Narrative:

I found working with commercial medical advisory resource time consuming and more difficult than it could be. I also have many questions about how the process is supposed to work. I think a more organized 'patch checklist' and space on the form listing the drugs and supplies used from the enhanced medical kit along with the name, address, phone number and proof of identify of the medical personnel or person using the supplies is needed. Also, a head set with microphone in the cabin for the flight attendants and medical personnel to use. The situation was a 79 yr old man with chest heaviness. Fortunately a canadian emergency room doctor was on board who volunteered to help. I was informed of the problem after the doctor began to assist the passenger. The doctor had the 'pilot initiated patch checklist' and the flight attendants did not want to interrupt him to get the form filled out. I was asked to call commercial medical advisory resource by the flight attendant because the passenger was utilizing the oxygen bottle. I only knew the estimated age and sex of the passenger when I reached the med-link doctor via HF path. The doctor was hard to understand on the HF frequency. I did not even hear his name clearly. He, of course, wanted more information than I had been given. He wanted pain on a scale of 1 out of 10 and blood pressure. He wanted one aspirin and one nitroglycerine tablet administered and the man's blood pressure taken before and after these drugs were given. I passed this on to the flight attendant who relayed this to the doctor. In the mean time the med-link doctor asked about distances from airports for a divert. Portland would have been closer. I then asked for a more direct route to tou our next major fix. We were clear to this fix, which cut several mins off ur time to destination. When I explained to sea center that we had a medical emergency involved chest pain, we were given priority handling. The doctor in the cabin took so long getting me the information wanted the doctor suggested I call back. I did pass on the information that one aspirin and one nitroglycerine was administered, but I did not have blood pressure, pain level, or a completed form. We were now in the descent and heading more direct victoria VOR and direct yvr. When I finally got the patch checklist, I could not read the writing. There was no information on the form concerning what medications the doctor on board had administered. I think the form specifically needs a place to put drugs give. Otherwise, how can we account for the drugs or supplies used from the kit? I called back because the doctor wanted me to report back to him information from the patch checklist. I had to talk to the doctor in back directly to find out what drugs were administered. When I told the med link doctor that the patient was 79 instead of 70, was daily on 8 drugs for his heart, that the doctor in back had administered four nitroglycerine and the pain 5 out of 10, the med-link doctor asked me what airport we were close to for a divert. At this point we were in a high speed descent for direct base leg to runway 26L at yvr. Over 10 mins was cut from out time with the priority landing. The doctor asked that on more drug be administered so the pain would be zero instead of 5 out of 10. I relayed this to the doctor in back and he did not know of the drug suggested. He said it must be an american brand name that he was not familiar with. Later he told me it was morphine and that he passenger did not need it. The patient was removed by paramedics at the gate in yvr. He seemed alert and even thanked me as he walked off with assistance. His wife was concerned about which hospital he would be taken to. The paramedics assured he they would help he get him to wherever they needed to go but first he was going to the closest hospital. This was my first time working with commercial medical advisory resource. I was not clear who was in charge of the passenger care -- the commercial medical advisory resource doctor or the emergency room physician on board? What if the doctor on board just does his thing and ignores the commercial medicaladvisory resource's recommendations? Do the flight attendants let the doctor on board take over or do they attempt to maintain control? What if commercial medical advisory resource had pushed for a divert and the doctor in the back said it was not necessary? I recommend someone look over the med-link form that this doctor used and come up with a better form. 1) perhaps a before and after blood pressure, pulse, respirations section. 2) more space for the medications list. 3) room for name, address, phone number, e-mail of physical, and proof of identify. 4) a section that lists what drugs and supplies were removed and used from the kit. My intention with this report is to pass on information and get an improved form and a commitment from management or maintenance to install head sets in the cabin for these emergencys.

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Original NASA ASRS Text

Title: A B737-700 CREW EXPERIENCES PROBS GETTING INFO FROM THE CABIN AND ADDITIONALLY COMMUNICATING VIA HF RADIO WITH A COMMERCIAL MEDICAL ADVISORY RESOURCE.

