Cabin crew first aid training
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Cabin crew first aid training
Have just flown to BHX from AMS.
The girl in the seat next to me had a major nose bleed soon after takeoff. This happened to co-inside with the tea and cake trolley run. I attracted the attention of one of the cabin crew and asked for a supply of paper towels/napkins as the few tissues the girl had were by now used up.
The stewardess (sorry if that's not an appropriate term in this age) looked blank, asked if the girl was OK,was it a nose bleed and did she want any water. She gave a glass of water and a few napkins off the trolley, saying she could get me more if I called and then went back to serving leaving me to look after this stranger.
Neither cabin crew came back to check on the girl and I had to press the call button for more tissues. As this was immediately before the captain put the seat belt signs on it was some time before he came and a bit longer before he came back with the tissues. It may have been my imagination but he did seem a bit p***d off with being asked to do this small act.
Luckily all was reasonably contained by the time we disembarked and the girl was much appreciative of my help.
My point is - should it have been left to me to act ? Surely even on a short 50 minute flight the cabin staff should have had more input in this situation.
I'm no medic. Luckily I am a reasonable expert on nose bleeds having suffered frequently. Surely as a passenger I should not have had to take on this problem as the captain said - the cabin crew are there for your comfort and safety - which should include more that getting you safely off a crashed aircraft and serving drinks - mighty important though those are.
I'm interested in any comments from cabin crew.
In this day of litigation I was put in a situation which could have resulted in my prosecution. I just think there must be procedures for minor traumas and would like to know if these procedures were carried out in this instance.
An otherwise very satisfied member of the SLF club
The girl in the seat next to me had a major nose bleed soon after takeoff. This happened to co-inside with the tea and cake trolley run. I attracted the attention of one of the cabin crew and asked for a supply of paper towels/napkins as the few tissues the girl had were by now used up.
The stewardess (sorry if that's not an appropriate term in this age) looked blank, asked if the girl was OK,was it a nose bleed and did she want any water. She gave a glass of water and a few napkins off the trolley, saying she could get me more if I called and then went back to serving leaving me to look after this stranger.
Neither cabin crew came back to check on the girl and I had to press the call button for more tissues. As this was immediately before the captain put the seat belt signs on it was some time before he came and a bit longer before he came back with the tissues. It may have been my imagination but he did seem a bit p***d off with being asked to do this small act.
Luckily all was reasonably contained by the time we disembarked and the girl was much appreciative of my help.
My point is - should it have been left to me to act ? Surely even on a short 50 minute flight the cabin staff should have had more input in this situation.
I'm no medic. Luckily I am a reasonable expert on nose bleeds having suffered frequently. Surely as a passenger I should not have had to take on this problem as the captain said - the cabin crew are there for your comfort and safety - which should include more that getting you safely off a crashed aircraft and serving drinks - mighty important though those are.
I'm interested in any comments from cabin crew.
In this day of litigation I was put in a situation which could have resulted in my prosecution. I just think there must be procedures for minor traumas and would like to know if these procedures were carried out in this instance.
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In this day of litigation I was put in a situation which could have resulted in my prosecution
The above, sorry to say, is not true. Though not publicised, there is legislation in place that prevents good Samaritans being prosecuted in these cases, it also covers trained First Aiders.
The question came up at my last First Aid renewal and was answered as above.
Or as the instructor put it
How many First Aiders/Samatritans have been taken to court - NONE"
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Interesting one Sheds.
In our mob, train every year how to recognise a large variety of serious illnesses and traumas, and how to deal with them.
Garden variety afflictions like a nosebleed do not come up. Things like that are left to the common sense of the flight attendants. (stewardesses is fine BTW
)
I wasn't there of course, but the FA probably had to choose between either assisting with the nosebleed (and subsequently not being able to complete the service to all passengers) or executing the service schedule as planned and leaving you to deal with something that did not appear very serious to him/her.
Just like some pilots are said to be occasionally afflicted with getting-there-itis, some FAs will suffer from must-do-the-service at all costs.
Not because they don't care, but because with the airlines calculating exactly the maximum of service they can squeeze out of FAs, the FAs have to be very very focused to complete the required service, to all the pax, within the short time frame. This can occasionally lead to FAs prioritising the tasks at hand in a manner which is wrong or can appear wrong & inexplicable to individual passengers.
