PAN-PAN Medical Emergency

[Cartman's Twin]

Afternoon Folks!

Imposter ATCO alert.... I'm a London terminal control bod and just woken up after my night shift, and I'm just trying to make our lives that little bit easier and increase mutual understanding etc etc.....

This morning had a LL inbound arriving just after the gates opened and about 40 miles before OCK the chap in question (you know who you are!!) declared a 'medical emergency' with a sick pax.

The reason for my post is that our hands are tied you see. These days the term 'medical emergency' technically carries as much of the proverbial welly as 'fuel emergency' - ie. none. It is a very minor point I realise, but the only call which will automatically give you priority is a PAN-PAN or MAYDAY. Just declaring a med emergency is more likely going to result in the ATCO trying to get you to say P-P on the tapes, further wasting your time and causing confusion at a point when I'm sure both sides would prefer to be making arrangements for your expeditious arrival.

I realise it seems ludicrous but there have been instances where a 'med emergency' has been loosely called shortly after 20 minute delays have been advised to the crew - convenient! I'm sure you can imagine how much work is caused when the system designed to handle a/c in a orderly manner has to make the 23rd in line the new number 1. (If you can't please do come and visit us at TC). By just giving us a PAN-PAN due to sick pax the ball will get rolling that little bit quicker and we can all have a slightly easier life!

Kind regards

PS. Hope the pax was ok

[Airbubba]

Glad we don't dwell on such R/T technicalities in an emergency situation in most other parts of the world, thanks for the update, I'll be flying through your airspace in a few hours.

>>I realise it seems ludicrous but there have been instances where a 'med emergency' has been loosely called shortly after 20 minute delays have been advised to the crew - convenient! <<

I sure understand how the level of urgency can be misrepresented by pilots running late for a commute back home. Still, I've sure been hesitant to ask for priority handling with a real problem onboard if it looks like we're getting in with no delay. If delays are announced, it does put me in a somewhat suspicious situation if I then request priority, as you point out.

If you called Pan-Pan in the U.S., most folks wouldn't have a clue what you were talking about.

[Human Factor]

If it's the guy I heard, he mentioned on first contact that he may have a medical problem. The controller asked if he was declaring an emergency to which he said no and would keep him advised. My understanding has always been (evidently correct) that ATC won't do anything special for you in this case unless you mention the P or M words.

[Cartman's Twin]

>>> Still, I've sure been hesitant to ask for priority handling with a real problem onboard if it looks like we're getting in with no delay. If delays are announced, it does put me in a somewhat suspicious situation if I then request priority, as you point out.


Just to clarify, if any a/c actually declares a PAN (or MAYDAY), be it just after the delay has been announced or 2 miles short of the hold, or indeed when you're the only a/c on frequency, no controller would question your judgement. As far as we're concerned if you declared either we'll offer every possible assistance and the seas will part - no question

[Freeway]

Thanks for that clarification Cartman.
I declared a medical emergency to Shanwick 2 weeks ago during a transatlantic sector. They were very helpful and relayed our problem to London and allowed us to increase to our max mach.
On handover to London, the controller advised that there was currently a 15 minute arrival delay into LGW and if even though he understood that we had a medical emergency, unless we declared a pan or mayday, then we would not be treated as a priority.
We declared a pan and were treated expeditiously by London as a priority.

[feet dry]

In the nautical world there are strictly two types of Pan call. The Pan Pan which describes an Urgent situation, there is also a Pan Pan Medico call. This latter call is intended for those vessels where they require medical advice for an ill or injured person on board. These calls are routed via the jolly old CG to one of two hospitals where an on call doctor can provide treatment advice and/or will recommend evac or similar.

Just thought you might be interested.

[normal_nigel]

As an aside at LHR if you want paramedics on arrival you have to declare a medical emergency/pan/mayday/start screaming or whatever.

No paramedics based at LHR despite it being the size of a small town!

NN

[Paracab]

normal_nigel,

I think the info about Paramedics not being based at LHR is incorrect, I was working with a chap today who was telling me about his days working at LHR ambulance station and I got the impression it was within the confines of the airport, however will clarify when we are rostered on together next.

Someone will probably do that for me as I've just checked my diary and its not until next week !

[normal_nigel]

Not any more. Its the London Ambulance Service based externally.

Or so everyone else tells me

[Jerricho]

If you called Pan-Pan in the U.S., most folks wouldn't have a clue what you were talking about.

Am I the only one who finds that a little concerning?

