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I've read about people getting sick on-board a flight (or worse) - say a heart attack, or choking, or seizures or something that really requires urgent medical attention that isn't available from the staff and equipment on-board a flight.

What's the procedure at that point? Is it up to the captain to make a decision on detouring, or the airline, or can a passenger request it, for example? Or do you just continue on and hope all ends well?

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Short answer:

The captain has to divert to the nearest airport in case the urgent medical attention will save a life.

Long answer:

The first thing the crew should do once there is a sick passenger is looking for a medical professional onboard. A doctor will be preferred but a nurse or so will do the job in case no doctor is available. Now if there is a medical professional onboard then he/she will be in charge of deciding whether to land the aircraft in the nearest airport or not (emergency landing).

The confusion comes when no doctor is available onboard, usually the pilot will decide to land right away in case of heart attacks or seizures or when the passenger is unconscious. Meanwhile the crew will try their best to save the passenger's life, all crew members are trained for Basic Life Support and almost all aircrafts are equipped with AED, doctor kits and first aid kits.

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    Slight correction: the ultimate responsibility for deciding to land right away or not always lies with the captain. The doctor's advice is obviously a major factor, but sometimes it will be faster and safer (better hospitals etc) to just proceed to the destination.
    – lambshaanxy
    Commented Jan 23, 2013 at 9:55
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    Also, most airlines have access to on-call doctors who will try to diagnose the issue if there are no medical professionals on board.
    – lambshaanxy
    Commented Jan 23, 2013 at 9:55
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    @jpatokal you are right. But no captain will ever refuse a doctor's request to divert to save a life.
    – Nean Der Thal
    Commented Jan 23, 2013 at 17:04
  • I know on Virgin flights some flight attendants may be trained to perform certain medical procedures with the aid of medical staff communicating through some teleconferencing technology; my aunt had to do this twice - she was also the massage therapist for the long haul flights.
    – user1997744
    Commented Jan 3, 2015 at 11:41
  • @user1997744 all flight attendants are trained for basic life support and many other common medical emergency situations...
    – Nean Der Thal
    Commented Jan 3, 2015 at 11:42

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