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PAN-PAN Medical Emergency

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Old 13th Dec 2004, 22:09
  #41 (permalink)  
 
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Question PAN...MAYDAY....calls?

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

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

OTC

OOPs.....message should have said good to hear from you guys on the forum.....
OTC
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Old 14th Dec 2004, 07:08
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I was flying to CDG from BCN the other three days ago and an easyJet aircraft stated "I have a medical Emergency and request Divert to TLS". The controller initially told him to maintain F360 for seperation and then cleared him direct to Toulouse with descent allowed shortly afterwards.

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

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

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

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

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

Finally, I'm very pleased this topic was brought up because it certainly made me consider my personal actions in such a situation. Thank You !
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Old 14th Dec 2004, 09:07
  #43 (permalink)  
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Thank you for your post Cat and OTC. I thought understanding could be improved and your comments are much appreciated.

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

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

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

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

cont.....

Cat O Nine Tails,

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

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

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

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

PS. Dont know whats up with my / \\ / \\ s.....
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Old 14th Dec 2004, 10:35
  #44 (permalink)  
 
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Suppose you have a problem with the FMC and have lost BRNAV capability.

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

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

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

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

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

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

And believe me that it can be quit challenging for a Chinese to explain ATC what the nature of the problem is. However PAN, PAN will do just fine.
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Old 14th Dec 2004, 12:39
  #45 (permalink)  
 
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OTC - Just to add my agreement with Cartman's answer to your question. I am a sim trainer and my predecessor used to teach the same thing, i.e. use the Pan or Mayday word with every transmission. So we had a big debate about it and the only reasonably valid thing he could come up with was that it prevented them forgetting to use the word on checking in to a new freq. which is a requirement.

So we don't teach that any more, but there are lots of guys around who were taught under the old system who, because (thankfully) their experience of using P or M is limited, revert to old practices under pressure.
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Old 14th Dec 2004, 15:00
  #46 (permalink)  
 
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Thumbs up Pan & Mayday calls....

Thanks Cartman's Twin & keithl for your responses.

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

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

Thanks again....cheers

OTC
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Old 14th Dec 2004, 15:35
  #47 (permalink)  
 
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I had a female passenger get violently sick during a scenic flight over Sydney a few years ago. Not long into the flight she said she wasnt feeling well and I decided to expidite our return but vie the normal route -outside controlled airspace.

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

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

Thanks to the ATCO's that made my job so much easier in a very stressfull situation.
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Old 14th Dec 2004, 16:39
  #48 (permalink)  
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Angry

Oh please! Let's not start endless recollections of "I once had a vomiting pax in my little Cessna and I did/didn't declare [choose one](emergency/pan/pan medico/mayday). This discussion is about the nuances of emergencies and how to declare them. We all know that ATC will do what they can to expedite a routing/arrival if there is a problem. The main point here is what words trigger their reaction and what mental thumbscrews they will apply to you in the UK if you don't use the magic word.
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Old 14th Dec 2004, 20:09
  #49 (permalink)  
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Ok, here's how I work.

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

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

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

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

Sensible?
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Old 14th Dec 2004, 22:18
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Ambulance Situation @ LHR

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

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

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

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

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

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

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

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

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

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

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


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Old 14th Dec 2004, 23:08
  #51 (permalink)  
 
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I usually apply the common sense route which isn't neccessarily the one we are taught.

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

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

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

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

When priority is affected by ATC then the controller who initiates the priority has to fill in paperwork which is forwarded to Investigations, so trying to avoid the phrase (and subsequent form filling) only delays the paperwork for a few weeks. I know how we all try to avoid it, but its still part of our job on both sides.
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Old 16th Dec 2004, 19:07
  #52 (permalink)  
 
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RANTING ATCO ALERT!!!!



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

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

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

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


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


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

Rant over, thanks for listening!!!
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Old 16th Dec 2004, 20:12
  #53 (permalink)  
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Since we are being a bit pedantic, lets take another look at what Pan and Mayday mean and using that look again at the posting by 5 miles baby.

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

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

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

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

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

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

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

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

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

Regards,

DFC
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