[Captain Airclues]

If you called Pan-Pan in the US most folks wouldn't have a clue what you were talking about

Perhaps they should read US Aeronautical Information Manual 6-3-1(c)......"The initial communication, and if considered necessary, any subsequent transmissions by an aircraft in distress should begin with the word MAYDAY, preferably repeated three times. The signal PAN-PAN should be used in the same manner for an urgency condition".

Airclues

[Falconpilot]

Hello to you all,
thanks for the clarification for the Pan or the mayday, we all need some reminders...
The question raised is what sort of priority do you get from ATC when you are a "medical flight" carrying a heart or other body parts to save somebody's live at your dest? Just those two words gave me plenty of priorities in the past. And we never declared a pan or a mayday ( as by definitions it's for the flight safety itself) .

Cheers
Falconpilot ( yes I'm an old viper driver that switch to civilian)

[normal_nigel]

The point being, and often pointed out in our sims,that PAN may go unrecognised in many parts of the world.

One example is Maquettia control (CCS) who barely recognise a non-emergency word. I doubt PAN would get past them.

3xMAYDAY may just work.

Actually does anyone think the Spanish controllers would recognise PAN??

NN

[BigAir]

Feet Dry mentions about pan-pan medical being used in the nautical world....

I believe under JAA the term is used, but only to a medical transport flight pursuant to the 1949 Geneva convention.

In my understanding this is for when you have a sick bod onboard from start to finish, or if you are presumably SAR with wounded on board or carrying live organs etc. Maybe someone from ATC can confirm this, I believe the idea is that they give you priority routing but know you obviously are going to be there in advance so in some ways can "plan" for you. I don't think it is phraseology that would be used in the situation described above, again if someone from ATC side can maybe clear this up.

cheers

Bigair

[keithl]

3xMAYDAY may just work.

Not in Rimini it didn't! But that was 20 years ago. I expect they're better now.

[055166k]

Freeway, when is a medical emergency a real emergency?.....that is a problem for ATC.
If it is that urgent why do you chaps fly over some of the finest medical treatment in Europe to get to your original destination?
Some years ago we were inundated with medical emergency calls to the point where we had to prioritise one from the other; we are not doctors, and one of the simplest ways to filter out the not-too-serious cases is to put the onus on the pilot [probably after consultation with the company] to help us define the seriousness of the situation......if you declare PAN we know you mean it......and a wondrous set of procedures and co-ordinations takes place behind the scenes.....you may be asked to squawk 7700 as a means of letting other traffic sectors and other ATC agencies know not to bother the handling controller....short term flow restrictions may be put in place to protect your transit and expeditious handling from sector to sector.
We don't double guess the call or question the validity of it...we go for it big time.....that is what we are trained to do.
Falconpilot. your flightplan will include the term "Hosp Flt" or similar, and that information is known to the controller. Anything within the rules will be done to expedite your flight; sometimes we may even arrange a short cut with the military for all or part of your route.....London and Swanwick mil are really very good in this respect. Some companies use a callsign highlight on first contact or even as part of the callsign proper.

[Over+Out]

Falconpilot. If you say 'Medical Flight' going into the London TMA, you will receive no priority at all, just the same as if you say we have a'VIP' onboard. No Priority.
If you are carrying human organs etc, if you consider it is 'urgent' that you need to be on the ground ASAP, then call PAN and we will not question it, you will have No Delay.
If in doubt, tell us in plain English and everything possible will be done for you.
However, please tell us as soon as you know you need a priority approach so that we can plan around it.
I would much rather be told when you are lots of miles out than when you are at the top of a stack, having just been given a 15 min delay.
Sometimes the info does not get through properly, so if you enter a 'new country' (Air Traffic Control Centre), makes sure your requiements are known. This may even mean getting your Company to phone TC.

[Cartman's Twin]

Morning all!

I'm glad this post's taken off....

I agree with the previous post using the cunning disguise 055166k - where did that come from!

My understanding (and I'm sure you dont need to be invited to correct me) is that a vast majority of airlines subscribe to a third party medical org in America (I think) who use info provided by the persons on board to attempt a diagnosis and take responsibility for deciding what should or shouldn't be done regarding declaring anything, diverting etc. They've a huge database of all the facilities available worldwide down to the contents of your secret medical kit under the stairs (you see I know!)

This takes the liability away from the airlines and keeps the lawyers happy! As an aside I have to agree with 08764545412454578745k that I do sometimes wonder why almost all flights (for example) zoom straight past Gatwick on their way to deliver a critically ill patient to the centre of London!!

Pan-Pan is (or should be) a globally recognised term, and although I've no doubt some parts of the world may not have a Scooby what you're talking about. I'd certainly hope America wasn't one of the offending parties... Mind you, when it comes to unilateral decisions......!