Narrative: I FOUND WORKING WITH COMMERCIAL MEDICAL ADVISORY RESOURCE TIME CONSUMING AND MORE DIFFICULT THAN IT COULD BE. I ALSO HAVE MANY QUESTIONS ABOUT HOW THE PROCESS IS SUPPOSED TO WORK. I THINK A MORE ORGANIZED 'PATCH CHKLIST' AND SPACE ON THE FORM LISTING THE DRUGS AND SUPPLIES USED FROM THE ENHANCED MEDICAL KIT ALONG WITH THE NAME, ADDRESS, PHONE NUMBER AND PROOF OF IDENT OF THE MEDICAL PERSONNEL OR PERSON USING THE SUPPLIES IS NEEDED. ALSO, A HEAD SET WITH MIKE IN THE CABIN FOR THE FLT ATTENDANTS AND MEDICAL PERSONNEL TO USE. THE SIT WAS A 79 YR OLD MAN WITH CHEST HEAVINESS. FORTUNATELY A CANADIAN EMER ROOM DOCTOR WAS ON BOARD WHO VOLUNTEERED TO HELP. I WAS INFORMED OF THE PROB AFTER THE DOCTOR BEGAN TO ASSIST THE PAX. THE DOCTOR HAD THE 'PLT INITIATED PATCH CHKLIST' AND THE FLT ATTENDANTS DID NOT WANT TO INTERRUPT HIM TO GET THE FORM FILLED OUT. I WAS ASKED TO CALL COMMERCIAL MEDICAL ADVISORY RESOURCE BY THE FLT ATTENDANT BECAUSE THE PAX WAS UTILIZING THE OXYGEN BOTTLE. I ONLY KNEW THE ESTIMATED AGE AND SEX OF THE PAX WHEN I REACHED THE MED-LINK DOCTOR VIA HF PATH. THE DOCTOR WAS HARD TO UNDERSTAND ON THE HF FREQ. I DID NOT EVEN HEAR HIS NAME CLEARLY. HE, OF COURSE, WANTED MORE INFO THAN I HAD BEEN GIVEN. HE WANTED PAIN ON A SCALE OF 1 OUT OF 10 AND BLOOD PRESSURE. HE WANTED ONE ASPIRIN AND ONE NITROGLYCERINE TABLET ADMINISTERED AND THE MAN'S BLOOD PRESSURE TAKEN BEFORE AND AFTER THESE DRUGS WERE GIVEN. I PASSED THIS ON TO THE FLT ATTENDANT WHO RELAYED THIS TO THE DOCTOR. IN THE MEAN TIME THE MED-LINK DOCTOR ASKED ABOUT DISTANCES FROM ARPTS FOR A DIVERT. PORTLAND WOULD HAVE BEEN CLOSER. I THEN ASKED FOR A MORE DIRECT RTE TO TOU OUR NEXT MAJOR FIX. WE WERE CLR TO THIS FIX, WHICH CUT SEVERAL MINS OFF UR TIME TO DEST. WHEN I EXPLAINED TO SEA CTR THAT WE HAD A MEDICAL EMER INVOLVED CHEST PAIN, WE WERE GIVEN PRIORITY HANDLING. THE DOCTOR IN THE CABIN TOOK SO LONG GETTING ME THE INFO WANTED THE DOCTOR SUGGESTED I CALL BACK. I DID PASS ON THE INFO THAT ONE ASPIRIN AND ONE NITROGLYCERINE WAS ADMINISTERED, BUT I DID NOT HAVE BLOOD PRESSURE, PAIN LEVEL, OR A COMPLETED FORM. WE WERE NOW IN THE DSCNT AND HEADING MORE DIRECT VICTORIA VOR AND DIRECT YVR. WHEN I FINALLY GOT THE PATCH CHKLIST, I COULD NOT READ THE WRITING. THERE WAS NO INFO ON THE FORM CONCERNING WHAT MEDICATIONS THE DOCTOR ON BOARD HAD ADMINISTERED. I THINK THE FORM SPECIFICALLY NEEDS A PLACE TO PUT DRUGS GIVE. OTHERWISE, HOW