Evac Q

[blackace]

I've always wondered this and would appreciate your comments.

In an emergency evacuation procedure what is the procedure for evacuating wheelchair or bed ridden medical patients ?

Do they get priority or do they get off last ?

And exactly how are they evacuated, are they just tossed down the chute regardless of their condition, or is there an alternative evacuation procedure for these patients ?

Of course the priority is to get out and get out fast and any possible injury has to be weighed against being burnt to a crisp. But just what are the procedures in these cases.

[misshostie]

My previus airline told me that we had to brief them and tell them that they could evacuate once the majority of passengers had evacuated.
I can only assume this is because they will be holding up everyone if they went first. Discrimatory yes...
When they evacuate they will have a crew member cross armed with them behind them on the slide.
They are instructed ONLY to go out through a floor level exit. Ie. No window exits.
They are given priority on boarding however, they are not given priority should an emergency situation occur.
There are so many what if's in this industry. It can be disheartening because crew are instructed not to risk their own life or go back into the plane if there is immediate danger...now with the disabled evacuating last...they may need to be left behind. Let's hope that never happens.

[blackace]

Thanks for that, but if that is the case how are you instructed to deal with the following hypothetical situation.

A stretcher case, a guy with a broken neck or something similar. Evacuating him might kill him, leaving him might also. Your not medically in the position to make any decision as to whether moving a patient might actually be more hazardous.

In a dangerous case like this is a doctor required to be always travelling with the patient so that he can make that decision, or is your decision final. the discretion to carry the passenger in the first place is the airlines so do they insist on the doctor being present before they allow him even on board.

Its understood that most evacs are safe and there is no real immediate danger, only a few cases are really important get out now or die situations.

There must be some kind of guideline from the airlines as to how to deal with this.

[SkySista]

The method MissHostie describes is pretty much it. If crew can get them to a floor-level exit, it's down the slide they go (with the CC member sitting behind them, legs over theirs, and arms holding theirs crossed over the chest) to secure them down the slide... preferably with others to catch/assist at the bottom. If no slide/undeployed, then it's pass them out the best way you can, hopefully you have ABPs, if not, harsh but true a broken ankle is better than dead, I guess you just have to drop them out as gently/best you can and get them moved away... I'm sure in any evac situation you'd have pax already outside you can scream at to come and take the person if need be...

It is sad but true that each case would be on its own merits, if the crew felt they would imperil their own lives by going back for a disabled pax, then it's their decision not to do so (one which hopefully I or any other CC would never have to live with)

However, if they felt it was safe then you have to weigh up the risks... (a potential to cause further injury vs a certain horrible death) would clinch it for me... if they were going to die and they could be saved with little risk to myself then I guess the decision would be to save them... can worry about causing further injury later... as one instructor said to me, better off injured than dead!! At least they have a chance... and no, we are not qualified to decide if someone should be moved on medical merits... it's more a 'Will they die if they are left? Can I evacuate them without harming/killing myself?' If you can do it, go for it... otherwise if you know help is on the way it may be better to leave it to the professionals... any way you put it, it's a tough call... but I'd hazard a guess not much time is actually spent thinking about it when it actually happens, but decision is made in the heat of the moment without 'conscious' thought... if that makes sense!!!

All the above goes to show the importance of a thorough, detailed briefing and ensuring the pax understand what you are telling them!!! I reccomend anyone who cannot assist themselves off the aircraft to have a comapnion who can assist them if need be.. at the moment it's not madatory for all wchr pax but maybe it should be, to give that extra margin of safety... after all, who better to help them than someone that does it all the time...

As for stretcher pax, I think these days (in Aus at least) most of those are taken care of by RFDS/ air ambulance rather than commercial carriers for the above reasons... e.g they have a nurse to look after them should there be an emergency

Ok, that's my 2c....

[britanniaboy]

Hey blackace

It's a nice hypothetical that you've put down there.

In emergencies and evacuations in partcicular, it's always the greatest good for the greatest number.

"Its understood that most evacs are safe and there is no real immediate danger, only a few cases are really important get out now or die situations."

Any full scale evacuation of an aircraft is considered a "get out now or die" situation; the decision to evacuate an aircraft is not taken lightly as there is ingerrent risk of serious injury to passengers in both the cabin itself and from descending the slides (indeed, there has been a case of a person involved in a full scale test evac to gain an aircraft it's all-clear for service being paralysed).

The bottom line is that in an evacuation, the Cabin Crew's first priority is to get each and every person off of the aircraft.

Generally speaking a medic (not necessarily a doctor, but more often someone who has trained as a nurse before specialising in accompanying ill passengers on fights) does have to travel with passengers such as the one you described, and most (if not all) UK carriers require that any passenger who is of reduced mobility (be the physically or mentally handicapped, blind, or is in a situation that renders them incapable of properly caring for themselves) has to be accompanied on the flight (usually their spouce or family member). This is not only to tend to their needs during a normal flight, but to assist them in an evacuation.