Regarding what actually happens if a PAN is called it varies slightly depending upon conditions but I doubt many pilots fully understand how much effort is put in to save as much time as possible (not that it's your job of course!). Suffice it to say we do all we can and unless you're unfortunate enough to coincide with a MAYDAY, you'll be wheels down as soon as humanly possible.

[Fox3snapshot]

I can assure you that the term Pan is not a well rehearsed procedure for getting ATC attention with the US military in this region, and this is based on experience not hearsay....on a daily basis!

Every other word that sorta sounds like we have a problem is transmitted until you basically put the words into their mikes for them so you can afford the appropriate level of priority. RAF, RAAF, RNZAF, UAE, Omani, Italian, Canadian and others through this patch are all familiar and have at various times conformed to the International conventions of seeking priority handling and duely looked after, these obviously are not needed by "Due Regard" operating aircraft from the land of the free.

:ugh:

[DFC]

Air Ambulance flights including Organ transfer are afforded priority A (highest priority) by UK ATC provided that "safety of life is involved".

This basically means that a flight rushing a heart to an urgent life saving operation will get highest prioprity but the flight bringing some young buck back from the ski slopes with a leg in plaster will not be deserving of the same priority.

Unfortunately, in both cases, the flight plan often will be annotated sts/hosp flight.

However the important thing is that they are totally different from an unexpected medical problem in flight.

I also can't see why crews declare a pan medical emergency and then bypass suitable enroute alternates.........I would not however say bypassing Gatwick to get to Heathrow makes much difference.

It would not be appropriate to declare a Mayday for an inflight medical emergency unless it is the pilots who have the problem because having someone sick down the back does not place the aircraft in "Grave and imminent danger" no matter how bad they are.

Regards,

DFC

[Beanbag]

Bypassing alternative medical facilities to get to LHR is all the more surprising when you consider that the chances are the patient will end up in the West Middlesex Hospital. Local residents will know what I mean.

[ALLDAYDELI]

Silly question but does anyone actually monitor, record & investigate these types of medical emergencies that arrive at airports, certainly UK ones. What is the procedure when arriving say at LHR with a medical emergency, apart from medics waiting aside the gate - who else is there to make a report or log the event to see if there was such medical problem in the first instance?

[TopBunk]

Normal Nigel

Actually does anyone think the Spanish controllers would recognise PAN??
Actually yes. I had to declare a 'PAN' about a month ago en-route LIS-LHR and diverted SCQ with a medical problem to a pax.

The handling by Madrid Control was excellent and we landed about 15 minutes later from FL360. Sadly the young boy died 4 days later. The ambulance arrived about 5 minutes after chox - I doubt LHR and LAS would better that.

[Jerricho]

Alldaydeli, if and aircraft is afforded priority and used the magic words, the controller in position will be filling out a report as well.

[DFC]

Having declared a "Pan" or any other emergency, the pilot is required to make a report.

Regards,

DFC

[pilotwolf]

Not going to get involved in this one due to certain bias...

But doesn't MAYDAY include grave or imminent danger to LIFE as well as/opposed to just the vessel?

PW

[Falconpilot]

Came back on the forum two days later, and after some discussions with my colleagues on the topic...
Thanks for all your answers guys. Therefore "pan pan medical" is the best answer to my question.
Pass this on...
Salud.
Falconpilot.

[Cartman's Twin]

PAN's are fully logged and investigated. The Capt and the controller who first acknowledges the call log reports.

Regarding the Wolf Like Pilot, you are quite right. MAYDAY can refer to Grave and Imminent Danger of an individual. Generally, my understanding is that it would only be called by an aircraft if it was likely to affect the safety of the plane itself, eg when a pilot has been incapacitated.

And although we deal with PAN PAX calls very seriously, one of the only times they wouldn't receive the highest priority is when there is another aircraft who is having problems staying up there in the first place...

Going on to Falconpilot's last. A PAN PAN Medical is certainly something I'd fully understand. If an a/c just declares "PAN..." the controller would always need more information anyway. In most cases I've born witness too, the pilots notify ATC as soon as they have a potential medical problem on board and a period of time later you receive a call like:

"VIR601, we're declaring a PAN due to our sick passenger..."

A bit non-standard maybe, but it's understood. The only time I've heard "PAN-PAN PAN-PAN PAN-PAN....." was when the aircraft itself was in trouble, and the pilots were a little more 'focussed'!

Seems like this post has actually done some good!!

