Nurse fury at Ryanair as woman dies on flight from Italy [Archive]

Irishboy

26th Sep 2006, 08:50

http://www.unison.ie/irish_independent/stories.php3?ca=9&si=1694841&issue_id=14689

Airline criticised over lack of 'basic' equipment for mid-air lifesaving bid

A NURSE who had to give unprotected mouth-to-mouth resuscitation to a dying passenger on a Ryanair plane has hit out at the lack of medical equipment.

Kate Douglas, who was returning from a holiday in Venice, rushed to the aid of a 24-year-old au pair who had collapsed at the rear of the plane.

But she said the Ryanair staff were unable to provide her with any latex gloves or a resuscitation mask.

"I was basically giving that girl who I didn't know, mouth-to-mouth CPR, exchanging fluids. I wasn't not going to do it, but it's not a nice position to be placed in," she said.

The medical emergency arose on the Ryanair flight from Treviso in Italy to Dublin last Friday. The captain of the plane appealed for any medical personnel to come forward and Mrs Douglas, another Irish nurse and an Italian doctor all responded.

Mrs Douglas, from Youghal in Cork, said she could not believe the plane did not have basic medical equipment, such as an airway device or an ambu-bag which is used to force air into the lungs of people with breathing problems.

"We were in extreme difficulty doing the CPR because we didn't have that. It was very distressing anyway, but then you just get angry because there wasn't even the most basic equipment."

The 24-year-old woman was lain across three seats and given CPR for around 40 minutes while the Ryanair plane was diverted to Charleroi Airport in Belgium.

She was given further medical treatment by the emergency services when the plane landed but pronounced dead shortly afterwards.

The other Irish nurse on the flight, Suzanne Scott from Malahide in Dublin, said she had written to the Irish Aviation Authority to express her concerns.

"They didn't have any type of airway equipment although they did provide us with an oxygen bag and an oxygen cylinder. The staff did their best but they didn't seem to have much competence in first aid or CPR - one air hostess said she was only trained to take a pulse."

A Dublin family, who were due to receive the young woman as an au pair, wrote an e-mail to RTE's 'Liveline' programme to express their shock at her death. It is understood that she died from a brain haemorrhage.

Regulations

Under European aviation regulations, all planes on short-haul flights must have first-aid kits containing a list of 24 items, including one resuscitation mask and two pairs of latex gloves. However, there is no requirement to have medical equipment such as airway devices or ambu-bags.

Ryanair said all of its aircraft were stocked with two security-sealed first-aid kits, as required under the regulations. A spokeswoman said the first-aid kits on the Treviso-Dublin flight did contain four sets of latex gloves and two masks but she could not explain why the two nurses had not been provided with them.

"As the cause of death of this passenger has yet to be confirmed, it is pointless to speculate whether any piece of medical equipment could or would have averted this tragedy. All of our thoughts and prayers remain with the friends and family of the deceased."

The spokeswoman added that all Ryanair staff were trained in CPR.

The Irish Aviation Authority said it would respond to the nurses about the concerns they had raised. "But it's a medical matter and it's not really an aviation matter to be investigated," a spokesman said.

Meanwhile, a Ryanair flight from London to Derry was forced to turn back last night after the captain collapsed with suspected food poisoning.

Passengers say they were around 15 minutes from Derry when the announcement was made and the plane was turning back to Stansted Airport.

The passengers were put on another flight.

Michael Brennan

tu154

26th Sep 2006, 09:25

That must have been back it the dark ages then. On a recent CPR refresher course (non aviation) I was given a small pack to take away containing gloves and a barrier mask. The nurse is absolutely correct.

Lon More

26th Sep 2006, 09:41

Reminded of the "exposé" of cabincrew training by one of the locos on UK television some time ago. If some of the crew had gone through that the fact that gloves etc. were not provided could be explained,
I'm sure there was discussion of this here but can't find it, also I don't think it was Ryanair that featured.

Farty Flaps

26th Sep 2006, 10:04

df1

26th Sep 2006, 10:05

Kalium,

Might be worth considering updating your first aid certificate as the aforementioned items are a must! A one-way valve and a pair of gloves are considered essential and, I would have thought, common sense!

Another example of them playing at aviation as opposed to doing it properly.

anotherthing

26th Sep 2006, 10:16

Df1,

They may be a 'must' in some eyes, but not essential in the requirments of doing CPR - they are required on courses and recommended.

They are a must to most 'sensible' first aid practitioners, but not essential. gloves and barrier do not prevent the first aider from providing the same level of cpr as they would be able to give with them.

farty flaps

This woman would have stood a better chance on a UK registered carrier with Doctors kits and extensive first aid kits theraputic oxygen and defibs, ie something for everything

depends on what her condition was whether your statement is true.

Defib machines are not the be all and end all, too many people get excited because they are allowed to use shiny pieces of kit that used to be only available to qualified medical staff. Defib machines work for what they are supposed to do, but only that.

As we do not know why the woman died, we cannot categorically state that having a fuller first aid kit would have helped her, although the basic kit that the IAA seems to allow could do with some enhancements.

df1

26th Sep 2006, 10:45

Just to set the record straight:

I wasn't suggesting that you refuse to assist in the absence of these itmes in much the same way that you wouldn't refuse save someone from drowning because your didn't have you swim suit and goggles with you! I'm quite amazed that a commercial operation (especially airline) could find themselves without these basics. I agree that they are not essential to life saving itself and I wasn't suggesting that they were. They are essential in the sense that there really is no excuse not having them. It really is a matter of basics. I renewed my first aid certificate recently and there was a heck of a lot of emphasis on maintaining this personal hygene and safety standard.

My issue was with Ryanair apparently not having this most basic of eqiupment which is of trifling cost and in leaving a otherwise experienced nurse in a "not a nice position" to use her own words!

eidah

26th Sep 2006, 10:47

FCS Explorer

26th Sep 2006, 10:50

I can just picture it now. Fellow on his back in the middle of the street, not breathing. Fifty people standing around looking at one another, saying: "Sorry, can't try saving his life, I don't have a rubber glove on me."
Sheesh.
well.
1. i was told to hold the person's mouth closed and blow into the nose. so unless the face is a total mess, there should be little exchange of fluids.
2. on the street u can call an ambulance. in the air u can call it, too. but the medics' arms will be to short to get up to you. so it would be nice to have *some* usefull equipment.

Irishboy

26th Sep 2006, 10:52

As we do not know why the woman died, we cannot categorically state that having a fuller first aid kit would have helped her, although the basic kit that the IAA seems to allow could do with some enhancements.

From the article above...
It is understood that she died from a brain haemorrhage.

SLFguy

26th Sep 2006, 11:21

Why on earth should you need masks and gloves for doing CPR?! Ok, if it is available, you can use them, but these items do not improve any chances of survival.

er ....they do sport - if the victim is HIV they will increase your chances of survival no end!

What a numpty :ugh:

keyboard flier

26th Sep 2006, 11:22

Just out of interest, how many people do die on planes in a year?

Farty Flaps

26th Sep 2006, 11:27

Well I can only comment on the time i had a seal problem on a kit for ryr. During the audit of the contents I was shocked by the poor quality of equipment. It was of no higher standard than a kit in a vw or boots off the shelf little first aid box. Compare that to the compulsory Extensive doctors kits and uk first aid kits and there is a greater chance , as i said , in any med emergency to get treated with the kit that might save you on a uk aircraft.I'm not blaming ryr , just its pet regulator and the other toothless tigers at the belgrano.

angels

26th Sep 2006, 11:36

despegue - My brother's best mate is a copper. One of his pals performed CPR on a local alcoholic tramp who had collapsed.

The herpes he got that day will stay with him forever.

Seat1APlease

26th Sep 2006, 11:37

http://www.unison.ie/irish_independent/stories.php3?ca=9&si=1694841&issue_id=14689
The Irish Aviation Authority said it would respond to the nurses about the concerns they had raised. "But it's a medical matter and it's not really an aviation matter to be investigated," a spokesman said.

If this is an accurate quote then I find this lack of concern by the IAA absolutely staggering.
In the UK the CAA used to approve the extensive medical training courses which CC and Flight crew undertake, and their refresher training. They also approve the medical kits, drugs and equipment carried on board. To say that it's not an aviation matter in Ireland is staggering.
What I find equally difficult to accept is that RYR is also one of the UK's major operators, it isn't really good enough to operate within the UK to inferior standards by hiding behind another regulators lax standards.
On a final point whilst some conditions may have come on slowly it would appear that this patient was not breathing and had no pulse, and yet it took 40 minutes to land at a suitable airport whilst carrying out CPR?
Tell the cabin crew to throw all the trays etc. in the toilets and you should be able to get it on the ground in 15 minutes max from anywhere in Europe!

anotherthing

26th Sep 2006, 11:37

Irishboy

thanks for that I must really read the initial post more closely!!!

That said, a defib would, more than likely, not have helped in this sad case.

FCS

So how would you deal with a brain haemorrhage even if the A/C had the extended kit?

If it was fitted out as per IAA regulations, who is more to blame, RYR for being shoddy and trying to get away with the bare minimum (a budget airline after all - the clue is in the word 'Budget'), or the IAA??

captjns

26th Sep 2006, 11:56

If this is an accurate quote then I find this lack of concern by the IAA absolutely staggering.
In the UK the CAA used to approve the extensive medical training courses which CC and Flight crew undertake, and their refresher training. They also approve the medical kits, drugs and equipment carried on board. To say that it's not an aviation matter in Ireland is staggering.
What I find equally difficult to accept is that RYR is also one of the UK's major operators, it isn't really good enough to operate within the UK to inferior standards by hiding behind another regulators lax standards.
On a final point whilst some conditions may have come on slowly it would appear that this patient was not breathing and had no pulse, and yet it took 40 minutes to land at a suitable airport whilst carrying out CPR?
Tell the cabin crew to throw all the trays etc. in the toilets and you should be able to get it on the ground in 15 minutes max from anywhere in Europe!

Does anyone know what the communication was between cabin crew and pilots? I know the statement seems to be and it is cruel and morbid, but passengers traveling on a US carrier in the states never die in flight... they always die on short final.

stator vane

26th Sep 2006, 12:06

15 minutes??

a bit optimistic aren't we?

have you read reports of other emergencies recently? once you declare an emergency, you had better make sure all your "eyes" are dotted and "tees" crossed, because the multiple CAA's and JAA will go over every thing you said (recorded) and did with a fine tooth comb.

the only thing that would merit a "balls to the wall get down on the ground" event would be a fire! or loss of both engines and neither one came back!

if they didn't have the charts to their diversion airport at hand, weather, approach speeds, etc, it would take some time to get ready to do the approach.

we cannot risk the aircraft and all others on board and maybe others on the ground to possibly save one passenger.

df1

26th Sep 2006, 12:12

Neither the mask/shield nor the gloves in debate here would improve a persons chances of survival or improve the quality of their treatment - I think that we all agree.

