Dead Pax...

[pilotwolf]

Hi All,

Hopefully someone can(sensibily) Answer this one for me - or point me in the right direction of an old thread...

If you have a passenger who dies on board where do you put the body?

I appreciate all the usual attempts to resuscitate would be made, with or without a doctor, nurse or paramedic assistance, but if resuscitation is stopped where does the unfortunate passenger go?

I have heard rumours that no one dies in another country's air space due to the potential prblems with the Coroner's office. But do you just prop up the corse and make them look comfortable or would they be moved somewhere - not that I can think of anyway realy suitable except perhaps the crew rest area?

[CD]

Here is a link to an article that addresses this very subject...

"In-flight Death of a Passenger Requires a
Thoughtful Response from Flight Attendants

New studies of passenger deaths during flight will help airlines to update policies and procedures in light of data that are more accurate and current. The probability of the in-flight death of a passenger on any specific flight is low. Nevertheless, given the volume of passengers and changing demographics, a cabin crewmember could be called upon to respond appropriately if a death occurs."

Flight Safety Foundation - Cabin Crew Safety (http://www.flightsafety.org/ccs/ccs_jul_aug99.pdf)

[cabinkitten]

About a year or so ago I was unfortunate enough to have a passenger die onboard. It was a night sector and by the time we were alerted to the situation it was too late to initiate c.p.r.He had died in his seat.

Unfortunately it was a full flight so options were limited. In the end it was decided to cover him with a blanket and leave him where he was.

Some people have since suggested that we should have moved him. However although there is no hard and fast policy on this I can fairly guess that any options that include dragging down the aisle, propping up in the toilet or lodging in a trolley stowage are best avoided.

In this situation I think we made the correct decision.

Death on board is a rarity. If a pax keels over and stops breathing we will initiate resuscitation. We are trained to keep on with this until the paramedics reach us. In 99% of cases crew will still be working on a passenger when this help arrives.The question of what to do with a body therefore is not one that usually arises.

[ladyboy]

pilot wolf, are you cabin crew??? probably not, because if you were, you would know that dead pax would be treated as ill pax, i.e oxygen mask over mouth and blanket over the body

[Flygor]

This is a hard one...
My company's procedures are that in the absence of a qualified doctor, noone else can confirm death and halt resucitation attempts, if this means we do CPR for 3 hours over the atlantic then so be it. In this case we would not seek to hide the body anywhere as until the last minute we would be working to preserve life. Im not sure what would happen if a doctor was onboard and did confirm the passenger was dead. Our flights are often full and I'm not sure how other passengers would react if a dead passenger had to be left in the next seat to them until we could land (we have no crewrest areas). Hope I never have to be in this situation but in this job we never know what might have to deal with..

[flapsforty]

Same procedure as described by Flygor. In addition, if a doctor is on board to pronounce death, we have a body bag available.

[min]

What about rigor mortis if you leave them sitting up in a seat?? Laying out, perhaps in a modifed form to the method used in hospital would be preferable, wouldn't it? Even tho they are dead, they need to be shown some respect, and leaving them sitting up in a seat pretending they're alive doesn't seem to do that. I'm not sure what you'd do with them then of course...difficult in a confined space.

Doing CPR for 3 hours would be incredibly difficult - hope you're very fit!!

M.

[Xenia]

Well, there are different procedures for each airline. So far I realized most airlines (or at least the ones I worked for) require cabin crew to carry on CPR until paramedics take over (no matter how long we have to do it for. Most of the times we are enough crew on board to help each others and to take over). Unless we r flying over the middle of the ocean, diversion it's always a first choice.
What to do if you find a death body on board? :confused: Well, I believe I have never come across such a thing in no manuals at all, but a bit of "common sense" is helpful. Maybe in respect of the person (and probably family/friends travelling with him/her)we could see a sensible option. I agree with covering the body with blankets, close eyes, maybe if we have the space we could also move other pax away from the "scene".
Defenetly a "NOT" the use of toillet or trolley storages!!!!
Flaps, tell us more about that bag...never heard of it before!!!

[ 15 October 2001: Message edited by: Xenia ]

[Joaquín]

Xenia!!!!!!!!!!!!!

No me lo puedo creer. Where have yopu been you sweetiest? Give me a buz for God's sake!!!

[pilotwolf]

Thanx for your info so far. Things are pretty much as I suspected.

My reason for interest is I m currently working as a paramedic, (with 12 years experience), on the ambulances and as a single responder at/near LGW and regularly attend sick pax and was recently asked by another member of staff what happens to a body on board, (I also have a commercial pilots licence - but for helicopters), the question being provoked by an incident which is not appropiate to discuss here.

I appreciate the theory of not stopping CPR until relieved by medical personnel but this isn't always pratical. As someone said try doing CPR for 3 hours - 10 or 15 minutes in the back of an ambulance or hospital is extremely tiring for staff who are well practised in the technique and indeed in an a&e deptartment the person doing chest compressions is changed every few minutes for that reason. It is generally accepted during CPR teaching that you continue until relieved or you are physically unable to continue.

I know some airline have varying degrees of comunication with firms like Medlink, (I believe Virgin were trialling ecg and video downlinks?) and wondered whether a doctor would use this info to terminate resuscitation remotely.