[Check 6]

This is a very informative discussion. Regarding using PAN and MAYDAY in the U.S., I believe we are a little more pragmatic, and "DECLARING AN EMERGENCY" is used more than MAYDAY. In 37 years of flying in the U.S. I have never heard PAN used, though it was mentioned in ground school for my private license.

I had to declare an emergency departing RAF Akrotiri about two years ago, and directed my FO to "declare an emergency," which he did, in those words. The very talented and professional RAF controller understood those words without a hitch- bless him!

Check 6

;)

[Cartman's Twin]

Glad you're finding it informative...

In the past 6 months I've heard maybe 15 PAN calls and 1 MAYDAY. Admitedly over half have probably said 'declaring a medical/emergency' but have had to be prompted to say the hallowed word 'PAN'

[pilotwolf]

Cartman's Twin Wolf-Like pilot?! Only on full moons!

Think there is the commercial aspect to be considered here too. A couple of years ago I was a transatlantic pax who had to use the day job skills to treat a patient. On discussion with the flight deck crew I sensed a reluctance to seek advise from the ground unless unavoidable due to the probably insistance to land ASAP to avoid potential litigation. As it happened there was no need for either and the patient made a full recovery. Need to add though it was made very clear that the decision to divert was mine and I only needed to say the word regardlless of any incurred delays or costs.

But... thanks to the increased use of Medlink I think there are an awful lot of ambulance responses to flights, including diversions that are unnecessary. Again I can only assume this removes the risk of legal action as it is very difficult to diagnose accurately via RT/phone, especially if the signs and symptons are being taken/described by non medical personnel. Had one last summer for a 4 day old mosquito bite....

Also guess its un-official but GMC at LGW always seem to give priority to medical emergency traffic.

Maybe airlines should employ paramedics to fly on all long haul routes just in case! I only need to give 1 months notice.... :)

PW

[Duff Man]

In the land of Flying Doctors, we've a well established priority system of MED1 and MED2 medical emergency designators. Not at all sure if there is any ICAO equivalent obviously nothing similar in the UK. Without getting the definitions, MED1 are life-critical flights, and are afforded the highest priority in Australia under aircraft in distress (MAYDAY/PAN). The seas won't generally part but they mostly get no delay. MED2 are ambulance flights of lesser urgency and are afforded the same priority as RPT.

[ShyTorque]

Pilot: PAN PAN - Medical emergency!

ATC: Roger, clear to land, number 1. What is the nature of the medical emergency?

Pilot: There is a lady on board who is going to have a baby!

After aircraft has shut down, ATC: How imminent is the baby?

Pilot: Thanks very much for the help, it'll be 9 months from tonight. We are just off to the hotel..... :E

[RUDAS]

you make a good point,CARTMAN,i've almost never heard pan,pan,pan declared when a 'med emergency' was declared.interesting.i'm sure it has to do with the amount of paperwork the crew face if they actually declare a pan.?:confused:

[Riverboat]

Cartman - you are cynical! If a pilot declares that there is a medical emergency on board you have an obligation to do what you can to help. No point in resorting to the rule-book, stating that if they don't say PAN you are going to ignore what the pilot has said, because in today's world I suspect you will be potentially liable for negligence.

We British can be very stuffy and pompous, and this posting started off like that. Nevertheless it is probably a posting worth making, but the bottom line is - the world has moved on: you have to respect your fellow professionals even if they are not following procedures.

If anyone says that they have a medical emergency on board, you HAVE to take heed of it, whether or not they say PAN, PAN PAN, or MAYDAY. Being "correct" is not always being sensible.

[BALIX]

Being "correct" is not always being sensible

That's a fair point. Sometimes we lose sight of the common sense in our eagerness to do things by the book.

Case study number one: I was controlling the Scottish Sothwest sector a couple of weeks ago when Shanwick phoned to say that the BA LAX-LHR flight was probably going to declare a medical emergency upon reaching NIBOG (the boundary between oceanic and domestic airspce). Pilot of said aircraft called up about eighty miles out and in our subsequent discussion he stated his intention to declare a medical emergency due to the condition of the passenger (which I won't go into on this forum...) though he would be continuing to LHR. At NIBOG I asked him to squark 7700 and arranged a direct routing from there to BNN. This took him through Shannons airspace (just a small bit as it happens) and coordination was affected with the Irish. Aircraft was handed off to LACC and as far as I was concerned, that was it. Hopefully, the passenger was OK.

Case study number two: The very next day a VS flight from LAX-LHR declared a pan due to a medical problem on board The controller (it wasn't me) squarked him 7700 and arranged a direct routing etc.