The Red Cross first aid advice is that gloves are considered as the "basic materials" and the mask as a "useful edition" in a first aid kit. Without argument then neither are vital to life saving.

They do however form part of a kit which ought to be readily available and low in cost (excluding defrib etc) in any commercial workplace especially one which accomodates a fare-paying public. All staff, particularly any nominated first-aiders, should know where the kit is located and how to access it. Putting one of these kits together isn't brain surgery and neither is checking its inventory.

As I read it, the nurse thought these elementary yet important items. she takes issue with not having or being able to access a basic set of eqiupment - including equipment to protect herself from injury or infection.

Really, this is not at all about what equipment helps or doesn't help save lives - what saves lives is a proper approach to dealing with emergencies and Ryanair, it seems, sails close to the wind. It is absolutely about the reputation of an airline that digs itself deeper and deeper into a hole that it is reluctant to climb out of. Maybe, though, when the average cost of a decent first aid kit is more than the average price of the ticket it might be worth pax reconsidering who they fly with. Next time we might not be debating rubber gloves but something more sinister! I sincerely hope not!

Mac the Knife

26th Sep 2006, 13:00

Sounds like this pax coned, so all the CPR in the world wouldn't have made any difference.

I hate to say this, but without suction, a laryngoscope and a cuffed tube CPR of someone who's really not breathing isn't that successful. Like as not the airway is full of vomitus or gastric contents that's hard to clear and keeps coming back. The stomach inflates and it's almost impossible to ventilate someone successfully for long, if at all.

External cardiac massage may keep a bit of circulation going, but it isn't enough. If you can't get at least some spontaneous cardiac output pretty quickly then it's sayonara.

For effective on-the-street CPR you need good ventilation, circulatory access (a drip), the right drugs, a defib, some idea of what you're doing and a lot of luck.

T-shirt, etc.

apaddyinuk

26th Sep 2006, 13:00

TooL8

26th Sep 2006, 13:22

The Red Cross first aid advice is that gloves are considered as the "basic materials" and the mask as a "useful edition" in a first aid kit. Without argument then neither are vital to life saving.

There are two item of medical equipment in the bag; you can chose ONLY one, the gloves OR the mask.

Your DRABC drill shows you're gonna have to do CPR, which bit of kit would you chose?

The gloves (because the cabin floor of any Ryanair acft is seething mass of vomit, chewing gum and chocolate muffin?:yuk: No, the mask, because it gives you a greater level of protection than the gloves.

I think the Red Cross should revise which one is essential.

apaddyinuk

26th Sep 2006, 13:29

There are two item of medical equipment in the bag; you can chose ONLY one, the gloves OR the mask.

Your DRABC drill shows you're gonna have to do CPR, which bit of kit would you chose?

The gloves (because the cabin floor of any Ryanair acft is seething mass of vomit, chewing gum and chocolate muffin?:yuk: No, the mask, because it gives you a greater level of protection than the gloves.

I think the Red Cross should revise which one is essential.

Yup, definately the mask!

compressor stall

26th Sep 2006, 13:44

At risk of thread digression, in the CPR context, yes the mask is more important.

But for the broad subject of "first aid" - covering any injury - then the gloves are probably more essential in preventing disease transfer both ways.

And to answer an earlier question, yes HIV can be transmitted orally if the infectee (?) has open cuts around the mouth (especially possible with bleeding gums or a mouth ulcer).

eidah

26th Sep 2006, 13:58

This thread is absolutely terrifying!!! Another reason why I will be advising all my friends and family to never touch Ryanair with a bargepole!!! Id the crew had been properly trained they would know where the First Aid kits were, they would know that they contain latex gloves and face shields and THEY WOULD KNOW HOW TO USE THEM!!!

Surely the crew member who can only take a pulse is not fully legal to be flying under Irish Aviation regulations???

I actually know the nurse from Malahide so next time Im home I shall be having an interesting chat with her!

I would like to make it clear that the crew are properly trained they know where the equipment is everyday there is a briefing as with most other airlines in that briefing it discuses the day etc etc how many passengers and speicifc detail i.e. if theres going to be turbulence etc etc then at the end each crew member is asked by the supervisor safety questions these questions relate to first aid, drills, equipment location, use of equipment if they do not answer these questions they do not fly it as simple as that. Every year there is recurent training where they go through all the first aid drills procedures etc etc then at the end an exam with a very high pass rate fail that you do not fly they dont have a job.

Magplug

26th Sep 2006, 14:06

Inescapably....... You get what you pay for

The arrogance of O'Leary will only permit the absolute minimum of equipment on board that is mandated. Anything else is a waste of money & fuel.

This is the RYR way.

blackmail

26th Sep 2006, 14:43

hello gents,

the required emergency outfit onboard is regulated by the jar ops1 & there should not be any difference wether the aircraft is irish, uk ,ba, bmi, monarch, ryr,ez, high cost, low cost etc.

OpenCirrus619

26th Sep 2006, 14:43

Please somone correct me if any of the statements below are incorrect:

The masks and/or gloves in question cost a few pounds/euros
The masks and/or gloves in question are provided in sealed bags - assuming the bags are not opened they are good for many months
A new passenger plane costs $50-200 MILLION
The marginal costs per flight (fuel / landing charges / crew wages / ....) are considerable

The cost, per flight, of providing DOZENS of these masks/gloves is fractions of a penny - compared to the tens of thousands of pounds/euros that the flight costs to lay on. I guess thats the value that MOL and RYR management put on the life of one of their passengers (guess they can't complain once they're 6 feet under).

By my standards the above statement is outrageously provocative - but, in this case, it's how I feel. I would love someone from the company to explain to me why I should change the above - I am always open to more information.

OC619

P.S. This does assume that the kit was not on board. If it was then the crew training needs looking at.

backofthedrag

26th Sep 2006, 14:59

Ryanair said all of its aircraft were stocked with two security-sealed first-aid kits, as required under the regulations.

When our UK charter airline started many years ago we had a sealed first-aid kit. The restocking and resealing was done under the engineering contract and cost £150 per time plus items.
Most flights needed the kit resealing after each fkight where perhaps one paracetomol had been taken out.
After five years of this someone cottoned on and the cabin crew took on an unsealed kit of obvious pills and bits to be restocked from Boots at leisure.
Eventually a Doctor's kit was put on which was sealed as it contained drugs that could only be prescribed by a physician.
In the interim there was an obvious reluctance to break open a sealed kit with the inherent high cost and this may have been a factor in this incident.

dunadan06

26th Sep 2006, 15:11

Last year I went thru First Aid training. The teacher was a professional fireman.
Here is what he told us when asked if we should use them on the street:
"For us (pros) it is a professional mistake (liable to sanctions by management) not to use both of them" followed by "but you can do what you want". :hmm:

In this case, the problem is not to know if it would have saved the passenger or not, but more to the point, how is it possible to have cabin crew not knowing the content of the first aid kit? :confused:
Could it be due to lack of training?

RVR27/09

26th Sep 2006, 15:21

I wonder if the crew are fully aware of the kit at their disposal on board :confused: it appears not in this case.

bacardi walla

26th Sep 2006, 15:26

Can the MODS explain why they removed my post about possibly sending the a/c back to STN as a commercial move ??

blackmail

26th Sep 2006, 15:28

hello every one
what did the italian doctor do?

flash8

26th Sep 2006, 15:29

>The other Irish nurse on the flight, Suzanne Scott from Malahide in Dublin, said she >had written to the Irish Aviation Authority to express her concerns.

Good luck... she'll need it.

gingernut

26th Sep 2006, 15:31

Difficult to comment without knowing the full facts, but it's unlikely that an increase in the complexity of the basic equipment would have saved this poor girl.

I'm not sure how many unexpected deaths there are in the skies each year, but I have seen a recent article suggesting that about 200 lives per year could be saved in the UK per year if we were all proficient in CPR.

I would have thought it prudent to carry some cheap basics on board,- I'm not a first aid expert, but a one way mask/tube, and ?perhaps an assortment of airways would be useful. I'm not sure if this would help the patient that much, but from my experience, cardiac/ and respiratory arrest usually involves the airway becoming obstructed by vomuit/mucous. I'm not sure why rubber gloves are that important.

Of course, you could impact on the 120,000 premature deaths each year, and stop selling cigarettes.

bacardi walla

26th Sep 2006, 15:31

hello every one
what did the italian doctor do?

sadly, and by the looks of it, not much :uhoh:

Condolences to the family involved.

LH2

26th Sep 2006, 15:49

Please note:

Sounds like this pax coned, so all the CPR in the world wouldn't have made any difference.

Mac The Knife (from his handle you should be able to guess what he gets up to for a living) said it all in his post. Please go back to it and read it in full.

/LH2 (who used to be a lowly EMT in a previous life)

workformonkeys

26th Sep 2006, 16:01

If this is an accurate quote then I find this lack of concern by the IAA absolutely staggering.

And you are surprised!!! Have you read the thread cullen v O'leary??? The only thing the IAA care about is money. Too many people in HQ got there because they know someone and not something. Everyone should be calling them up and asking them questions because nobody seems to regulate them.They are a law on to themselves.

ezybus

26th Sep 2006, 16:25

Not sure if you are all aware, but if you give mouth to mouth to someone, 99% of the time they will vomit if they begin breathing again . I for one would want to make sure i had gloves on to clear the airway from vomit. Why should that nurse put herself at risk when she is nopt in her work place. If she caught a virus due to not having protection, who is to blame ????

Most airlines ( shorthaul ) only carry the standard 1st aid kit and don't carry defibs, or doctors kits.

speech

26th Sep 2006, 16:28

On a final point whilst some conditions may have come on slowly it would appear that this patient was not breathing and had no pulse, and yet it took 40 minutes to land at a suitable airport whilst carrying out CPR?
Tell the cabin crew to throw all the trays etc. in the toilets and you should be able to get it on the ground in 15 minutes max from anywhere in Europe!
They probably didn't give it a thought. It's more important for them to land at a RYR base for commercial reasons :mad:

411A

26th Sep 2006, 16:33

Ryanair bashing, plain and simple, from some of the posts here.

Lets review.
RYR have the IAA required emergency medical kit required.
The kit was readily available, yet the nurse who attended the patient couldn't find the latex gloves.

One wonders, why not?

Now, it would seem to me that RYR did all they could under the circumstances, including diverting as required.

Quite frankly, if airlines are required to carry on board medical equipment deemed suitable by a some folks, I would expect there would be no room for the passengers.

Lets face facts here.
This young lady could just as well have passed away either before or after the flight.