Yours sounds like it might have been such a case..
Then again, it might have been plain stupidity.
In our mob, train every year how to recognise a large variety of serious illnesses and traumas, and how to deal with them.
Garden variety afflictions like a nosebleed do not come up. Things like that are left to the common sense of the flight attendants. (stewardesses is fine BTW
) I wasn't there of course, but the FA probably had to choose between either assisting with the nosebleed (and subsequently not being able to complete the service to all passengers) or executing the service schedule as planned and leaving you to deal with something that did not appear very serious to him/her.
Just like some pilots are said to be occasionally afflicted with getting-there-itis, some FAs will suffer from must-do-the-service at all costs.
Not because they don't care, but because with the airlines calculating exactly the maximum of service they can squeeze out of FAs, the FAs have to be very very focused to complete the required service, to all the pax, within the short time frame. This can occasionally lead to FAs prioritising the tasks at hand in a manner which is wrong or can appear wrong & inexplicable to individual passengers.
Yours sounds like it might have been such a case..
Then again, it might have been plain stupidity.
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Though not publicised, there is legislation in place that prevents good Samaritans being prosecuted in these cases, it also covers trained First Aiders.
Any First Aider worth their salt should treat a nosebleed as potentially a symptom of other underlying problems.
Leaving a probably unqualified passenger to deal with a bleeding stranger is unacceptable in my opinion.
What happens when the unqualified passengers gives the casualty incorrect advice? What happens if the passenger is squeamish or panics? How long do you allow a casualty to bleed from the nose before deciding medical attention is required?
Where do you draw the line in getting passengers to treat each other?
Quite apart from anything else, promoting recovery involves reassurance. Handing a few tissues to someone and walking off misses that mark a bit.
"Good Samaritan" laws may apply in the USA and some European countries, there isn't a specific law in the UK ( at least when I last checked). If you do first aid in the UK you have a duty of care to your casualty. here's an interesting (?) link - it covers those of us who would use automatic defibrillators or perform CPR...but some of it will also apply to other types of medical assitance rendered by passers by or workplace first aiders.
Legal Status of those who Attempt Resuscitation
The Duty of Care section makes interesting reading for Cabin Crew with regard to an ill or injured passenger possibly taking action against the airline (in the UK).
Leaving a probably unqualified passenger to deal with a bleeding stranger is unacceptable in my opinion.
What happens when the unqualified passengers gives the casualty incorrect advice? What happens if the passenger is squeamish or panics? How long do you allow a casualty to bleed from the nose before deciding medical attention is required?
Where do you draw the line in getting passengers to treat each other?
Quite apart from anything else, promoting recovery involves reassurance. Handing a few tissues to someone and walking off misses that mark a bit.
"Good Samaritan" laws may apply in the USA and some European countries, there isn't a specific law in the UK ( at least when I last checked). If you do first aid in the UK you have a duty of care to your casualty. here's an interesting (?) link - it covers those of us who would use automatic defibrillators or perform CPR...but some of it will also apply to other types of medical assitance rendered by passers by or workplace first aiders.
Legal Status of those who Attempt Resuscitation
The Duty of Care section makes interesting reading for Cabin Crew with regard to an ill or injured passenger possibly taking action against the airline (in the UK).
Last edited by Blues&twos; 28th Dec 2008 at 22:56.
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here in our country trained first aiders (ambo paramedics, etc.) are very limited in what they can do. If for instance a diabetic needs to be given an insulin shot, a tained first aider or a paramedic on an ambulance cannot always do this
Just my opinion though......In Oz there are no 'Good Samaritan' laws but here, and pretty much universally worldwide, the standard applied is the 'reasonable person test' - what would a reasonable person, with the same level of knowledge, equipment and training, do in this situation? Someone applying first aid in good faith, for the good of the patient and in line with their level of expertise has nothing to fear. HOWEVER, someone FAILING to provide same can be in DEEP do-do. Everyone has a duty of care to their fellow man; some peoples duty of care is more specific, such as in the described circumstances of this thread.
FWIW, I think the FA should have paid closer attention to the situation (as it was described anyway) and probably referred it to the SFA for a management decision. Appropriate care BTW, is head forward in a comfortable posture, nose held in compression at juncture of the bone and soft tissue, cold pack if available applied to back of neck and compression left in place for a good 10 minutes before any checking to see if bleeding has stopped.