Both cases were handled identically despite one being a 'medical emergency' and the other being a 'pan'. Whether either case warranted a full emergency I've no idea - the fact that both flights continued to LHR would maybe suggest not - but that is not our call. If you feel you have a problem, we'll help, no matter what is declared.

[eyeinthesky]

BALIX: If he calls the emergency on the Ocean (whether he uses the PAN words or not), but then flies on for another 90+ mins, past perfectly good facilities at Prestwick, Manchester, (Shannon?) and others, then in my books it's not an emergency!!If there's 20 mins holding for Heathrow then he might as well do that as well as it doesn't seem that urgent to get on the ground.

Having said that, if you call it as an emergency, you will get treated as one. If they don't say it, I will usually ask "Are you declaring a PAN?" That usually elicits a Yes or No and is handled accordingly.

With ref to the discussion about British stuffiness and the need to use the correct terms, I think you also need to consider the effect on other flights. If they are in or are put in the Hold to let someone go first who should be well behind them, then there had better be a very good reason. Paperwork will of course follow, but we need to be able to explain to the Airline Manager of Big Airlines why his aircraft spent an extra £xx on fuel while First Time Airlines went straight through.

Don't even get me started on 'Fuel Emergency..!!"

[BALIX]

eyeinthesky

BALIX: If he calls the emergency on the Ocean (whether he uses the PAN words or not), but then flies on for another 90+ mins, past perfectly good facilities at Prestwick, Manchester, (Shannon?) and others, then in my books it's not an emergency!!I

Which is pretty much the point I was trying to make. Perhaps the Virgin declaring a 'Pan' was more correct than the Speedbird declaring a 'medical emergency' but when it gets down to it, we are not going to deny a reasonable request for an expiditious routing over semantics. Of course, we must assume that the pilot is not telling porkies in order to get to the bar a few minutes earlier ;)

A couple of months ago I had a similar situation with a Speedbird coming off the ocean. However, the pilot decided not to declare anything as, in his words, the patient was now sitting up and having breakfast. Good for him, it must have been tempting to follow his company's advice (he had been speaking to them on his other box) and declare a medical emergency just to jump the queue at BNN.

[Cartman's Twin]

Riverboat, before anybody jumps the proverbial cannon, let me clarify things for a sec.

I am not suggesting for one minute that somebody who simply declares a 'Medical Emergency' is going to ignored. That was never my intention and is NEVER the case. Summarising my point- the ONLY recognised declarations in the UK are MAYDAY and PAN. If a pilot suddenly develops a problem with the aircraft then we aren't going to get caught up in pointless discussions as to exactly how impossible their task is going to be. On the other hand, if the a/c is fine, they're 10 minutes from the holding point and need to queue jump for a sick pax and delay another 20 aircraft then if you simply declare a medical emergency then in 95% of cases you will be nudged in the direction of, or asked if you're declaring, a PAN.

In these days when the London TMA is as busy as it is, it is often pushed to the very limits and as ATCOs we are 100% focussed on getting to guys and gals from one side to the 'tother without touching. With delays the norm, if an a/c is in any kind of emergency and needs special treatment you can typically multiply our workload by a factor of 2 or 3. Now for genuine situations we are only too willing to do so but the implications for ourselves and the other 20 aircraft in the vacinity have to be considered and accounted for.

It is not purely the ATCOs decision either. If every a/c that has a slight medical problem received preferential treatment there would be carnage every day. If there are 20 minute delays and somebody needs to jump the queue then fine, but the only way we can be sure is by clarifying the situation. Lets not forget the requirement to obtain authorisation from the 'Powers that Be' above mere ATCOs as well.

Basically, if you declare a Med Emergency the ATCO will think 'Is he/she declaring a PAN', and time will be wasted. If you decalre a PAN with a Sick Pax, then we can all concentrate on getting you back on the black-top.

It is very much like the old fuel emergency situation. I'd wager a fair few pennies that the ATCO's response will be - 'Are you declaring a PAN/MAYDAY?'

[Cartman's Twin]

I assure you that there is NEVER a question of not respecting those sat in the business end of the aluminum tubes.

Don't really think I'm pompous or stuffy either - what do you think Northern Gal??!

[Off the clock]

Thanks for the reminder....good to year you guys on the forum...and keep up the excellent ATC work. UK ATC is hard to beat.