It will be interesting to find out the actual cause of death, if ever determined.
I seriously doubt that the flight was on RYR had anything to do with it.

Clearly however, the RYR bashers will not be deterred.
A bit like a broken record...on and on.:ugh:

Final 3 Greens

26th Sep 2006, 16:42

411a

You are a professional captain and quite rightly if I, as a PPL, commented on your flight deck you would tell me in no uncertain terms to butt out.

However, you have the termerity to pass a negative comment on a nurse who, despite opening herself to legal action and having no professional obligation, did her best to help the unfortunate young woman for no financial consideration. And also, she did it without protective equipment, for whatever reason.

That, as they say where I came from, is putting your money where your mouth is

Sumatra

26th Sep 2006, 16:50

It appears the unfortunate girl died of a pulmonary embolism. Listening to the interview today a simple resuscitation tube that only costs a few cents but which no short haul airline is required to carry in their kit was on the medical practitioners wish list. It could have happened on any short haul airline in Europe so surely the emphasis must be on upgrading these medical kits they carry onboard and concentrate on suitable training of cabin crew. The flight was fortunate to have a surgeon, nurse and trauma nurse on board. It must have be awful for all involved to loose someone.

hobie

26th Sep 2006, 16:54

I had a quick look at BA's "Medical care in the air" info and it's worth reading .....

http://www.britishairways.com/travel/healthcare/public/en_gb

hit the PDF download link in the "Aircraft medical kits" section to see just how comprehensive the BA kit is ....

Perhaps a guide for mandatory regulations by the U.K. and Irish Airline Authorities? .... :confused:

lexxity

26th Sep 2006, 17:14

I can just picture it now. Fellow on his back in the middle of the street, not breathing. Fifty people standing around looking at one another, saying: "Sorry, can't try saving his life, I don't have a rubber glove on me."

I have seen this happen. Waiting for an Amtrak in California, an eldely gentleman just collapsed. NOBODY went forward to help him except my Mum and another gentleman, who was a British Doctor. Everyone else just averted their eyes.

Disgusting.

Middle Seat

26th Sep 2006, 17:41

Apparently, the lesson is that if you can't be successful, you shouldn't try.

Ryanair spokesperson: "As the cause of death of this passenger has yet to be confirmed, it is pointless to speculate whether any piece of medical equipment could or would have averted this tragedy. All of our thoughts and prayers remain with the friends and family of the deceased."

norunway: Not to stray from the point the young woman who died on this flight could not have been saved even if she had of been traveling on a CAA registered airplane so why don't you have a think about that

I doubt very much anybody knew that the chances of success were slim when they began CPR (I've always been trained to try regardless), but it seems here that people are using the clarity of hind sight to justify the lack of medical equipment and an ill-prepared crew. Heaven forbid if they even consider an AED on board.

CamelhAir

26th Sep 2006, 18:00

The following radio programme clips are very illuminating.

From RTE News at One (listen to this one first):

http://www.rte.ie/business/2006/0926/ryanair.html

(see audio clip at bottom of page).

From the Joe Duffy Show on RTE Radio 1:

http://www.rte.ie/radio1/liveline/

Click on Tuesday's show, it starts after about a minute. It's long, but worth listening to MOL squirm
as he, in case you had any doubt, demonstrates his total lack of interest in pax.
He appears at about 45mins in and attempts to backtrack on his earlier comments. He then
rather blots his copybook by reducing the girl to a statistic that wasn't worth saving.
Then listen to Joe treat him to a taste of his own medicine in interview technique.
He also says he will lobby the IAA for more equipment on board (rather omitting that he
doesn't need IAA permission to add extra equipment). :yuk:

Essentially its MOL's word versus the doctor, nurse and pax. Obviously the laters
honesty is unknown. However they have no reason to lie and Ducksy's every
word (on any subject) is a usually a pathological lie, so who you gonna
believe?

Once again the mind boggles as to why the IAA will no doubt look the other way.
It's outrageous. As also in MOL's absolute denial of the evidence of at least 5 pax and his
refusal to countenance an investigation. A disgusting disregard for the value of human life.
Sounds like a cover-up.

Blues&twos

26th Sep 2006, 18:35

As a former ambulance crew who instructs lifesaving in my spare time, I can honestly say that giving a stranger mouth to mouth without a mouth shield (e.g. Resusci-aid) isn't particularly pleasant. Not actually required for effective resus, granted, and it wouldn't stop me giving assistance but given the choice I think most people would use one. Don't forget, there are plenty of bacterial & viral infections you can quite easily contract from mouth-to-mouth contact ! I have to say that I am surprised that Ryanar were unable to provide these items - I carry a pretty decent FA kit in my car - there must be room enough on an a/c. And a member of cabin crew saying they're "only trained to take a pulse"? That can't be true, surely? Taking of pulses hasn't been part of resus for ages!
Congrats to the nurses for keeping up the CPR for 40 mins, they must have been knackered. Unfortunately under the circumstances it seems that nothing short of neurosurgery would have made any difference.

air pig

26th Sep 2006, 19:23

How about impounding some of MOLs aircraft in the UK under the Health and Safety at Work Act 1974 sections 2 & 3 in that ryr have not provided for the health safety and welfare of their staff and those not in their employ ie passengers. The use of barrier protection is seen as best practice when performing CPR.

Long haul flights do provide defibrillators under the control of the flight crew and having seen a demonstration by a Virgin Atlantic team, their skills left a few professional medical staff in awe, me one of them. There are many airlines do have a telemedicine facility to obtain advice and indemnity insurance when their advice is followed.

Training and repeated training can only do some much, the first cardiac arrest that you attend always leaves a lasting impression, and if you fail, as high percentage do, you always have a feeling could I or we as a team, have done more ?? having been to many cardiac arrests you still have that feeling.

Congratulations to the nurses and doctor who stepped forward, many today would have had second or even third thoughts about doing so!!

The number of in flights deaths per annum is remarkably low considering the diversity of passengers flown each day. My fear is that a passenger has a tropical disease in the incubation phase and goes on a long haul flight, transiting a couple of main hubs, the senario does not bear thinking about. This did happen a couple of years ago in Berlin fortunately it was only Yellow Fever.

Carmoisine

26th Sep 2006, 20:00

Listen to that interview, most importantly, listen to the Doctor who was onboard and his version of events. This is not a Ryanair issue in terms of equipment carried, he says it himself.

What is the issue here is the way MOL spoke about the nurses.

Lon More

26th Sep 2006, 20:41

I wonder about the standard of help MOL hoimself would now get should he be unfortunate enough to end up in hospital. I rather think "circling the drain" or "NWS" might be wtritten on his notes

411A

26th Sep 2006, 20:41

Yep, Carmoisine, seems to be accurate, as far as it goes.
Clearly, folks have a choice.
Fly Ryanair...fly with someone else.
Now, as RYR certainly in most cases, offer low(er) fares, folks vote with their wallet.
Nothing new there.

Low cost is low cost, period.

Nothing but a knee-jerk reaction to a successful airline, whom appears to beat the sox off the competition.
You can't have it both ways, yet apparently some folks try.
And moan.
And groan.

They apparently meet the IAA requirements...get used to it.
Want it changed?
Write to the IAA.
Continuing to bash RYR clearly will do absolutely no good.

Simple, really.:rolleyes:

BEagle

26th Sep 2006, 20:50

"Low cost is low cost, period."

How true.

The cost of everything, the value of nothing........

hobie

26th Sep 2006, 21:02

As a matter of interest how many passengers have died on Ryanair flights in the past twenty years? .... :confused:

bjcc

26th Sep 2006, 21:05

Someone asked how many people die on aircraft. A fair number, we used to have a around 2 a week arrive at Heathrow dead.

Of those a number were suffering from a terminal illness anyway, and would have died no matter where they were. Of the rest, most were heart attacks, although DVT's probably accounted for a number too, but it wasn't something that was linked with air travel in the way it is now.

On the subject of CPR, and speaking as someone with a 100% fail rate when I've done it (tried 3, lost 3), on 2 of the occations I didn't have any form of mask, I used a tie. It wouldn't be perfect in preventing me getting anything, but better than nothing. On the other occation, I started with a tie, until another PC arrived with a mask, which I found useless. Probably because I wasn't using it properly, so it got chucked away very quick, not having the time to read the instructions. Back to the trusty tie.

The most disgusting thing I ever saw, was arriving at a call to male collapsed on a bus, airside at LHR, I found the bus full of passengers, all studying the wall, while one guy blew into the apparently lifeless body of a guy who'd collapsed. Those same people however all left when given the option to help or, well, shall we say told to get off the bus.

What I found out after the third failier, was that CPR doesn't often work. Strange no one ever tells you that on first aid courses.

The mask may have been a nice to have for the nureses, and was probably what they were used to having, it isn't nessesary, there are other things you can use. As for gloves, I really don't see wy they are needed.

Carmoisine

26th Sep 2006, 21:09

BEagle, You have a long history(to my short memory) of posting comments about Ryanair and their service, culture, dislike for the CEO and also how much you enjoy your business class trips in other threads. Your not the only one on here thats for sure! This is I am sure down to a previous negative experience with FR. Thats all fair enough, thats your right. I work for FR as a pilot, and they are a damn lousy employer. I am not interested in defending them one bit. I certainly even hate some of our top brass, but I do hate crap talk, and I believe crap talk is what you are doing.

This is not specifically about Ryanair though, is it? It happened to occur on a Ryanair flight. If you actually listen to what was said by the doctor who was actually on board, unlike you,me and the tabloid journalists. He said that the EMT in CRL said the same was true of all other airlines in Europe, with the few exceptions of the likes of BA who choose to have a higher standard of equipment on board. Thats the fault of the regulators/JAA/EASA. Take your pick. If there is a minimum standard, airlines will follow it. If the minimum standard needs to be raised, then raise it. The airlines do not have enough depth in medical knowledge and yes, god forbid they are driven by profit, the regulators need to make those decision.

Where do we stop with the emergency equipment? Defibilators. Ok so we change the rules. Bang. Done. Whats next? Shall we carry a doctor on board? A whole operating theatre? In fact why don't we do away with all the passangers altogether, we will never have any medical emergencies then!

So what do you specifically recoment Beagle? I am genuinely interested to know as an industry professional. Or where you just here to make yourself feel better, by getting a dig in, about a bad flight you had with Ryanair?

Topcover

26th Sep 2006, 22:03

My understanding of the issues from listening to the radio interviews today is that the main issue was O'Leary's attitude to the nurses on board the aircraft. He maintained that the item of equipment that they especially had an issue with, the resuscitation bag was supplied in the first aid box. The nurses say that it wasn’t. According to what I heard on the programme, this item is required by the IAA.

Who would I believe....the nurses.

According to an Aer Lingus engineer on the radio programme today. Not only do all their flights carry first aid boxes but also a fully equipped doctors bag.

