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Nurse fury at Ryanair as woman dies on flight from Italy

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Nurse fury at Ryanair as woman dies on flight from Italy

Old 27th Sep 2006, 23:13
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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.
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Old 27th Sep 2006, 23:29
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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.
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Old 27th Sep 2006, 23:32
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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?
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Old 28th Sep 2006, 00:14
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ryr prof

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.
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Old 28th Sep 2006, 02:01
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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.
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Old 28th Sep 2006, 02:34
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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.

Sorry for such a long post but some of the arguments on here need to be rebuffed.
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Old 28th Sep 2006, 08:31
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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.

Last edited by topdog1; 28th Sep 2006 at 10:06.
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Old 28th Sep 2006, 10:28
  #108 (permalink)  
 
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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.
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Old 28th Sep 2006, 10:47
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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
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Old 28th Sep 2006, 11:06
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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.
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Old 28th Sep 2006, 12:12
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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.
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Old 28th Sep 2006, 12:41
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Alibaba,

Originally Posted by alibaba View Post
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.
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Old 28th Sep 2006, 21:14
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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
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Old 28th Sep 2006, 21:25
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Originally Posted by blackmail View Post
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 !
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Old 28th Sep 2006, 23:37
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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
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Old 29th Sep 2006, 00:35
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"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.
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Old 29th Sep 2006, 00:55
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Originally Posted by BEagle View Post
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.
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Old 29th Sep 2006, 09:20
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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.
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Old 29th Sep 2006, 14:04
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Originally Posted by woodpecker View Post
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?????
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Old 30th Sep 2006, 18:21
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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.

"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. 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.

Last edited by alibaba; 1st Oct 2006 at 00:18.
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