A quick question though. Recent sim check, Trainer insisted hat after making a Pan or Mayday call it is a requirement to prefix ALL further communications with ALL controllers with Pan or mayday ? Sounds a bit over the top to me. Quite like the FAA requiement : "The initial communication, and if considered necessary, any subsequent transmissions.........etc". Seem more appropriate. Can anyone point me to the actual requirement in the UK.
Cheers,

OTC:confused:

OOPs.....message should have said good to hear from you guys on the forum.....
OTC

[Cat O' Nine Tails]

I was flying to CDG from BCN the other three days ago and an easyJet aircraft stated "I have a medical Emergency and request Divert to TLS". The controller initially told him to maintain F360 for seperation and then cleared him direct to Toulouse with descent allowed shortly afterwards.

My point!
I thought that the controllers actions were correct although I was surprised the words PAN PAN Medico were not used.

Subsequent discussion with my colleague on the subject whilst transiting the sector were:

At no time was the passenger's condition discussed which surprised us, as the usefulness of at least the symptoms could prepare the ground crew/medical crews for what if anything might be necessary upon arrival.

I believe that being able to speak with a doctor either on initial frequency or a discreet frequency would make good use of the twenty or so minutes it takes to get from cruise altitude to the ground to better co-ordinate the subsequent actions after the arrival of the aircraft such as possible medi-vac to hospital in a helicopter or even having a team of specialised individuals on hand to perform any immediate remdial actions prior to departure from the airport to medical facilities.

I am well aware of the nautical facility available to chat with a doctor, but is this available in avaition circles?

Finally, I'm very pleased this topic was brought up because it certainly made me consider my personal actions in such a situation. Thank You !

[Cartman's Twin]

Thank you for your post Cat and OTC. I thought understanding could be improved and your comments are much appreciated.

Taking your Sim Trainer's comment first I don't agree that every subsequent TX should be prefixed with PAN/MAYDAY. Firstly I'm certain it's not a requirement and secondly I'd say it's a dreadful waste of RT time and pretty much useless. Once an a/c has made a declaration I assure you the controller will know your callsign (!) and RT 'seconds' are precious, so I wouldn't recommend it personally.

Some might suggest that it might discourage new a/c arriving on frequency not to make verbose transmissions, such as "ABC123, just airborne from Heathrow, about to level off at FL100, any chance of further climb and left five to avoid a micron of cloud or even direct to JFK!" There is some mileage in this argument but certainly on the frequencies I'd work, I'd rather save the 2 RT seconds of each transmission. Besides there is so much work going on behind the scenes that often a/c being transferred TO the PAN freq are warned beforehand. Also I've found a quick 'negative due emergency traffic' does a perfectly good job. You guys (n gals) don't quibble when 'fellow Brother Friars are in the lurch' (anybody spot the Blackadder line??).

I would accept that prefixing your first transmission to a new centre (eg from London to Manch) with the status of your flight would be enirely appropriate. The message should always have been transferred ahead of you but if the controller is working a busy freq, it will certainly ensure you of their best attention upon your arrival. Within the same centre it is my belief that you don't have to prefix your callsign, and you can wager the controller has already been informed, but for the reason outlined above, it's no bad thing. Quite often we are aware of your impending arrival and work as hard as we can to clear as much regular traffic off the freq before your dulcet tones drift down the airwaves!

From experience, most UK and European operators don't use PAN apart from when they first declare, but those who've been imported from across the pond always prefix their first transmission to a new freq with PAN. In my opinion eithers fine!

cont.....

Cat O Nine Tails,

I was also aware of the Pan Pan Medico phrase used in the nautical world, and although I\'m sure any controller would understand it\'s meaning I was never taught it as official phraseology. Most of the time the pilot\'s either referred to a Medical Emergency which becomes a PAN after clarification or a PAN is declared in the first instance.

I\'ve no knowledge of the particular instance you mentioned although possible thoughts would be. If the a/c was near the boundary anyway then there may be little point trying to get info from the pilot when he could be talking with the French direct leaving less room for Chinese Whispers. I\'m surprised the controller didn\'t clarify whether a PAN had been declared at the outset, but again he may have thought it\'s better for the French to follow their own procedures once the a/c is transferred to them (besides it\'s paperwork for us too!). I\'m sure this would have been cleared up before landing. Again the controller may have thought that as the incident would have finished in France it\'s more efficient for the French controller to ensure all their requirements are met than risk wasting the pilots time obtaining information that would prove unnecessary.

Generally, and I speak entirely from my own experience within the London TMA the pilot will be asked for a little detail about the patient but most importantly whether the medical facilities have been arranged through your company. Generally this \'should\' be the case, although it\'s understandable if the nature of approach leaves little time or capacity for this to be effected. We just need to know one way or another! There could be nothing worse than making a fighter style approach to Gatwick only to be met by the aircraft cleaners (worthy though their job is) and a mop!!