I think that O'Leary's image and creditability have been badly damaged by the way he has dealt with this issue and his appearance on the "Primetime" programme about flight crew fatigue. His last comment on that programme, about the union rep.being a "failed pilot" especially comes to mind.

I certainly wouldn't trust anything that the man says. When travelling I would pay that little bit extra to avoid flying Ryanair.I know many people who can afford to do so, will do that as well.

I think that it's time for O'Leary to go, think of how profitable the airline could be with a slight change of attitude towards its customer service and someone at the top with a better attitude.

Hampshire Hog

26th Sep 2006, 22:46

I was a St. John Ambulance officer for many years, before children etc. got in the way. I have also taught loads of people first aid.

When I look at a patient now, I make a decision about their background and whether they are a safe bet for risking mouth to mouth and other unprotected treatments. This is based on visual evidence available and undoubtedly introduces a certain amount of unjustified prejudice. Sorry, but the first rule of first aid is to ensure your own safety.

Would I take a decision not to resuscitate an individual in a major city who looked like they might fit steriotypes of being a tramp, drug user or other medical risk to me. You bet. My life is more valuable to me and my family than theirs, whatever the 'have-a-go heroes' might say.

Would a defibrillator have made a difference to this lady? Maybe, as has been said, it depends on her condition. However, given that Network Rail are now providing automatic external defibs on most major railway stations and many larger offices have them, it would hardly be unreasonable in this multi-million pound business to expect to find one on an airliner. In a straight myocardial infarction, the individual's survival chance decreases by 10 - 15% per minute after the initial 3 minutes, unless they receive defibrillation. Basic cardiac drugs, if you have qualified medical staff on board, add to the increased chance of survival significantly.

Would a mask have made a difference, in this case no, since the nurse carried out resuscitation anyway. However, in the event there is a reluctance to resuscitate, based on a risk assessment (however valid) carried out by a trained first aider at the scene (and risk assessments should hardly be alien to professional pilots) it might influence a decision where someone is worried about what they might catch.

I once read an article in the British Medical Journal by a biker, with multiple body piercings and tatooes, who had nearly died following a road accident. Whilst semi-conscious in A&E, he overheard someone say something like 'Oh, don't bother with him, he's probably got AIDS or something'. Fortunately someone did bother - turned out he was an A&E registrar from another hospital. Lesson 1 is don't make judgements based on prejudice. Lesson 2 is, you probably will anyway. The protective equipment might, in a similar situation, save the life of someone who is actually a valuable member of society.

I completely understand the reluctance to take the risk without it. The equipment (masks at least) costs hardly anything, so the message to Ryanair and any other operators who don't take their responsibilities towards safety of passengers as seriously as Network Rail - get on with it.

HH

grimmrad

26th Sep 2006, 23:57

From memory I believe that ryr use std boeing first aid kits.Little inadequate kits that look like they were bought at woolies , tacky standard of equipment. They are a joke. This woman would have stood a better chance on a UK registered carrier with Doctors kits and extensive first aid kits theraputic oxygen and defibs, ie something for everything. This is the IAA's fault not ryr. They let them carry these mickey mouse kits and dont legislate for better equipment.Quite frankly their First aid training is a joke as well. But again the fault of the regulator for letting them do it.
Surely the sham of dublin being their head office should be addressed and the CAA make legal moves to change the situation. :mad:

Even though the kits might be a joke (I only had to use the pretty good kit of a transatlantic BA 767 or 777, don't remember; never saw Ryan Air's) unfortunately her outcome would not be much different if she really had brain hemorrhage as stated above. The only intervention that could have saved her would have been a craniectomy to relief increased intracranial pressure and further invasive therapy (clipping, coiling, operation for AVM or berry aneurysm as the main dd). Only quick invasive intervention would have helped - and I think a craniectomy set is not included on any set...
Sad story indeed.

grimmrad

27th Sep 2006, 00:01

I can just picture it now. Fellow on his back in the middle of the street, not breathing. Fifty people standing around looking at one another, saying: "Sorry, can't try saving his life, I don't have a rubber glove on me."
Sheesh.

I guess nobody meant that. However, one of the primary rules in first aid is also the safety of the "first aidee". And with such basic and cheap things it should really not be an issue on a commercial transportation device (aka plane). I had more stuff in my car (when I had one) than it seems was provided to the people involved. As was said above: the availabiliuty of these items might also influence someones decision making on if to intervene or keep quiet...!

NutLoose

27th Sep 2006, 00:15

You do not need rubber gloves or the mouth valve for mouth to mouth it is advisable but not essential. How many of you have been to a night club and kissed a total stranger.
Ryanair do have first aid kits on board aproved by by IAA and in one of them I believe does have a mouth piece and gloves.
The question is now why did the crew not use them who knows state of panic we all make mistakes when we are faced with stressfull situations.

I Agree about the stressful situation and it being missed.. we are all fallible.

Though the person you are kissing in a night club probably isn't dying from something that could be contagious but unknown.... a sick passenger possibly is,

A tragic death, perhaps some good will come out of it and a review will be undertaken .

grimmrad

27th Sep 2006, 00:16

I have seen this happen. Waiting for an Amtrak in California, an eldely gentleman just collapsed. NOBODY went forward to help him except my Mum and another gentleman, who was a British Doctor. Everyone else just averted their eyes.
Disgusting.

No, not good, agreed. And the reason for this? Malpractice Lawyers! I know doctors that rather change direction than do CPR on the street only to be sued later on the basis that the old guy of 85 didn't fully recover to smoke again 2 packs a day- obviously the CPR's guys fault (in spite of the good samaritan law).
But back to the topic...

Pigsfly

27th Sep 2006, 03:33

IAA=
Institute
Against
Aviation

TheSailor

27th Sep 2006, 04:59

Hello,

The first rule on safety..when a intervention is needed..is to see if the salvage will not put a other life in danger.
That's the risk assesment....
Useless to have two victims...instead one :rolleyes:
So..think about that, when you have to make a ressucitation needing a contact with fluids of a other human....
Obviously...you are in danger of dead if not elementary precautions taken.
Bizzare...but it's the true.
However..you still free to act how you want...but you will have to be responsible of the consequences of your actions...

Regards. http://photobucket.com/albums/v509/Bebermaur/th_bye.gif

woodpecker

27th Sep 2006, 08:22

angels

27th Sep 2006, 08:46

Well said TS6.

RogerIrrelevant69

27th Sep 2006, 08:57

Beausoleil

27th Sep 2006, 09:02

Two contrasting attitudes from this thread strike me:

1. You shouldn't take risks with the aircraft to get it on the ground fast even if there's a chance that it might save the person's life.

2. If there's no barrier mask, first aiders ought to risk catching a virus in order to do CPR if there's a chance that it might save a persons life.

Something interesting about the situations in which risk assessments are made.

And one puzzling thing. When I did a cpr course we were told they had to be on a hard surface - "get them off a bed and onto the floor" -, yet the report suggests the CPR was done over three seats.

SXB

27th Sep 2006, 09:19

And one puzzling thing. When I did a cpr course we were told they had to be on a hard surface - "get them off a bed and onto the floor" -, yet the report suggests the CPR was done over three seats.

That's because there is insufficient space in the aisle to administer CPR, just remember the position you must be in to give such treatment.

Bertie Thruster

27th Sep 2006, 10:12

Isn't the most recent protocol for CPR just chest compressions only?

eidah

27th Sep 2006, 10:53

Unlike ocean going passenger liners, aircraft are not obliged to carry a doctor or any other medical staff. They are obliged to carry minimum medical equipment as specified by the aviation authority (the IAA for Ryanair) that oversees their operation. Ryanair no doubt meet this obligation as do every other airline under the IAA jurisdiction.

A few years ago I witnessed a woman suffer a near fatal illness on a flight from Dublin to Chicago on an Aer Lingus A330. The cabin crew adopted the headless chicken routine while the lady beside me (who was a nurse) rushed to assist. Not much she could do except keep the old dear who was down breathing and comfortable. The captain diverted to Quebec to get emergency medical attention.

Later on when the nurse returned to her seat, she complained to me that the medical equipment on board was totally inadequate and the cabin crew were completely useless.

I really don't see a stick to beat Ryanair with this recent story. The blame, if there is any, lies elsewhere.
Could this have been what happened with the mask on the flight that the cabin did operate the headless chicken routine and I dont think that is down to training. You can have all the training in the world for example the ryanair training course which includes first aid you can be asked all the safety questions every day but what dosent happen in training you dont see dead people you just have a doll. So when the cabin crew is on board and they see a callopsed passsenger who needs resucitation for the first time who knows how they are going to react. A nurse for example probably has had a dealing with this in her job depending what department she is in she might deal with death once a week. The difference is in a hospital you would probably be with someone who has dealt with that situation before. On a flight you might not have to ever use your first aid skills.

eidah

27th Sep 2006, 11:08

No we don't have anything for migraine...
No you cant hold onto that paperback for take off, it must go in the overhead locker, your in an emergency exit row...
No I am not concerned that the eighty year old couple, her with an extension seat belt, who took twenty minutes to walk 100M to the aircraft , having been pre-boarded, are seated in an emergency exit row...
And there was not a ten year old grandson seated next to them on landing (Oh yes there was)...
I think my English is good and I don't think it would help for those of you who do not understand what I am saying if I slowed down a little...
You may in your airline brief all those seated in emergency exit rows prior to every departure, we would brief you about opening the exit only if we had an emergency...
I don't think that all pre departure PA,s should be safety related, lots of passengers are interested in scratch cards...

I, for one, am not impressed with Ryanairs Cabin Crew.

Obviously reading through you have no insight into aviaton the reason everything has to go up for take of and landing when you are at an emergency exit aisle is 1) you may be needed for an evacuation to assist the crew with the evacuation this is with most airlines, 2) anythng might fall into the path of the exit and it is then a trip/slip hazard and would end up been a useless exit.
A frail eighty year old women at the exit what good is she in an emergency if she can hardly mave how the :mad: do you expect her to open the door if the cabin crew became incapacitated on impact.
You dont given headache tablets for migarine. the reason because of the type of world we are in its the same in any proffesion you administer them drugs i.e only a tablet for a headache and they die becasue of a reaction the crew will be in court because they are not medically qualified they are just first aid trained.
The reason you are not briefed on how to open the door in an emergency its not an IAA requirement its juist a CAA requirement.
All these things you are complaining about are set by the IAA for your safety no other reason.
You can say what you like about Ryanir but I am sure they would never break the IAA's rules its not in there interest they would lose there operating license. Ryaniair will operate to the minmium requirement because thats all they have to do.

essexboy

27th Sep 2006, 11:49

As Ryanair Pilot I used to have a little kit in my flight bag containing Latex gloves, some parasetamol, vasalene etc. Guess what it was taken off me by security.

aidanf

27th Sep 2006, 12:24

I listened to Mick's two adventures in radio yesterday and there was one line in particular that I'd like someone more informed on here to clarify. I can't recall whether it was on the 1 o'clock news or Liveline (which immediately follows the news), but the discussion was about the level of equipment which Ryanair are directed to have on board. Mick stated very clearly that if the IAA OR THE CAA instructed them to carry more equipment, then they would of course do so.