As for who makes the dicision as to whether the situation is serious enough that they should be moved, the initiation of an evacuation is that decision. I doubt that a medic accompanying them would try to override the Cabin Crew in making sure their charge was evacuated, but in the hypothetical situation you have descibed, I personally would do my job and maintain my authority on the situation which dictates that the CC are in charge on the aircraft.

There are no real special ways to evacuate a disabled passenger - they have to go down the slides the same as everyone else, but as they tend to be among the last ones to be evacuated, more care can be taken on how they board the slides.

As for your initial point that it could be more hazardous to move the patient you described than to leave him, the fact is that in an emergency we don't have the luxury of hindsight. It's a simple case of everyone gets out.

[ozangel]

It's a bit of a tough one. On the one hand, you can't really discriminate. Hence why when we brief passengers, I tell them that if they feel capable of getting to an exit without impeding or slowing the egress of anyone else they are welcome to. If they have a carer, I explain the same to them and delegate the responsiblity to them.
Of course, if there is an ABP who is willing to volunteer his/her help, they would be the first I would go for in a preparation time permiiting, to pair them up.
If it all goes pear shaped, I certainly wont be risking my life for anyone elses more than absoultely necessary, and I would hope the rest of my crew would be of the same opinion. 1 life lost is not quite as bad as 2, and even with basic first aid training, we are more use to the injured on the ground, and assisting marshalling passengers. Great quote from the united FA who survuved the Siox City DC10 crash - when the fires to hot, water too deep or smoke too thick, save yourself.
It's not a nice scenario to imagine, let alone deal with im sure. Unfortunately there is no 'ideal' solution that is in the best interests of everyone - and it would be impossible to prepare for every possiblity.

As for the stretcher cases, well, I would fully expect them to have a medical professional of some sort travelling with them. If they didn't, and it came down to live or die inside the aircraft, i'd be throwing em out the door quick smart. If theres no hope of them surviving inside, theres at least a glimmer of hope if they try and get outside. I certainly wouldnt want any nurse hanging round on board a burning plane arguing the slide decent would kill them. Shed have my boot up her a*se quick as a flash.

Its a very very tough call - history has shown us time and time again, what can start out as a small fizzle of smoke can kill hundreds in minutes.

[END BAG]

This is something i have often wondered about because as part of my job every day at some stage of the shift i will be on duty on the ambulift.Many times the person rquiring the ambulift will be paraplegic often as a result of motorbike accidets /car crashes etc. which means the only way that person can get on the a/c isby me and another person lifting them from wheelchair to carry chair then carrychair to seat.often it will also involve lifting them across two more seats once we are on the a/c until they are in their proper seat.to do this one person will be at the legs and feet end while the other person reaches over the top of the seat to lift under the shoulders or across the chest.if your passenger is around the 14 to 18 stone mark believe me you have got to be very strong and also at least 5-10 to 6 foot to reach over the seat.Most of the a/c i work on are holiday charter flights so the person will just be travelling with family off on their annual holiday.why i have often thought about this is because it is mostly holiday charter flights you often see the cabin crew are young ,new just starting in their careers and often quite slim and petite. i just think how on earth would they be able to lift an 18 stone paraplegic from their seat to safety

[GalleyWench]

We are told that pulling the passenger on a blanket towards the exit is an option. It is far easier to pull along a floor a great weight than to do it in a dead lift.

[Dolley]

Great quote from the united FA who survuved the Siox City DC10 crash - when the fires to hot, water too deep or smoke too thick, save yourself.

Yes, it's a great quote and I believe in it 100%.

But unfortunately the same FA commited suicide a few years later because she couldn't cope with the 'survivers guilt'.

It's something cc has to be very aware of, that we might have to exactly make this decision: To save our own live whilst other people might die!
It sounds horrible but easy enough, obviously you would save yourself! But nobody thinks of the consequences this decision brings with it. It very hard and everybody has to make up their own mind and be aware of the responsibility (for YOUR life, and that of others). It's not easy but part of our job. Although we obviously all hope that it will never come to this.

About disabled pax, I would say without a doubt everybody else of first. It's not discrimmination, it's common sense. Don't forget, there would be a panic too, there is no way anybody would wait for the slow evac of a wheelchair pax. If it's still safe to do so the cc should assist after everybody else is off. If not, remember the seatnumber/location and let the professional helpers know. You won't only have disabled pax, you will have people who experience negative panic and won't move, might even attack you if you try to move them. You have to be aware that you might have to leave people behind. Let's hope it never happens!

At the end of the day, I believe, we all have to make our own peace with this question. There is no easy 'This is right!' or 'This is wrong!'. You have to be able to live with yourself afterwards, and that's probably the hardest part.

[PER210]

with reguards to the FA who commited suicide, do passengers who survive ever get the same way? feel the same guilt? Do they offer to help in these situations?