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So what exactly CAN they do - I mean this is pretty basic stuff..... Just my opinion though......
Though I must agree that trying to stop a nosebleed is probably just that, damage control, you wouldn't be treating any possible underlaying cause. And I also agree that the least the cc could have done was to keep an eye on the passenger in question.
My point was just about WL's "no prosecution" comment.
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"Good Samaritan" laws may apply in the USA and some European countries, there isn't a specific law in the UK ( at least when I last checked).
It's apparently buried within other legislation, the "trainer" was a senior guy from the British Red Cross so I have no reason to doubt his statement.
It works on the statement earlier
what would a reasonable person, with the same level of knowledge, equipment and training, do in this situation? Someone applying first aid in good faith, for the good of the patient and in line with their level of expertise has nothing to fear
A thought I had on the original question. I wonder did the FA assume that Shedrus and the girl were travelling together, so as far as she could see the matter was being dealt with, she would have no way of knowing any differently without being told/asking or checking the pax list.
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Very good point west lakes, maybe the flight attendant DID assume they were traveling together. However, personally, i always ask when i come across something like that, "are you traveling together?"
We get very intensive First Aid training, from nose bleeds to heart attacks or strokes. The golden rule, in my opinion, when dealing with nose bleeds, is to wear gloves.
Nonetheless (and it's an assumption only), i can't help but thinking that the CC in cause might've had an "issue" with blood. What i mean is that yes, one is trained to deal with it, and mentally knows what to do but the "insides" tell one different. I struggle to deal with a pax who is physically sick but I'll react in an instant when a pax has a, say, heart attack.
And as flapsforty mentioned, for various reasons, in a CC's mind the service HAS to be done, it's a pressure all CC's have to deal with.
I stand to be corrected but here's my say:
As it was a very short flight and so much to be done (aren't short flights the worst?), a nose bleed is hardly a major thing. You did ask for more tissues before the CPT put the seatbelt sign on, but maybe the CC was securing the galley for landing, as we tend to know exactly when the seatbelt sign will go on and that's when we know we have to start securing the cabin; so that was a bit of time saving. I doubt it very much the CC was p****d off, maybe he/she was focusing on securing the cabin?
Rgds,
ATS
PS: It was very nice of you to look after the girl. We appreciate pax like you and we thank you.
We get very intensive First Aid training, from nose bleeds to heart attacks or strokes. The golden rule, in my opinion, when dealing with nose bleeds, is to wear gloves.
Nonetheless (and it's an assumption only), i can't help but thinking that the CC in cause might've had an "issue" with blood. What i mean is that yes, one is trained to deal with it, and mentally knows what to do but the "insides" tell one different. I struggle to deal with a pax who is physically sick but I'll react in an instant when a pax has a, say, heart attack.
And as flapsforty mentioned, for various reasons, in a CC's mind the service HAS to be done, it's a pressure all CC's have to deal with.
As this was immediately before the captain put the seat belt signs on it was some time before he came and a bit longer before he came back with the tissues. It may have been my imagination but he did seem a bit p***d off with being asked to do this small act.
As it was a very short flight and so much to be done (aren't short flights the worst?), a nose bleed is hardly a major thing. You did ask for more tissues before the CPT put the seatbelt sign on, but maybe the CC was securing the galley for landing, as we tend to know exactly when the seatbelt sign will go on and that's when we know we have to start securing the cabin; so that was a bit of time saving. I doubt it very much the CC was p****d off, maybe he/she was focusing on securing the cabin?
Rgds,
ATS
PS: It was very nice of you to look after the girl. We appreciate pax like you and we thank you.
The problem with apparent minor injuries is that they may be a symptom of something not so minor, which has already happened (e.g. earlier blow to head etc), or something which is about to happen. Blood coming out of anyone unexpectedly isn't right. Most of the time these things remain minor and are easily treated. A first aider should remain with a casualty where possible until their treatment is effective, they're obviously getting better or you hand over to someone else. Another point is that I quite often found myself treating not only the original casualty, but other people (frends, relatives etc) who had decided suddenly that they didn't like the sight of blood and were now also feeling a bit wobbly.