Most of the actual medical discussions is effected off the main frequency, either with the company direct or through the Medilink people and a Dr. I\'ve never had a request for this to be arranged through the controller although if needs must, we could probably find a way!

PS. Dont know whats up with my / \\ / \\ s.....

[ARMGAT]

Suppose you have a problem with the FMC and have lost BRNAV capability.

Many pilots would just tell ATC that they have lost BRNAV without making the PAN call. The reason is NOT that pilots do not know they have to make the PAN call, reality is that they, after advising ATC of the problem, simply forget about it.

Making the PAN call i.s.o. the MAYDAY call is simply telling ATC that there is a problem, a problem that does NOT impose an immediate danger to the aircraft or it’s occupants that requires immediate assistance and priority.

I would advice pilots to make the PAN call in order to avoid the ATC system to overreact and go to code red while not needed.

It’s my understanding from this discussion, which as far as ATC support is concerned while still in the air, the ATC reaction would be the same in case of a PAN or a MAYDAY.

As such pilots have all interest to make the PAN call. If you do not do that then you are putting something on the plate of ATC they want to react to but do not know how.

ATC is a service provided to the pilots but you have to clearly tell them what you want.

And believe me that it can be quit challenging for a Chinese to explain ATC what the nature of the problem is. However PAN, PAN will do just fine.

[keithl]

OTC - Just to add my agreement with Cartman's answer to your question. I am a sim trainer and my predecessor used to teach the same thing, i.e. use the Pan or Mayday word with every transmission. So we had a big debate about it and the only reasonably valid thing he could come up with was that it prevented them forgetting to use the word on checking in to a new freq. which is a requirement.

So we don't teach that any more, but there are lots of guys around who were taught under the old system who, because (thankfully) their experience of using P or M is limited, revert to old practices under pressure.

[Off the clock]

Thanks Cartman's Twin & keithl for your responses.

Agree with your pragmatic comments...... particularly in the current often very busy ATC environment. It is great to hear what actually happens following a Pan or Mayday from someone who sits on the receiving end.

keithl you indicate that using the prefix IS a requirement when first contacting a subsequent controller rather than it being advisory (ie if you think it appropriate?) (The latter seems more practical and is what I would probably do). A reference for this would be apprecated.

Thanks again....cheers

OTC:ok:

[Ozgrade3]

I had a female passenger get violently sick during a scenic flight over Sydney a few years ago. Not long into the flight she said she wasnt feeling well and I decided to expidite our return but vie the normal route -outside controlled airspace.

However as we orbited over the Sydney Harbour Bridge she became violently ill to the point where I was worried she was going to choke on her own vomit. I informed ATC that we had a sick passenger and requested a track direct to Bankstown, which cuts across the ILS of 16L and 16R at Sydney International. Its pretty rare that this would be granted but they gave me an immediate clearance, vectoring 2 QF jets with some track lengthening to enable me to get accross.

Less than 5 mins later we were on the ground thanks to some expeditious handling by the Sydney and Bankstown ATCO's. Turns out she had accute food poisioning and spent the night in hospital.

Thanks to the ATCO's that made my job so much easier in a very stressfull situation.

[cargo boy]

Oh please! :hmm: Let's not start endless recollections of "I once had a vomiting pax in my little Cessna and I did/didn't declare [choose one](emergency/pan/pan medico/mayday). This discussion is about the nuances of emergencies and how to declare them. We all know that ATC will do what they can to expedite a routing/arrival if there is a problem. The main point here is what words trigger their reaction and what mental thumbscrews they will apply to you in the UK if you don't use the magic word.

[cdb]

Ok, here's how I work.

1.
If its obvious there's a big problem eg.
BAW123: Engine Fire!
or BAW123: The wings just fell off!
then you get the works - number one, straight in, all that.

2.
If on the other hand, I'm not sure how urgent the situation is eg.
BAW123: Funny smell in the cockpit
or BAW123: Ill passenger
then I ask you: ARE YOU DECLARING AN EMERGENCY?

If yes, then you get priority, see 1 above. If no, then you wait, like everyone else.

So, you don't NEED to say PAN but I can't give you priority unless you agree to declare an emergency, or its so obvious that I choose to declare one myself.

Sensible?

[Leezyjet]

"No paramedics based at LHR despite it being the size of a small town!"

There is one LAS ambulance based at LHR, in the Fire Station on the perimeter road.

The annoying thing about LHR though is that it's all or nothing. If you call in with a minor medical problem for a passenger, it's either the all singing all dancing blues and two's or bugger all.

Passengers are not even able to use the medical centre in QB as that is for staff only, so the only way the airlines can cover themselves is to call out the Paramedics.