Does the CAA have authority over Ryanair? If so, why don't they use it more (from what I can read here, a lot of blame is laid at the feet of the IAA)

If they don't then why did Mick say they did? I can understand him being hopeless on medical topics since he's not a medical professional, but I would have thought that as head of one of the largest airlines, he would know who he should or shouldn't take directions from!

Finally for those that had a go at the nurse in earlier posts, can I point out that it was in fact 3 nurses (two with specific training in emergency med.) and 1 consultant doctor (also with specific training in emergency med.)

... oh, sorry ... there's one other thing. A reporter was also on the radio from Italy (from whence the poor girl originated from). He mentioned that a coroner's report may hint at potential issues regarding 'cabin pressure being incorrect' as a possible contributary factor.

alibaba

27th Sep 2006, 12:52

A Resusci-aid (barrier) is aboard RYR a/c as well as Latex Gloves, which is in the emergency trauma kit.

The worrying thing is that it wasn't given to the doctor or nurses. But who knows what actually happened on board the a/c. The kit might have been given but no barrier was sought as cpr was already being given. Nobody on the forum really knows what was said or done on the a/c unless they were there.

I'd hope the CC's knew where the equipment was but it could have been a dropping of the ball on their part or just pure stress during the event.

Saying RYR didn't have the equipment is wrong though as it is aboard RYR a/c. Cabin crew actions is another argument. I'm sure that will come out in an investigation.

brain fade

27th Sep 2006, 13:08

Say what you like about Ryanair. They've stuck to their knitting!

No frills means 'no frills'. What do you expect for 50p + tax?

In aviation as in life. You get what you paid for.

Final 3 Greens

27th Sep 2006, 13:33

The bottom line on this is simple.

If an airline wishes to call on the services of travelling professionals, for free, exposing them to potential litigation, then the very least that should be provided is the equipment that these people need to do their job.

For whatever reason, the nurse says that she was not provided with this equipment.

She subsequently exposed herself to an unknown risk to try and save a life.

I have ultimate respect for this type of behaviour, which strikes me as being based on an admirable values system.

bia botal

27th Sep 2006, 14:01

On come on you lot, have a listen to the story through the mouths of the people that where there and you will hear that it was no the shortage of the masks and the gloves that they had a problem with it was the fact that there was no plastic tube to put in the airway and squeezable attachable airbag (i am sure there is a techie term, but anyway we have all seen them on shows like ER), none of which are required under IAA CAA or JAR for short flights such is operated by ryr and many others, no doubt the likes of topdog1 and others who fly on aircraft with more equipment are going oceanic.

There can be little doubt that if there was a requirement for that sort of gear on fr flights they would be there, there is no way they would leave them selfs open to that sort of legation, because as always they would lose.

There is no point in coming out with outrages comments about how much better some company may train there crews compared with others, i am sure the crew on that flight would have liked nothing better than to have save this women, the fact remains that even trained professionals couldn't due to lack of equipment... But,,, Had the right equipment been on board and no nurses etc..... are the crews legally entitled, trained or not, to insert a plastic tube down the throat of a unconscious person,, how on earth is anyone with out a medical degree meant to make that call. no doubt if it was done wrong then it could be the fundamental reason why the person may die..... think about that as you admirer your "full emergency equipment including a de-fib" first aid kit.

I am sure from time to time there will more events such as this one, but maybe of a different nature and someone will say, " well if they had of had this blah blah blah on board we could have saved them, shame on that airline".

rant over.....

oh by the way, i agree MOL is a :mad: , but hey we all knew that right...

more beer

alibaba

27th Sep 2006, 14:01

I don't think it is just the airline that wants the expertise of the medical professionals........ I think it is the person with the medical emergency that asks for the help 3 green. :uhoh:

I would regard this as part of a doctors or nurses medical or ethical responsibility to help people in need.

Just to reiterate. The equipment in question is aboard RYR a/c. :ok:

BEagle

27th Sep 2006, 14:10

A plastic tube and a squeezy bag....

Would some rudimentary surgery to a drop down oxy mask system provide the necessary components? I recall a surgeon carried out some makeshift life-saving surgery on a ba jet some time ago using whatever came to hand...

Ah - but now, of course, the nanny state has banned useful things like Leatherman tools, so perhaps this idea would have been a non-starter?

Anti-ice

27th Sep 2006, 14:34

You do not need rubber gloves or the mouth valve for mouth to mouth it is advisable but not essential. How many of you have been to a night club and kissed a total stranger.
.

Errh, come on... the difference here is lust in a nightclub and a desperate medical situation - you DO need protection.

Many people on suffering a heart attack vomit - and the very action of chest compressions itself increases even more.

With the dry air in the cabin, the crews lips could have small cracks in allowing any infection to cross-over...

Who is to say whether anyone you are working on, is not suffering from pneumonia,meningitis,herpes,hiv,tuberculosis etc or a hepatitis carrier - most of these can be deadly....

There is no question that proper protection MUST be provided and that MUST be used and properly trained in the use thereof...

Final 3 Greens

27th Sep 2006, 14:40

Alibaba

I don't knoe if you misunderstood my post, but what I am saying is....

1 - airlines rely on travelling health professionals to assist

2 - these people should be provided with the equipment required, to do their job

No more and no less.

I am not disputing that the kit is carried, but the nurse said she was not provided with it.

That is my point.

Please re-read my original post and you will see this is what I said.

alibaba

27th Sep 2006, 15:18

Thanks for the advice 3 greens, I have done what you said. :ooh:

The equipment was and is aboard the a/c. The reason why it wasn't used is unknown...... Unless you have the answer? ;)

It could be a multiple of reasons why it wasn't used. Don't forget the Nurse's and Dr's involved with this situation would have had high adrenaline levels just as much as anyone else. A report will show the outcome of events and procedures followed. It is not always individuals that are at fault but could be procedures or other causal effects with human factors. It seems too many people on this website like to point a finger of blame at a person or company without evidence or just cause. :=

The procedures could have been wrong or Cabin Crew Fatigue could be an issue. 6 early 12 hr days in succession could be a reason? Who knows? Only a detailed report from the IAA, RYR, Coroner and or the Irish equivalent of the AAIB would show the factors involved and how the emergency was handled.

I don't particularly think it is the airlines that are relying on the help of a medical professional but the person who might be in this terrible situation.... It would be stupid and unprofessional not to ask for help from a medical professional in this situation and would also make the news if not asked and a DR was onboard who could have given assistance. After all it is the person's life that is at stake here. Not to ask for help from someone involved in this profession would be criminal in my mind in an event such as this.

The point I was trying to make about the equipment is referring to a barrier and latex gloves which are aboard the a/c. If the nurse or someone on the thread was referring to equipment that should clear the airway? Well that is not aboard and that is something people should take up with the relevant regulatory authorities. Not RYR. But as someone previously stated a Cabin Crew member sticking a plastic tube down someone’s neck is not something I would advice. Either in a legal context or that of safety issue.

blackmail

27th Sep 2006, 15:20

hello final 3gr.

if & i mean if the nurse was given the first aid kit, would she not find what she's looking for in this kit? she is after all supposed to have more experience with this medical stuff & so on. as said before, until the investigation in this tragic accident is made public, i think it's premature to jump to conclusions & all the ryr bashing is pure nonsense.

Final 3 Greens

27th Sep 2006, 15:27

alibaba

27th Sep 2006, 15:40

So your point is general 3 greens. The answer to your point is that the equipment is onboard.

As far as I am aware unless someone can tell me that I am wrong? It is a JAA and or an IAA requirement to have these parts of equipment onboard. So most airlines if not all airlines flying a/c of this size should have the equipment. That is what RYR have and so have met the regulatory obligations.

Steam Chicken; the commonwealth is no longer the powerhouse in the world it used to be sadly. Get over it. :)

grimmrad

27th Sep 2006, 15:51

Unlike ocean going passenger liners, aircraft are not obliged to carry a doctor or any other medical staff. They are obliged to carry minimum medical equipment as specified by the aviation authority (the IAA for Ryanair) that oversees their operation. Ryanair no doubt meet this obligation as do every other airline under the IAA jurisdiction.
A few years ago I witnessed a woman suffer a near fatal illness on a flight from Dublin to Chicago on an Aer Lingus A330. The cabin crew adopted the headless chicken routine while the lady beside me (who was a nurse) rushed to assist. Not much she could do except keep the old dear who was down breathing and comfortable. The captain diverted to Quebec to get emergency medical attention.
Later on when the nurse returned to her seat, she complained to me that the medical equipment on board was totally inadequate and the cabin crew were completely useless.
I really don't see a stick to beat Ryanair with this recent story. The blame, if there is any, lies elsewhere.
As I mentioned above a few years ago I was involved in an in-flight emergency with a young guy en-route on BA to LHR from BOS. Equipment was very good (2 large boxes with medications, syringes, tubes, gloves etc.) as was the cabin crew, assisted very profesionally and calmly. So it can be done differently - and shouldn't it be the best equipment if the health of your paying customers is concerened - as with the flying equipment? Or shouldn't you at least know WHERE the kit is? Of course the nurse wouldn't know, its the responsibility of the crew! So, if as it seems the ac had the kit on board, why was the crew unable to deliver it in an obvious emergency situation? That seems to be the main question here, is it not?

Final 3 Greens

27th Sep 2006, 15:53

Alibaba

As you prove to be incapable of understanding my point, I will not try and make it any further.

Why don't you read Grimmrad's post, that summarises it elegantly.

grimmrad

27th Sep 2006, 16:02

BEagle

27th Sep 2006, 16:23

To be fair to Mo'L, he did at least say on the RTé interview that they would be having an internal inquiry to establish why the CC couldn't find the kit which should have been on board - if indeed that was what happened as has been stated by the nurses.

Who did the first pre-flight? Presumably that included a check of the emergency equipment inventory?

Mind you Mo'L could have saved a lot of hassle by saying: "We're all very sad indeed about this poor woman passing away. We also thank the nurses and doctors who came to help for doing the best they could for her and we will also be using their expert knowledge to establish what more we could do were this sad tragedy ever to happen again"

And if pressed about where/what had happened to the first aid equipment: "We will be carrying out an internal inquiry and addressing all the comments made by the passengers who tried so hard to save this poor woman. If we find that there were any shortcomings on our part on this occasion, we will ensure that they are rectified immediately".