West Lakes, the Good Samaritan laws don't exist in the UK, but as the link explains, you would more than likely be able to put up a defence against possible claim against you for battery or negligence, thanks to some wording regarding what is a reasonable course of action for a "rescuer" (!). So you'd be relying on being able to successfully defend your actions rather than there being any law saying you can treat people without fear of a claim being made against you. Although
In this case though, I think it would be pretty difficult to defend not doing anything at all when it is part and parcel of the job.
West Lakes, the Good Samaritan laws don't exist in the UK, but as the link explains, you would more than likely be able to put up a defence against possible claim against you for battery or negligence, thanks to some wording regarding what is a reasonable course of action for a "rescuer" (!). So you'd be relying on being able to successfully defend your actions rather than there being any law saying you can treat people without fear of a claim being made against you. Although
There are likely, however, to be limitations on the application of these defences when procedures are carried out by non-professional rescuers and the less well trained the rescuer the harder it may become to justify either defence. It becomes more difficult, for example, to argue that an unconscious person has given implied consent to a (relatively) untrained person performing what is in effect a medical procedure, notwithstanding that the procedure may be straightforward, automated and mechanical. Similarly, it may be harder to argue that treatment by a lay person is in the best interests of the casualty. Only if the action taken by a lay person is, under all the circumstances, ‘reasonable’ and in the best interests of the assisted person, is there likely to be a defence.
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Thanks for all the replies
In response to the very comprehensive replies I would just like to say:
West Lakes: Nice to know that being untrained I am safer from prosecution than a trained medic in similar circumstances.
In respect of your #8 - it may well be that the crew thought we were together. We boarded at widely different times but I would not expect the crew to notice. As I did most of the talking they could have construed we were together. That was an aspect of the situation that had not occured to me and would explain much of what transpired.
Jamair: Your comments regarding appropriate actions is welcome. It's nice to know that I did do more or less the full list.
Abusing the Sky: Nice to see you get all the training from nosebleeds to heart attacks. Again another aspect which I had not considered was the before landing tasks the crew undertake. It is more that probable that he was engaged in securing the galley and my pulling him away from that task may have given him the appearance of being less than happy.
And thanks for your PS. According to the girl good samaritans are hard to come by.
Rainbow: I tend to agree with your mountains out of nosebleeds comment. I did describe it as a minor trauma and take your attitude - treat the one you've got and if there are any more treat them when they appear. But I think that's a man thing.
By the way this was no lo-co operator. This was a major scheduled carrier. Admittedly their standards do seem to have dropped (slightly) since they stuffed frogs into the holes in the edam.
Once again thanks for the responses.
West Lakes: Nice to know that being untrained I am safer from prosecution than a trained medic in similar circumstances.
In respect of your #8 - it may well be that the crew thought we were together. We boarded at widely different times but I would not expect the crew to notice. As I did most of the talking they could have construed we were together. That was an aspect of the situation that had not occured to me and would explain much of what transpired.
Jamair: Your comments regarding appropriate actions is welcome. It's nice to know that I did do more or less the full list.
Abusing the Sky: Nice to see you get all the training from nosebleeds to heart attacks. Again another aspect which I had not considered was the before landing tasks the crew undertake. It is more that probable that he was engaged in securing the galley and my pulling him away from that task may have given him the appearance of being less than happy.
And thanks for your PS. According to the girl good samaritans are hard to come by.
Rainbow: I tend to agree with your mountains out of nosebleeds comment. I did describe it as a minor trauma and take your attitude - treat the one you've got and if there are any more treat them when they appear. But I think that's a man thing.
By the way this was no lo-co operator. This was a major scheduled carrier. Admittedly their standards do seem to have dropped (slightly) since they stuffed frogs into the holes in the edam.
Once again thanks for the responses.
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If I'd been working on this flight, I may have done the following:
Get more tissues asap (takes a few seconds to get from the toilets or elsewhere)
Asked if the girl has had this problem before.
Advised her of the correct position.
I most likely would have thought the two of you were travelling together, and I would have continued with the cabin service. Not because I don't care, but the rest of the pax need my attention too. I would also (without neccessarily saying so) assume that you'd come and get me if the problem became a massive thing.
Nosebleeds can happen for several reasons. Personally, I get nosebleeds when I'm really tired.
