When the Purser informs us of a medical issue we'll send a quick note to dispatch via ACARS to alert them and will ask the Purser to fill out a form that they have on their handheld devices which collects passenger information, medical professional information, vital signs, and the nature of the problem. They airdrop that form to one of our iPads and we relay the information to Medlink.

The first person we talk to at Medlink, via a phone patch on VHF or HF (most narrowbodies don't have SATCOM yet) does triage with that data then connects us to the doctor. Information is passed regarding the medical volunteer's qualifications and specialties. Seat numbers for the patient and volunteer(s) is passed so they know who they are and their travel plans.

The Medlink doctor asks questions and gives direction for treatment. If a diversion is needed, we give ETAs to several nearby airports and Medlink makes a recommendation as to which would be the best medical choice. Medlink arranges for the EMS response and car of the patient at whatever airport we go to, including our original destination.

Often we're told to have some first aid performed, maybe have them drink some juice, etc. and to monitor their condition. Updates are then provided at the intervals requested. If it's more serious, and we have a volunteer who can do a lot more, that information is passed as well from Medlink to the volunteer.

We carry a number of medical kits starting with two first aid kits. (We have two so that the airplane isn't grounded if the first one is used) One of the kits can only be opened by a medical professional with certain minimum qualifications. That kit contains instruments and medications that can not be used or administered by the F/As. Part of the F/A's preflight inspection is to ensure all of the required equipment is onboard and the tamper seals have not been broken. If they have, maintenance is called to replace them.

ATC is very accommodating when we declare a medical emergency. They will move other flights out of the way and give the affected flight direct routing and grant just about any request that they can. I've had a couple such landings at ORD (my base) and they go something like this:

I'll transmit, "United XXX, medical emergency" and wait for ATC's response. Sometimes they'll take care of a couple of pressing items to make time to get the information and they're likely alerting their supervisor who will redirect resources so that the controller has time to deal with our handling. When they reply, I'll have a specific request such as, "Request direct ORD, runway 28L" and they'll usually give exactly that. They'll ask for additional information about the passenger, if they are being attended by a medical professional, at what gate we will park, and whatever other things they'll need. They'll pass all of this information along to the next facilities and destination airport. When we land, everyone else has been stopped and we take a direct route to our gate where the EMS teams, arranged by Medlink, are waiting. It all happens very quickly.

The passenger's are usually pretty good at remaining seated to let EMS on board. If we can, we'll try to deplane a few at a time, front to back, when doing so won't interfere with the passenger's care and eventually deplaning.

Captain's are required to fill out a post-incident report as I believe is the Purser.

Medlink is also very helpful in making fly/no-fly decisions with ill passengers prior to departure. The gate agents have the ability to contact them, for that, but I don't know their procedures. We would use our procedures, described above, if we were involved in it.