10secondsurvey

27th Sep 2006, 16:45

So, due to the pressure(?) of the situation, the Ryanair cabin crew were unable to help by getting the first aid kit. God help us all if any of their fleet are involved in a real emergency. These cc are meant to help in aircraft evacuation for heaven's sake!!

As a pax, I regard the ability of cc to provide a first aid kit, as a relatively simple task. That is, of course, assuming they have one.

qwertyuiop

27th Sep 2006, 17:13

Rumour has it that during an emergency a couple of RYR CC were unable to open a door. All training done by a third party. Maybe a look at their training department is called for.

alibaba

27th Sep 2006, 18:24

3 green; I can honestly say that I don't understand your point? What are you trying to say? Is "grimmrad" or "10second survey" doing the talking for you here, because you don't want to come out and say exactly what you want to say in fear of being accused of being just another RYR basher? If you want to say it, then say it! At least have a pair of b:mad:s.

The equipment was available. Why it wasn't used will come out in an investigation. Did the nurse ask for it after or before giving CPR? Did the crew think as CPR was already being given the nurse's didn't need the barrier? In a hospital ER, maybe a barrier would be provided automatically by act of procedure and CPR continued? Can you say the crew knew this? Who knows? Most people on here certainly do not know what happened as they were not there. That is for sure.

It is interesting to see you have read the final report into the investigation grimmrad.:D The crew should have supplied the equipment etc. Again, how do you know whether they did or not? If someone screwed up here without any human factor problems just by shear incompetence, something will have to be done no doubt.

10secondsurvey; RYR as far as I am aware carried nearly 35 million people last year. Do you not think different crews from RYR's many bases around Europe would have not dealt with emergencies?

Look further down the Rumours and News and you will see another RYR emergency that was dealt with professionally and without incident. I would say RYR have emergencies the same as any other operator and deal with them on the whole professionally and without incident. It doesn't make the news because it was handled in an expeditious and professional manor most probably.

Now getting to the fact that RYR have multi national crews. Can I ask is there a problem with this? Is the crew less able to deal with an emergency? I think there is a bit of bigotry concerned with this subject. If people have a problem with multi nationals then they should think long and hard and decide if the problem is with them or ourselves and our own possible racist sentiments?

The equipment should have been provided 3 green I have no difference in opinion to you on that point. I agree. All I am trying to say is pre-empting an investigation as to why the nurse didn't or couldn't use the barrier is wrong. There is alot of the mud slinging at Ryanair without knowning the facts which will come after the investigation and reports are written. Not by us now, guessing on a web forum.

blackmail

27th Sep 2006, 18:43

10sec's

there are "normally" 3 first aid kits on board. one in bin 14def & 2 in last rh bin(row 33def). contents are published in the first aid manual.
again, "normally" the presence/conformity of these items & other things, O2 & fire extinguishers etc. are checked when the cabincrews perform their cabin safety/security check after boarding the aircraft for their first flight of the day.
as the hot topic here centers aroud the first aid kits, the cc can only check the precence & the seal of the box & hope the contents are ok.
the n°1 then informs the captain,who then signs the plog that the inspection is carried out correctly.

Final 3 Greens

27th Sep 2006, 18:50

Alibaba

What part of "medical professionals should be provided with masks and gloves" are you having difficulty understanding?

And at the risk of being boring, I really couldn't care less that the airline involved was Ryanair, my point is that if airlines (in general) wish medical professional to assist with mouth to mouth ressucitation, they should give them the masks and gloves.

Got it?

alibaba

27th Sep 2006, 19:00

Couldn't agree more. 3 greens. :ok:

The airlines do supply the equipment and I think they would want it used. I am not sure if you are medical professional or not but I would say it is the person on the floor with the problem that wants the equipment to be used just as much as you.

That person can catch something from you just as much as you obtaining something from them don't forget.

Blues&twos

27th Sep 2006, 19:37

Isn't the most recent protocol for CPR just chest compressions only?

Just caught up on this rapidly expanding thread. Don't you guys ever sleep?? Just to clarify the new UK Resuscitation guidelines (taught on all new FA courses) still require lung inflations (ratio of 2 inflations to 30 chest compressions). However, it was recognised in drawing up the new guidelines that chest compressions were comparitively more important - compressing the chest to squirt the blood round the body also squashes the lungs to a certain extent and they partially reinflate between compressions, although of course this isn't as effective as proper rescue breathing. It was also noted that people who were reluctant to do mouth to mouth for whatever reason then tended to do nothing at all. Now more emphasis is put on "even if you don't do the inflations, do the compressions". Incidentally, likelihood of bringing back a heart attack casualty with CPR alone is approximately zero. Paramedic help is required, despite the rubbish suggesting otherwise frequently shown on TV. And on that cheerful note......

Sven Sixtoo

27th Sep 2006, 20:26

Hi All

I'm a SAR helicopter pilot.

A few weeks ago we had three survivors in the water. The rearcrew brought the first one up unconcious. They then had to go for the other two. Some one has to fly the beast. That left me the copilot to do CPR.

A SAR aircraft is full of medical kit. I have several thousand hours in the business. I know, in theory, every bit of kit on board.

I went down the back, pulled the guy out of the way of the winching station, checked for vital signs, and got stuck into raw unprotected CPR. I did hesitate at the thought, but I wasn't thinking straight enough to grab any of the various barrier devices around the aircraft.

I'm a professional, experienced, and arrogant enough to think I'm quite good. Faced with the problem I didn't think of any of the solutions, so I just did what the military teach you every year.

Don't blame the cc - you can't simulate the real thing.

Sven

chinaman1119

27th Sep 2006, 20:55

This incident got me thinking and I'd like to add some of my own experiences.

Before I start, let me say that what happened on the Ryanair flight (obviously) can't be changed and seemingly only a full hospital ER would have been sufficiently equipped. The investigation/report will hopefully state on what really happened in terms of the gloves/barrier and what can be learnt from this. My condolences to the families involved.

(1) CX B747 ultra long haul flight in the late 80's /early 90's
Male cabin crew member became ill just into the flight. Doctor on board and together with/via link to company medical officer came to a prelim diagnosis of kidney stones. Extensive medical kit on board allowed appropriate pain killers and other appropriate medications to be administered. After allowing the drugs to kick in and after numerous calls plus patient input/feedback the it was decided to push on provided no change in condition. Regular updates followed and the flight landed at destination. QUESTION: Did the above-minimum-requirements medical kit enable a diversion (including substantial fuel dump) to be avoided? Needless to say, diversion or not, minutes or hours, the patient for sure will have appreciated the pain relief received.

(2) CX B747 ultra long haul flight in the late 80's
On last leg of the flight the aircraft diverted to a non CX airport on commanders decision due to medical emergency. As became known later, the crew performed some 30+ minutes of CPR including right through the landing. If I recall correctly the doctor/nurse aboard had at some point stated the fact that chances were increasingly slim. The crew continued nevertheless until handover to the airport medics. The passenger survived and made a full recovery from what was a heart attack. NO QUESTION: As published in the company newsletter, the crew did an excellent job and were credited with saving the passengers life. This incident still gives me goosebumps today (in a positive way). Not sure if any public press printed the positive story but I am sure that the 300+ other pax plus the patient will remember that CX flight and what they have seen forever and, overall, having been able to apply the training with such a result must have been a tremendous boost for the crew. Well done!

(3) CX B747 ultra long haul flight in the mid 90's
On the last leg of the flight a passenger became ill and medical assistance sought. Doctor plus nurse came forward. On arrival at the patients seat the crew volunteered the emergency kit and, as there was a doctor, stated to him that there was medical kit on board if needed. Again prelim diagnosis of kidney stones and after consultation with the company medical offiicer the patient received Paracetamol first with a stronger pain killer (Temgesic if I recall correctly) on standby to be administered by the doctor on board without further consultation with the company medical officer should the Paracetamol not provide sufficient relief. NO QUESTION: I was on board this flight and saw the both kits in action plus what I would deem to have been exemplary crew handling. The patient received relief from the pain and the flight continued to destination.

So to close:
- there is the emergency kit required by law
- there is the medical kit with a somewhat extensive stock such as BA, CX and many other carriers have on board
- there are the defib units
- there is crew training

As crew, a passenger, a patient or as pax with medical qualifications attending to another sick pax ... one can only hope that the aircraft one is travelling on carries as many as possible of the above.

For me personally I can come up with little excuse for any aircraft (regardless of airline, "flag carrier", charter or LCC) NOT to carry an extended medical kit. Apart from life being precious and myself possibly one day being in dire need aboard an aircraft ... if AVOIDING bad PR is not a reason enough ... a fuel dump, diversion, possible crew time problems and whatever else should be an easy equasion for any airline accountant - let alone for management with an ops background.

Defib units I could see a LCC declining on cost(/weight?) grounds ... but then it finally comes down to the question of what a passengers life if worth and what kind of airline you want to operate. We are talking equipment, not pretzels or caviar.

Training ... isn't that as much about meeting the minimum requirements as well as empowerment of your staff (be it up in the pointy end, further in the back or on the ground, be it for daily chores or emergency situations when the occur)? I think no staff is happy to be faced with running out of options/training/SOP's and being left with only "headless chicken" mode (again, regardless of where and for that matter even what industry). I think knowing what is on board plus volunteering the emergency kit plus making it known that there is (hopefully) a "bigger" kit available to qualified doctors is the minimum and at the same time somewhat acceptable, because ...

An airborne emergency aboard an aircraft is quite likely one of the top 10 worst places for such a thing to occurr - an that especially in a single isle plane versus the relative spacious luxury of a wide bodied jet.

Those are my 2 cents ... won't change anything but perhaps provide food for thought and again highlight the problem of "what factors rule our industry today". Perhaps our choice of airlines (when having a choice) based on the likelyhood of "the full works" being on board is the only option available.

Humans get sick (both crew and pax) and it happenes on aircraft (big and small, short haul and long haul, flag carrier and LCC) and it happenes at unpredictable times (V1, TOC, TOD or whenever) so this concernes every single one of us, flying on duty and travelling off duty.

woodpecker

27th Sep 2006, 21:53

EIDAH suggests...
You can say what you like about Ryanir but I am sure they would never break the IAA's rules its not in there interest they would lose there operating license.
An incapacitated 80 year old and a 10 year old child sitting in an Emergency Exit Row.??
What IAA rule allows that.
As for non-aviation background, you are quite right EIDAH, I'm retired now after 35 years at the front end of BA wide-bodied and loving it.
Perhaps that's why, EIDAH, having seen how the job should be done, I am less than impressed with the standard of Ryanair Cabin Crew

blackmail

27th Sep 2006, 22:13

woodpecker

before judging "ex cathedra", wouldn't it be wiser to wait until we all know exactly what happened via an official explanation? i know it's not easy,as those investigations take time & we all are eager & impatient & the imagination of some on this forum has no limits, especially as ryr is involved.