Pax react in different ways to medical issues on board. A couple of years ago, a colleague was on a domestic flight (ca 1 hour flight time) where a man had a heart attack. The whole crew were involved with trying to save the man's life. A pax sitting two rows behind (so could obviously see what was happening as they were all in the aisle at this point), shouted: "Am I gonna get a drink on this flight or what?"
.
Gg
Get more tissues asap (takes a few seconds to get from the toilets or elsewhere)
Asked if the girl has had this problem before.
Advised her of the correct position.
I most likely would have thought the two of you were travelling together, and I would have continued with the cabin service. Not because I don't care, but the rest of the pax need my attention too. I would also (without neccessarily saying so) assume that you'd come and get me if the problem became a massive thing.
Nosebleeds can happen for several reasons. Personally, I get nosebleeds when I'm really tired.
Pax react in different ways to medical issues on board. A couple of years ago, a colleague was on a domestic flight (ca 1 hour flight time) where a man had a heart attack. The whole crew were involved with trying to save the man's life. A pax sitting two rows behind (so could obviously see what was happening as they were all in the aisle at this point), shouted: "Am I gonna get a drink on this flight or what?"
.Gg
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Letting alone the issue of whether the flight attendants were helpful or not in this situation...
Shed, just what was it about the situation that you thought put you in danger of prosecution? It was a nosebleed, and you helped out. Where is your risk?
Shed, just what was it about the situation that you thought put you in danger of prosecution? It was a nosebleed, and you helped out. Where is your risk?
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In my nearly 40 years with airlines, I became "Godfather" twice, ending up with an extra SOB.
Both times there was either a nurse, or a doctor aboard...
One still sends me a Xmas/New Year card every year. Got her latest.
Likely to have competent help on a 400 passenger aircraft.
Maybe less likely with 100 passengers, but odds are still good.
xxx
And once ended with one less SOB upon arrival.
But that was "Hajj" flight. Holy Quran says that he went for paradise since going to Mecca.
xxx
As far as "First Aid" - crewmembers are generally rather competent.
I have to admit that as pilot, I was less proficient than the cabin staff.
After all, had to drive the aeroplane, is it...?
Unless a good looking young lady, I would not go to the cabin for "mouth-to-mouth"...
Only could consider a quick descent to the nearest airport.
xxx
With present "security concerns" - I wish doctors could still carry their medical kit on flights.
The airplane's emergency kit does not contain all items that could be required.
In the old days, many F/As had real nurse training background.
Some were fully qualified nurses, who did prefer the glamour of flying the world.
But as the F/A salaries got reduced to restaurant waitress levels, it is now extremely rare.
xxx
Happy contrails
Both times there was either a nurse, or a doctor aboard...
One still sends me a Xmas/New Year card every year. Got her latest.
Likely to have competent help on a 400 passenger aircraft.
Maybe less likely with 100 passengers, but odds are still good.
xxx
And once ended with one less SOB upon arrival.
But that was "Hajj" flight. Holy Quran says that he went for paradise since going to Mecca.
xxx
As far as "First Aid" - crewmembers are generally rather competent.
I have to admit that as pilot, I was less proficient than the cabin staff.
After all, had to drive the aeroplane, is it...?
Unless a good looking young lady, I would not go to the cabin for "mouth-to-mouth"...
Only could consider a quick descent to the nearest airport.
xxx
With present "security concerns" - I wish doctors could still carry their medical kit on flights.
The airplane's emergency kit does not contain all items that could be required.
In the old days, many F/As had real nurse training background.
Some were fully qualified nurses, who did prefer the glamour of flying the world.
But as the F/A salaries got reduced to restaurant waitress levels, it is now extremely rare.
xxx
Happy contrails
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cabin crew and first aid . . . . . .
In the old days, many F/A's had real nurse training background.
Some were fully qualified nurses
Some were fully qualified nurses
Many years ago, when Air 2000 was first inaugurated at EGCC (probably 1987, anyone else still remember Air 2000 ? ! ! ) I had the job of giving first aid training to the initial intake of cabin crew. I seem to remember that many had at least some nursing background. Since I was already a St John Ambulance training surgeon, the courses were based on the SJA First Aid at Work syllabus.
Once trained, any of those girls would have dealt with a mere epistaxis with ease !