Reading the posts it seem that there is no standard procedure and a lot of the decision is left to the crew at the time...

Perhaps it's worth a thought now on what you would do? I m pleased to see that several people mentioned their concerns for the pax and/or relatives feelings. Too many 'professions' in the medical trade forget that these people are somebodys' wife, husband, child or parent.... treat them as you would want your family treated and you won't go far wrong.

[ 15 October 2001: Message edited by: pilotwolf ]

[flapsforty]

Xen haven't got the manual to hand here, but off to "the old country" + work tomorrow, so if the internet connection is working there, I'll post it for you.

Pilotwolf good advice. Maybe less necessary for ourselves than for the medics though. Sickness and death are more run of the mill for people in that profession than they are for us, thankfully.
And of course most of us started out in this profession because we are "people people" anyway, and softies at heart.

Worst death I've had on board was a so called swallower. These people swallow a large amount of cocain-filled condoms, and transport the drug across international borders in their stomachs. When one or more of the condoms bursts, they die a very agonizing death.

Still got nightmares about that one occasionally, as I am sure do some of the pax on that fully packed flight.

[L.THOMAS]

Think this is a very grey area as thankfully its not very often it occurs.I was also trained that if a pax dies you cover them up with a blanket put an oxygen mask on them and make it look like they are sleeping.Also as said above you also have to think about the family.But lets say you are flying on 180 min etops and the customer was traveling on their own.I know that myself that i would not want to sit next to a deadbody for another 3 hrs.Im sure that 99% of pax would feel the same.So you then have the problem as mentioned above of taking them to a location out of site but that would involve a scene in the cabin as said before above.At the end of the day i dont think there is a right or wrong solution.It one of those situations where you "play it by there"

[Aeropig1]

Pilot Wolf - Are you 'solo' crew? if so p/message me I think I can assist you.

[ 15 October 2001: Message edited by: Aeropig1 ]

[PAXboy]

I am not a medic but charity work that I do in my spare time (for over 10 years) involves bereavement.

I asked a doctor friend of mine what happened when the "Is there a Doctor on the flight/in the house?" call arrived. He said that he always responded but knew of some Doctors who did not because they were i) on holiday ii) concerned about litigation. Takes all sorts.

He agrees that CPR has a finite time, not least because it is often (not always) apparent when death has occurred. In hospitals, he said that the medics often realise that death has occurred but keep going 'just in case' or until more time has passed as they do not want to stop too soon. Certainly, after 30 mins of respiratory faliure, serious brain damage will have occurred (if not terminal) but your operating instructions are your instructions.

If the pax has a fellow traveller, then it may well be easier to stop CPR because, as I said, they will see for themselves that nature has taken it's course. The change in skin colour is very rapid, without the heart doing it's stuff, the blood drains to the lower side of the body and the upper becomes very pale.

A man said to me recently, "I knew she [his wife] was gone. [He was instructed by the Emergency Service] I kept working until the ambulance arrived and then I watched them and knew that there was no point."

From a pax point of view, I would agree that the 'prop them up in a window seat with blanket and oxygen mask' makes very good sense. I would add that you should try to place plastic underneath them. A carrier bag will do as, if there is some time to go to destination, this will protect the seat cushion. Sorry if that is more information than you needed.

On the point of the eyes, bear in mind that they may not stay closed. Placing eye snooze-shades would work here. Also, the mouth will sag open within minutes of death, this is why the oxygen mask is such a good idea as it will disguise this. People in movies and TV dramas are usually considerate enough to keep their mouth shut after they die, which leads to this popular misunderstanding.

The question about rigor mortis, I think that this is less crucial. Although the average time is usually given as 4~6 hours, it varies with each corpse and can take up to eight hours to start, or begin very quickly.
Should it have set in, then the seats in front would be folded down and arm rests swung out of the way. Ground medical staff would then lift the body into one of those narrow aisle wheel-chairs.

Let's hope that it doesn't happen to any of us but dead bodies are less frightning than many folks think. Principally because it is obvious that the person is - simply - dead. The bodies that you do not want to see are the ones from the battlefield.

Safe Journey.

[ 16 October 2001: Message edited by: PAXboy ]

[Jennifer Crilly]

The thing to remember is not everyone who dies onboard is travelling alone so you must be compassionate to their companions. Our company policy is we would try to resuscitate the pax with aid of the de-fib onboard, regardless. Personally I think the decision to stop resuscitation should be made by any doctor/nurse in attendance, the crew envolved and of course the family!. Again the point of covering the body up should be made by the family. Their feelings in this situation is the number one priority. I would try to re seat the family/companions so they are seated with the body. Our S.E.P states that the body should be placed aft of a bulkhead preferably with any companions, family or any medically trained pax in the four seats infront. This of course is a very distressing situation I would like to think that anyone would treat any deaths onboard with dignity ( what if it was your mum or dad?) and not prop them up with a news paper in order not to cause any distress to other pax. Maybe using the same procedures that we would use for a stretcher case would be appropriate by proping up blankets etc to sheild the families/companions and the unfortunate persons privacy!.