Seat1APlease

27th Sep 2006, 22:29

Chinaman1119 I couldn't agree more.

I think you summed it up very eloquently. It isn't about minimum requirements but more about common sense. Diversions are costly and if they can be avoided then they should be. No-one wants to be offloaded in some remote airport with poor medical facilities if a proper medical kit would permit the aircraft to continue to a more appropriate place.

If you want doctors on board to volunteer their services then the least they can expect is the basic equipment to do their job.

The authorities may permit less to be carried, but does it make sense in the long run to skimp on these things?

You pays your money and you makes your choice, that applies both to the airlines and the passengers.

woodpecker

27th Sep 2006, 22:32

Blackmail,
I actually agree with you. All I have done is travelled with Ryanair on numerous occasions and highlighted the lack of professionalism often observed
PS Been away from the computer for a while, what's the latest on the Stansted Low Vis investigation? Anyone got any news?

blackmail

27th Sep 2006, 23:14

hello woodpecker
could you elaborate:"lack of professionalism often observed"?
for stn rvr a fci(flight crew insruction) was published to clarify the matter how & when to convert vis/rvr's with references to the ops manual.
but here we are drifting out of the original topic.

skytrax

28th Sep 2006, 01:01

A lot of the cabin crew in my airline carry with them a face shield or a pocket mask for CPR, even if it's not a requirment.
We have plenty of them in the medical kits but if you have a casualty you waist a lot of time till you get it, especially in a large airplane such as 777-300. So we carry them with us for our own protection and for a rapid response. I can tell u that it's not very nice to give CPR to somebody that vomited before.
We also have a defib on board of all the airplanes and the senior cabin crew are trained to use it.
I think basic CPR at least should be known by all the cabin crew and the airliners (even the low cost) should provide a lot of face shields and rubber gloves to the cabin crew. It's very basic stuff.

alibaba

28th Sep 2006, 01:34

Can anyone enlighten me and others to what BA carry in terms of the emergency medical equipment on short haul dedicated a/c only, such as a 73 or A32? The point about Defib's is a valid one and I think might be something for the JAA and or IAA to sit up and take notice of, for all the operators throughout Europe.

Seat1a; you must not be reading the thread properly the equipment is aboard and no skimping as you put it is taking place.

"If you want doctors on board to volunteer their services then the least they can expect is the basic equipment to do their job."

The type of equipment you are referring to is already there. As stated by many posters.

If someone were in such a state as to need a Defib onboard a short haul a/c mid-flight and you are flying anywhere in Europe you would be considering diverting to an enroute alternate/ suitable aerodrome. I don't think the accountant would come anywhere near that type of problem or should even be in your thoughts with the options you would have available. We are putting safety 1st here are we not? Africa is a different thing altogether granted. Continental Europe is not though.

A 74 / widebody or another a/c in that type of size has a lot more factors to consider when diverting unlike a 73 or A32 such as overweight landings and fuel dumping etc. Hence the different type of safety equipment carried!

The question about what a passenger’s life is worth. Well I think safety and the safety of its passengers is the first and most important item with ANY RESPONSIBLE OPERATOR. Referring to whether putting Defib's on an a/c is the same as caviar or pretzels is shocking! If you think LOCO's look at safety in that way, then you show your naivety and lack of industry wide appreciation for safety management. Safety is NOT the remit of full service carriers only. The quicker people understand that the better. Do you think EZY or Air Berlin and the rest of the low cost market work in such a manor?

Woodpecker can you give examples of how the Cabin Crew on RYR lacked professionalism? If so, could you state your reasoning behind your statement to this affect?

Training and re-training is as people would agree an important part of being in a profession. LOCO crew's whether some people in the aviation industry like it or not are well trained professionals. We should all want to better our knowledge and skills. To doubt that the bare minimum of training is given to LOCO crew's is again naive. Where is the evidence of this against LOCO's and RYR in particular? Could training be improved in this sector of aviation? Well I am not an expert but I would like to bet that the answer is yes. The same as any other part of aviation. The military don't spend so much time doing this activity for the sake of it. It works. Then we wouldn't be flying PAX around though as we would ALL be in the sim or on courses all the time. There is a compromise to be had. The argument is and should be the amount of compromise in this. Only the regulators know the answer to that question.

Nobody is a fan of MOL. That man though is not the be all of RYR or the other LOCO's. :ugh:

Sorry for such a long post but some of the arguments on here need to be rebuffed. :eek:

topdog1

28th Sep 2006, 07:31

My previous post where norunway called me an asshole, was to say that the airline I work for, now a low cost airline carry a full first aid kit and doctors box plus a de-fib, that de-fib, full kit and our excellent training allowed myself and a colleague to save a mans life having suffered a cardiac arrest without it he would have died inflight. Its the most terrible thing to happen to a cabin crew member so I do feel for the crew who only had the basics (if they did).
I am happy to fly with my airline knowing that should anything like this happen again we have the equipment to assist us or doctors if required. As a senior crew I am also issued with a small first aid kit to carry with me which includes gloves, painkillers, burn gel, plasters etc.

Seat1APlease

28th Sep 2006, 09:28

No Alibaba we are not talking about the same "basic equipment here".
What many are referring to is little more than a piece of plastic with a hole in it so that the mouth can be covered and the first aider can blow air in without making direct contact.
What I would consider minimum kit is what we used to call a "salad" airway. That is a piece of plastic about the thickness of a hose pipe and about five inches long and shaped like the letter "S". It is slipped over the tongue into the back of the throat to stop it blocking the airway and has a flange which seals agains the mouth, and then a small plastic "football" is attached to it. This ball can then be squeezed to pump cabin air or oxygen from a cylinder into the lungs without the necessity of a nurse blowing for 40 minutes. They come in a very small box, weigh next to nothing and cost a few pounds.
Now that portable automatic defbrillators are available I think you could argue the case that their carriage is justified, even over Europe, because whilst you might be able to get the patient on the ground in 15 minutes or so, that is stilll too long if the heart is not beating or in spasm, if you can shock it back into sinus rhythm then the chances of survival are much better. Yes it is costs money including the training costs, but I believe the passenger would accept the cost if properly explained. They already have to pay a "wheelchair levy", the extra cost would be peanuts.

Farty Flaps

28th Sep 2006, 09:47

Can I make one point clear.Unless they have changed since 203 ,kits used by ryr are about 8" by 8" and contain a motley collection of low quality bargain basement medical kit. Boeing std part number , get the aircraft out of seattle kits.Its the absolute minimum reqd by the IAA. I have had cause to audit one, and they are a joke. The extensive kits on CAA planes may not have saved this particular girl , but they are inadequate for all but putting a plaster on, so its just a matter of time. They are less extensive than the carry on kits carried by my current airline.Now we carry what is legislated, so do ryr. We both operate out of the uk ( forget the dublin bollocks) so why are they left unchecked. Just a flag of convenience. Total bollocks

alibaba

28th Sep 2006, 10:06

The Defib argument is something that we do agree on Seat1a. I have no problem with that.

I can see the arguments on both sides of the coin. With proper training in its use there should be no issues with it being aboard. The problem is where a wrong diagnosis by a CC on a PAX that might have some sort of disorder with their heart or even something else, and then we bring a Defib out and shock the PAX could be just as if not more fatal than the problem itself.....

I do think it is for the authorities and airlines to look into with proper regulations on its use. To try and blame RYR though for not carrying this item is not really acceptable when a multitude of other airlines throughout Europe will not have this item aboard. They are following the regulations the same as any other operator.

The piece of equipment that you called a "salad airway" is slightly different I think? This is not really basic equipment but is getting into the realms of ER I am no DR though and I freely admit that. As stated above this is not something that you want CC to be doing to a PAX. If it can be proved that it saves more lives, then it should be considered. Are there any statistics that show the amount of people saved using this equipment compared to not using this piece of equipment? If there is, then medical professionals out there should be lobbying the regulators for it's installation aboard a/c as maybe a DR or medically qualified professional only type instrument.

RYR like most operators have probably considered these items but have done a risk assessment and decided it was not feasible as it opens themselves up to all kind's of possible litigation. This is the world we live in unfortunately. It was probably decided that the benefits would not outweigh the risks. If these items where used by properly trained medical professionals then I would see no problem with there use or storage aboard.

I don't think that most people at the start of the thread were talking about a "salad airway" or a Defib though. We are adding item's after the fact. They were talking about basic equipment such as a barrier and Latex Gloves. These are aboard.

topdog1

28th Sep 2006, 11:12

Alibaba,

Just to let you know that the defib will only shock when the heart is in a VF rythm, it will not sock unless is requires it. It can also be used as a heart monitor only to assist a medical doctor or nurse should a pax be suspected of suffering from heart problems which can give an early warning. The statistics within my airline I believe are very good.

chinaman1119

28th Sep 2006, 11:41

Alibaba,

The question about what a passenger’s life is worth. Well I think safety and the safety of its passengers is the first and most important item with ANY RESPONSIBLE OPERATOR. Referring to whether putting Defib's on an a/c is the same as caviar or pretzels is shocking! If you think LOCO's look at safety in that way, then you show your naivety and lack of industry wide appreciation for safety management. Safety is NOT the remit of full service carriers only. The quicker people understand that the better. Do you think EZY or Air Berlin and the rest of the low cost market work in such a manor?

Please let me clarify the defib versus pretzels or caviar thing. What I was trying to put across is that these warrant two completely different decision making channels, hence my words "we are talking equipment here". Caviar, pretzels or no nibblies at all is something that can be looked at to save on costs - a defib unit we agree is aircraft equipment category but that does not automatically make it a must-carry-item. We mean the same though: ANY RESPONSIBLE OPERATOR as you said

Ultimately every operator out there will have at some point had the defib/no defib decision on the table. If at some point in the past the decision may have come up as no, then the issue should come up for review at some or multiple point/s in the future. Be that for reasons of regularly reviewing your product/safety, the cost of defibs coming down, the spread of defibs becoming wider ... or an emergency on board your aircraft or that of a competitor providing hard grounds for review.

IMHO defib units do serve to treat a very specific emergency condition (if broken down into percentages), albeit a very severe and not uncommon one. These units will continue to penetrate the market but as of today I would NEVER have any misgivings against any airline that do not carry these yet. Clearly though it is always only a matter of time until a defib on board will be needed to TRY and save a patient ... or a pax doctor fails in reviving a patient without a defib available and later becomes vocal about it.