CAN WE ACCOUNT FOR THE DRUGS OR SUPPLIES USED FROM THE KIT? I CALLED BACK BECAUSE THE DOCTOR WANTED ME TO RPT BACK TO HIM INFO FROM THE PATCH CHKLIST. I HAD TO TALK TO THE DOCTOR IN BACK DIRECTLY TO FIND OUT WHAT DRUGS WERE ADMINISTERED. WHEN I TOLD THE MED LINK DOCTOR THAT THE PATIENT WAS 79 INSTEAD OF 70, WAS DAILY ON 8 DRUGS FOR HIS HEART, THAT THE DOCTOR IN BACK HAD ADMINISTERED FOUR NITROGLYCERINE AND THE PAIN 5 OUT OF 10, THE MED-LINK DOCTOR ASKED ME WHAT ARPT WE WERE CLOSE TO FOR A DIVERT. AT THIS POINT WE WERE IN A HIGH SPEED DSCNT FOR DIRECT BASE LEG TO RWY 26L AT YVR. OVER 10 MINS WAS CUT FROM OUT TIME WITH THE PRIORITY LNDG. THE DOCTOR ASKED THAT ON MORE DRUG BE ADMINISTERED SO THE PAIN WOULD BE ZERO INSTEAD OF 5 OUT OF 10. I RELAYED THIS TO THE DOCTOR IN BACK AND HE DID NOT KNOW OF THE DRUG SUGGESTED. HE SAID IT MUST BE AN AMERICAN BRAND NAME THAT HE WAS NOT FAMILIAR WITH. LATER HE TOLD ME IT WAS MORPHINE AND THAT HE PAX DID NOT NEED IT. THE PATIENT WAS REMOVED BY PARAMEDICS AT THE GATE IN YVR. HE SEEMED ALERT AND EVEN THANKED ME AS HE WALKED OFF WITH ASSISTANCE. HIS WIFE WAS CONCERNED ABOUT WHICH HOSPITAL HE WOULD BE TAKEN TO. THE PARAMEDICS ASSURED HE THEY WOULD HELP HE GET HIM TO WHEREVER THEY NEEDED TO GO BUT FIRST HE WAS GOING TO THE CLOSEST HOSPITAL. THIS WAS MY FIRST TIME WORKING WITH COMMERCIAL MEDICAL ADVISORY RESOURCE. I WAS NOT CLR WHO WAS IN CHARGE OF THE PAX CARE -- THE COMMERCIAL MEDICAL ADVISORY RESOURCE DOCTOR OR THE EMER ROOM PHYSICIAN ON BOARD? WHAT IF THE DOCTOR ON BOARD JUST DOES HIS THING AND IGNORES THE COMMERCIAL MEDICALADVISORY RESOURCE'S RECOMMENDATIONS? DO THE FLT ATTENDANTS LET THE DOCTOR ON BOARD TAKE OVER OR DO THEY ATTEMPT TO MAINTAIN CTL? WHAT IF COMMERCIAL MEDICAL ADVISORY RESOURCE HAD PUSHED FOR A DIVERT AND THE DOCTOR IN THE BACK SAID IT WAS NOT NECESSARY? I RECOMMEND SOMEONE LOOK OVER THE MED-LINK FORM THAT THIS DOCTOR USED AND COME UP WITH A BETTER FORM. 1) PERHAPS A BEFORE AND AFTER BLOOD PRESSURE, PULSE, RESPIRATIONS SECTION. 2) MORE SPACE FOR THE MEDICATIONS LIST. 3) ROOM FOR NAME, ADDRESS, PHONE NUMBER, E-MAIL OF PHYSICAL, AND PROOF OF IDENT. 4) A SECTION THAT LISTS WHAT DRUGS AND SUPPLIES WERE REMOVED AND USED FROM THE KIT. MY INTENTION WITH THIS RPT IS TO PASS ON INFO AND GET AN IMPROVED FORM AND A COMMITMENT FROM MGMNT OR MAINT TO INSTALL HEAD SETS IN THE CABIN FOR THESE EMERS.

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.