Annoyingly in most cases the Paramedics are not actually required but there is no other alternative, unlike LGW that has the lone medic who will respond and asses the patient before deciding if an Ambulance is necessary. (Although they have a couple of paramedics on mountain bikes on trial in T4 only so things might improve in the future in the CTA)

If the LHR based ambulance is already on a call or has been prioritised to a more urgent call then an off airport ambulance will be dispatched. This can take upto 30 mins to arrive AFTER you have blocked on depending on the distance and time of day the ambulance is coming. It is not uncommon for an ambulance to be dispatched from Hammersmith ambulance station if that is the nearest available.

One last thing, when calling in on company if you have the following info to hand it makes our lives a damn sight easier when calling the ambulance out :-

1. Details of problem in as much detail as poss.
2. Details of any medication already given.
3. Is pax concious and breathing ?.
4. Approx age and Sex of pax.

Those are the most important for the ambulance service, but the following will also help us for Customs and Immigration purposes but isn't as important :-

1. Nationality and Passport Number (if International flt)
2. Name of pax and any people travelling with them
3. Seat Number, then we can access the DCS to get rest of info like bag tag numbers etc. but if downline station is not on DCS then we may need bag tag numbers too if they have them.

Hope that helps when your next i/b to LHR with a med emerg.


:ok:

[5milesbaby]

I usually apply the common sense route which isn't neccessarily the one we are taught.

If, as happenned recently, a pilot calls "London we have a medical emergency, request priority landing at destination" I will reply "Roger, PAN acknowledged, route direct..." as the words "emergency" and "priority landing" are quite blatent.

However I will ask if a pilot is declaring an emergency, maybe with explaination that priority will not be affected if none declared, in a situation which is still very common whereby at the end of the initial call the words "..and be advised we have a medical emergency" are added.

As has been previously said, if someone says "we have lost all power to all engines" I won't even ask "are you declaring an emergency" as its self evident.

Basically I choose what to say on what I am initially told, but it does make it so much easier and less naucious if the correct words/phraseology is applied within the initial call.

When priority is affected by ATC then the controller who initiates the priority has to fill in paperwork which is forwarded to Investigations, so trying to avoid the phrase (and subsequent form filling) only delays the paperwork for a few weeks. I know how we all try to avoid it, but its still part of our job on both sides.

[Barry Cuda]

RANTING ATCO ALERT!!!!



And the award for the most obnoxious pilot this evening goes to.... SIA320, inbound to Lamborne:mad: :mad: :mad:

Told on first call to Lam sector controller (me...) that delay is 10-15 mins...

"Roger, request no delay and priority approach due to an extremely sick pax"
"SIA320, roger, you'll have to declare a Pan for that at least"
"Er, roger, we'll take the delay..."

Right, says I, and again suggest that if he declares we would give him a straight in approach with no probs. The pilot comes back with the story of the sick pax and the fact that he was only asking out of compassion, before finishing with the classic comment.........


"You would have done something 2-3 years ago...":mad: :* :mad: :* :mad:


The moral of this tale? If you declare, we will clear the skies. We will not second guess you, or question why, we will clear the skies and get you in ASAP. If you don't, you're just another plane in the system, handled just like all the others, although we will think that you are simply tryin to buck the system and might not be quite so polite to you in future!!!!

Rant over, thanks for listening!!!

[DFC]

Since we are being a bit pedantic, lets take another look at what Pan and Mayday mean and using that look again at the posting by 5 miles baby.

Pan - a state of urgency
Mayday- a state of distress

5 miles baby replies to a call stating "medical emergency" with "pan acknowledged".

To me that is putting words in the mouth of the pilot and could be seen as guiding him down the road of urgency when actually a state of distress exists.

If the controller takes such an action and subsequently a mayday is called by another aircraft, then where does the controller stand if in fact the first pilot wanted to declare an emergency and should have used mayday because that it what the situation required.

Not at all happy with controllers putting words into pilot's mouths cause they can be the wrong ones.

Far better to either ask the question or if no sensible reply, work on the worst possible case scenario.

Currently, the information provided to crews from the UK authorities state that "fuel emergency" will not obtain any priority unless an emergency is declared. There is no mention of limiting the alerting service provided in any other situation regardless of what words are used.

Thinking of how hard it can be to understand comms with an oxygen mask and howling gale, I would not like to have my attempts at making an emergency landing twarted by my inability to communicate the magic word.

Situations like the one described in the post by Barry Cuda require reporting and action from the CAA because obvously that pilot never heard the story of the pilot who called wolf!

Regards,

DFC