As to your mention of EZY or Air Berlin and the manor they work in ... if that was directed at me then let me just point out that I specifically tried to keep my post neutral. No RYR bashing, nor any other carrier or type. Why? ... because frankly I do not have the picture of how every carrier operates/thinks. I fully agree with you that these issues we are talking about here apply industry wide and regardless of operator type.

For sure there are LCC's that carry the "full works" and there are full service carriers that do not. And that exactly is the point of the whole thing ... how much medical equipment you carry and how extensively you train (or how safely you operate your aircraft for that matter) should NOT be an issue of how cheaply or not you sell your seats.

There are black sheep out there and to deny that would be naive ... often such less visible differences only come to light after incidents become public.

graviton

28th Sep 2006, 20:14

Woodpecker,

“…I'm retired now after 35 years at the front end of BA wide-bodied…”

“All I have done is travelled with Ryanair on numerous occasions and highlighted the lack of professionalism often observed.”

This ‘lack of professionalism ’ hasn’t stopped you using Ryanair then? A person of your experience … almost seems like a recommendation to me!

G

fredchabbage

28th Sep 2006, 20:25

woodpecker
wouldn't it be wiser to wait until we all know exactly what happened via an official explanation?
Did you not read what PPRUNE stands for ? the whole idea is to generate discussion ! ;)

Nov71

28th Sep 2006, 22:37

To comment/discuss without Facts is to speculate.
So lets speculate.
If the passenger suffered a brain bleed, as reported, requiring CPR, it prob had affected her brain stem function. She would have been brain dead within minutes, but only a medic can pronounce, so most people 'die' after reaching hospital unless forensic/pathologist examination shows otherwise.
First Aid is exactly that. With a warm body any trained First Aider should be able to clear the Airway, restore/maintain Breathing & Circulation by ext CPR if possible until life extinct is pronounced by a qualified medic.
Rule 1 First Aider should not put themselves at undue Risk.
Rule 2 Patient should not be moved unless life threatened eg explosion,crush
Surgical procedures eg tracheotomy is not first aid How many scalpels/penknifes are allowed on board? The 'salad bowl' could be regarded as intubation, a risky surgical procedure - not first aid. A plastic film with a one way air valve and surgical gloves could be regarded as essential protection for the patient/first aider (Health & Safety)
As a first aider I would continue CPR and mouth to mouth for as long as possible or until relieved by a paramedic.
I am not familiar with current CPR guidelnes but chest compressions only are unlikely to provide sufficient air exchange to maintain life (snorkel effect)
Portable defibbrillators may be useful in certain medical emergencies if the first aider is current in cardiac resuscitaion protocols and authorised

alibaba

28th Sep 2006, 23:35

"The fact that unlike BA they do not have a "utility" first aid kit, in addition to the sealed kits, with plasters, paracetamol etc is a shame but is not going to kill anyone."

I believe there is a "utility kit" as you describe it onboard RYR a/c. With all the types of things as above.

Dan Winterland

28th Sep 2006, 23:55

A plastic tube and a squeezy bag....
Would some rudimentary surgery to a drop down oxy mask system provide the necessary components?

The recussitation kit my airline carries uses the portable oxygen system. A mask with a valve is attachted to the bottle regulator. Place the mask on the victims face, press the button to inflate.

However, if the heart has stopped and can't be restarted, with CPR probable survival chance diminish to zero in about 25 minutes. So if you're giving CPR in flight, unless you can be on the ground, shut down and the paramedices with a defib kit on board in that time, it's probably curtains. Some long haul operators carry portable difibrulators, but perhaps short haul operators should consider it too.

woodpecker

29th Sep 2006, 08:20

ezybus

29th Sep 2006, 13:04

Alibaba,

BA have the sealed first aid kits on all services, which when opened have to be returned to the supplier for checking/restocking. This from what MOL stated during the interview happened on the Ryanair flight in question. He suggested that there were three of these kits on the aircraft (he was even going to sent one of the kits to the interviewer). There was no mention of any other "utility" kit being available.

BA have the "face mask" readily available in the "utility" kit, They even gave us all one of them during the SEPT (training) day one year. I still carry it in my wallet. It is called the Resusci Face Shield supplied by Laerdal Medical. Sensibly it has a "CPR reminder" on the back.

If Ryanair do carry a "utility" kit (over and above the IAA requirements) what does it contain? Why I ask is that a while back a fellow passenger (one of a party returning from a stag do!) wanted something for a severe headache (not sure if the word migraine was used). He was told that there was nothing on board.

He would have been told this as the crew are not permitted to administer paracetamol to anyone who may be / or have been under the influence of alcohol. The crew are not to know when the last intake of alcohol was, so therefore could be giving drungs out whiles pax is tanked up! That crew member was in her right not to give out any, and the easiest way to say no is that there are none on board. Why didn't you buy any in the terminal?????

alibaba

30th Sep 2006, 17:21

There is a "utility kit" kit onboard RYR a/c. If MOL didn't talk about it then so be it. As we all know he gets alot of things wrong. ;)

I think ezybus summed it up perfectly as to one of the few reasons why you don't give drugs to PAX.:ok:

"He would have been told this as the crew are not permitted to administer paracetamol to anyone who may be / or have been under the influence of alcohol. The crew are not to know when the last intake of alcohol was, so therefore could be giving drungs out whiles pax is tanked up! That crew member was in her right not to give out any, and the easiest way to say no is that there are none on board. Why didn't you buy any in the terminal?????"

I think the thread has gone off track slightly because people are digging at anything to blame RYR.

I am no fan of RYR, let me make that clear. In terms of employee and PAX rights, RYR is disgusting. :yuk: There is probably no other company like RYR out there, which is so determined to make money at anyone’s expense or health. Unfortunately that is RYR and it's management. Until this changes, we have a choice though and if you don't like em don't fly em. Simple.

hobie

30th Sep 2006, 18:32

There is a "utility kit" kit onboard RYR a/c. If MOL didn't talk about it then so be it. As we all know he gets alot of things wrong.

He mentioned 3 kits ...two full kits and one lower level kit .... :ok:

virginblue

2nd Oct 2006, 16:29

A quick question that obviously has not come up: Why did the aircraft divert to CRL ? Was CRL as a Ryanair base by coincidence indeed the nearest airport to divert to ?

Irishboy

18th Oct 2006, 13:34

http://www.breakingnews.ie/2006/10/18/story281447.html

Transport officials facing questions about in-flight first aid
18/10/2006 - 08:32:10

The Oireachtas Transport Committee is due to begin an investigation today into the provision of first-aid equipment on flights and the training of cabin crews to deal with medical emergencies.

Officials from the Department of Transport and the Irish Aviation Authority are due before the committee to answer questions on the matter.

The investigation follows the death of a 24-year-old woman on a Ryanair flight from Treviso to Dublin last month.

Concern was raised at the time about the lack of medical equipment on board, but Ryanair insisted all its aircraft were stocked with first-aid kits as required by EU law and all staff were trained in CPR.

flyblue

18th Oct 2006, 17:27

As topdog1 says, a defibrillator can be used for for an electrocardiogram, to help establish a diagnosis and decide further action, which is very important in my opinion. Even if defibrillation is not required in one case, the ECG can be used by a doctor on board if there is one, or by the medical service on the ground that will be in communication with the cockpit.

In my airline (we carry them in Short, Medium and Long Haul) the procedure in case a passenger collapses is that someone takes care of him/her while another crew fetches the defib and ambu and systematically proceeds to connect it to the pax (electrodes). You can never know if you're going to need it, even if the pax only had a syncope and recovers immediately, and seconds are vital in these cases.
Thanks to this procedure, since we started carrying defibrillators (4 years) on all aircraft (251), we've had a % of full recoveries of 20%. Which is enormous, given that on the ground the % is of 3% (I'm still talking of full recoveries: additional 7% survive on the ground but with serious handicaps or brain damage while 10% become organ donors). The reasons for this difference is that the average time of action in case of cardiac arrest in the air is 3 minutes, while in the best of cases in the ground it is 15' to 20' (unless you are "lucky" enough to have a cardiac arrest at the hospital :rolleyes: ).

It is true that in this particular case gloves, mask and defib would not have changed the outcome, but the defib surely would have helped enourmously the doctor, nurse and crew involved to have a clue about what was happening.
The fact that it is not a requirement on aircraft is a shame and having seen the numbers for my airline, I must say it is a deadly shame.

Blues&twos

18th Oct 2006, 17:54

Absolutely Flyblue!

Defibs are relatively inexpensive and drastically increase chances of survival in cardiac arrest casualties, particularly if they are used almost immediately. I am surprised more airlines don't carry them as standard kit given that paramedic help is likely to be at least 20 mins away if you're in the air. Today's 'first aid' defibs don't require a medical degree to operate, they can talk you through the procedure and will only shock a shockable rhythm. Don't forget that CPR on a cardiac arrest is just buying time....

flybywire

18th Oct 2006, 20:10

Alibaba & Blackmail

Please note that I am not bashing Ryanair, my point is made generally. The fact that the airline in question is Ryanair is irrelevant as far as I am concerned and your sensitivity to inferred criticism is your problem, not mine.

Allibaba, you said "I don't particularly think it is the airlines that are relying on the help of a medical professional", but if you look in the first post it says quite clearly that the aircraft commander appealed for assistance - absolutely the right thing to do, I think that we agree on that.

I have no idea why the kit was not given to the nurse and am not trying to judge the reasons why, nor do I dispute that the aircraft carried the supplies required.

Once again, my point is that if health professionals are asked to assist, they should be provided with the gloves and masks.

After all, they might be putting their own life on the line by not using this basic equipment.

What I really do not understand is why the crew didn't do anything themselves first?
I know that procedures change from airline to airling but in MY airline, for example, there are only 3 occasions we can contact a doctor on board, if it's an immediate life-threatening situation (like suspected anaphylactic shock), if Medlink cannot be contacted or IF medlink tells us to.
Cabin crew in my airline are perfectly trained to carry out CPR, and nobody can forget the DRSABCD which are lying there at the back of our mind whatever we're doing on board. D stands for Danger, which means if there's any danger to MYSELF or the person who requires help then we must leave it until the situation changes. That is, if I have nothing to do a protected mouth-to-mouth with then I can skip it until somebody brings me some protection.

But there lays the difference. We have the appropriate equipment to deal with situation like these (a relatively frequent occasion unfortunately) and we know exactly where it is.
And 99% of the cabin crew in my airline would always carry a disposable "face shield" in their pocket at any time during the flight (we also have spare ones in the basic medical kit) which can be used while waiting for the resuscitation kit.

I believe the problem is in the safety culture of the airlines. Probably that woman would have died anyway, but at least the crew's/management's conscience would have been relieved knowing they had tried all the possible to save that woman's life.
After a stroke, a heart attack and a stillbirth in 5 years of flying, I know I would have felt a little bit better.

FBW