying the aircraft. This led to us being very fast descending through 10;000 feet which triggered the high speed master warning multiple times. I gave a stern call for correction once and then again I said more abruptly that he needs to slow the plane down again of which he made a less than sufficient correction but we eventually were able to get down to a correct airspeed by about 8;500 feet. It was about this time we had a break and I could read and complete the in range checklist. We were all caught up by about this time although still in a steep descent we did a 360 to help get down with the help of ATC. But calls from the cabin started to come back again from both the flight attendant and a physician who was tending to the passenger when we were entering a very critical phase of flight and also with the sterile light illuminated. Again despite my best attempts to help alleviate workload for the captain he was task saturating himself and taking his attention away from flying the aircraft. I could sense his manic pace that he was attempting to use to get the aircraft on the ground and tried to alert him to slow down and relax but it did not seem to have effect. As we soon approached ZZZ airport I and the Captain lost situational awareness due to task saturation and unfortunately marginal conditions at the airport. Which were reported as very VMC but due to a large amount of glare from landing into the sun made it difficult to see the field of which we were attempting a visual approach backed up with and ILS navaid as had been briefed. The approach checklist had been completed but due to us loosing situational awareness we were a lot closer to the airport than we thought and despite the captains attempts at some steep S-turns there was just no way to make that approach happen and we did get a sink rate aural warning on approach. So we broke off to the right and the captain asked me to request a visual approach to Runway XX; of which I obliged and the tower advised that it was closed. So I said how about left traffic for runway 9; tower said that's just fine and cleared us to maneuver as necessary and cleared to land runway 9. I checked the winds to make sure the tailwinds were not excessive (which it was a 6 knot tailwind component) and made sure the Captain was comfortable with making that maneuver which he said he was. From this point we made a left visual traffic pattern for runway 9 at about 1;000 AGL. I quickly gave the captain a the ILS course and frequency for backup and hoped the approach would work out better forus. Unfortunately the captain again overcome by his emotion to get the aircraft on the ground tried to rush too quickly and cut the turn to base way to short. We rolled final at about 400 feet and received and aural sink rate and bank angle warning on short final. We touched down relatively on speed and in the touchdown zone but the approach was far from stable. We turned off the runway and were met by paramedics who pushed stairs up to the aircraft and tended to the stricken passenger. Both the Captain and myself were visibly shaken by the event. The passenger was taken off along with another passenger who had a slight injury while helping the man suffering from the seizure but he was able to get fixed right up and boarded the plane again. We did what we could to try to block out what happened and concentrate for our next leg to continue on to destination which happened without incident. The captain told me later on that he had never had a medical emergency on one of his flights before.There were a lot of threats on this flight but as I see it the overwhelming factor that led to the undesired aircraft state was just the captains inability to slow down and take his time. I tried to explain to him at one point that risking 50 lives is not beneficial to helping one life but it did not seem to take effect. Also the basic division of attention which allowed himself to get far too task saturated and stop flying the aircraft of which I was guilty of as well. Other threats were that: the captain had never had a medical emergency before; the multiple and unnecessary calls coming from the cabin in a critical phase of flight; Marginal weather at our airport of intended landing; and lack of leadership in the cockpit. There were a couple undesired aircraft state's that occurred during this emergency diversion due to factors listed above but the most prominent undesired aircraft state that I observed was the airplane landing from a very unstable approach. The go-around was on the tip of my tongue during that whole approach; but being the fashion the aircraft had been operated up to that point I feel it was probably safer that we were on the ground; but landing from an approach like that is something I hope to never do again and I think the Captain would agree with me we were both very disappointed in ourselves in how we handled this emergency.In the future I will be much more vocal and assertive in taking our time and making sure there is one level of safety in an event like this to prevent undesired aircraft states like this one. I have had a few of these types of emergencies before and frankly have gotten mixed assessments from pilots in prominent positions in this company some saying to do everything you can to get that aircraft on the ground quickly and some saying the opposite. This may just be a position that is just left up to people and their opinions but after this event I realize just how bad things can go if you do not take your time and lose focus on the bigger picture.

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.