G-VIIO Las Vegas
OK.......since you ask....the below is taken from the current Boeing 777 FCOM, if you disagree with the terminology that follows I suggest you take it up with the likes of tdracer.
”Fuel Control Switch”- (situated just aft and below of the thrust levers)
When placed to “CUTOFF “
- closes the fuel valves
- removes ignitor power
- unlocks the engine fire switch.
When pulled:
- arms both engine fire extinguishers
- closes the associated engine and spar fuel valves
- closes the associated engine bleed air valves
- trips the associated engine generators off
- shuts off hydraulic fluid to the associated engine–driven hydraulic pump
- depressurises the associated engine–driven hydraulic pump
- removes power to the thrust reverser isolation valve.
If I recall the techy stuff correctly the reason for the emphasis in the evacuation checklist on operating the Fuel Control switches before operating the fire switches harks back to the Hatton Cross accident where it was discovered that on some aircraft in some mod states in some circumstances (!!) the spar valves would fail to close if the fire switches were pulled before the fuel control switches were placed to cutoff. I think at Hatton X they ended up with fuel p***** out all over the place until spar valves were manually closed by some brave souls in the emergency services or some brave engineers.
As an aside I note that it seems some think not enough opprobrium is being heaped on the LAS Crew....I haven’t seen anyone here being uncritical of at least some of the crew actions in the LAS case, so I have to ask is there a standard amount of ***** we are required to chuck at crews post accident, or is it a sliding scale dependent on airline?
Last edited by wiggy; 22nd Jun 2018 at 14:42.
Having observed the laborious and time consuming delays by some crews in the simulator finding the right page in the QRH for Evacuation. Then reading going through each item step by step before finally reaching the part where the captain says "EVACUATE", I really get concerned that time is running out and the passengers are still strapped into their seats. With no shortage of real life examples of fire breeching the cabin and associated toxic heat and smoke overcoming those trying to get out, I firmly believe the former Recall or Memory Evacuation checklist was safer overall. We know that deadly mistakes were made in some accidents where the Memory items were inadvertently omitted and that was the rationale for Boeing and other manufacturers to conduct a Read and Do checklist policy. BUT as a captive audience member jammed in my window seat and the smoke rolling towards me while on the flight deck someone flipping the pages of a QRH that tell the crew what to do next, I would prefer they take the risk of a missed Memory item but just get me out of there fast.
I am aware that research has shown the Read and Do Evacuation checklist is the safest option, but I still prefer to have my crew whipping through a Memory checklist and giving passengers a better chance of survival. Illogical maybe, but a gut feeling nevertheless.
I am aware that research has shown the Read and Do Evacuation checklist is the safest option, but I still prefer to have my crew whipping through a Memory checklist and giving passengers a better chance of survival. Illogical maybe, but a gut feeling nevertheless.
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Some information would help the crew:
1. A report from ATC that flames and smoke are visible when the "stopping" call were made or independent from it (this would help a crew to understand the gravity of the situation where they are unable to see it for themselves).
2. The ability to view the engines from the flight deck (camera surveillance) in order to understand the situation immediately after the bang and engine failure.
The decision to evacuate must be based on information about the conditions outside (and inside) the aircraft and I don't think a fire warning is enough to reach such a conclusion (what happens if said warning goes out because the fire suppression system did its thing and the fire was extinguished?).
Making an automatic connection between a fire warning AND evacuation, i.e. that the latter is the default action simply because of the former doesn't feel like an optimum solution.
I understand the captain and his surprise that ATC didn't tell him about the fire (which is common during other fire events such as American 383) when they reported "stopping". It would be pretty logical to assume some attention from that direction when an aircraft report "stopping" shortly after commencing take-off.
The mindset of this crew seem to be "engine failure with fire warning" rather than "catastrophic engine fire" with the associated need for prompt evacuation after coming to a complete stop. Keeping the other engine running indicate a mindset about vacating the runway and that the issue were more of a technical "glitch" rather than a potential disaster.
It looks like this event were linked to a lack of appropriate information, which slowed the whole decision process followed by a rush to get things done (thus the start of evacuation with the no 2 still running).
A simple "Speedbird 2276, you have fire on your left side, repeat fire on your left side, fire crews are being dispatched" from ATC would have assisted the decision making here. It is actually pretty surprised that no call to that effect were being made (compare it with the American 383 and British Airtours 28M).
1. A report from ATC that flames and smoke are visible when the "stopping" call were made or independent from it (this would help a crew to understand the gravity of the situation where they are unable to see it for themselves).
2. The ability to view the engines from the flight deck (camera surveillance) in order to understand the situation immediately after the bang and engine failure.
The decision to evacuate must be based on information about the conditions outside (and inside) the aircraft and I don't think a fire warning is enough to reach such a conclusion (what happens if said warning goes out because the fire suppression system did its thing and the fire was extinguished?).
Making an automatic connection between a fire warning AND evacuation, i.e. that the latter is the default action simply because of the former doesn't feel like an optimum solution.
I understand the captain and his surprise that ATC didn't tell him about the fire (which is common during other fire events such as American 383) when they reported "stopping". It would be pretty logical to assume some attention from that direction when an aircraft report "stopping" shortly after commencing take-off.
The mindset of this crew seem to be "engine failure with fire warning" rather than "catastrophic engine fire" with the associated need for prompt evacuation after coming to a complete stop. Keeping the other engine running indicate a mindset about vacating the runway and that the issue were more of a technical "glitch" rather than a potential disaster.
It looks like this event were linked to a lack of appropriate information, which slowed the whole decision process followed by a rush to get things done (thus the start of evacuation with the no 2 still running).
A simple "Speedbird 2276, you have fire on your left side, repeat fire on your left side, fire crews are being dispatched" from ATC would have assisted the decision making here. It is actually pretty surprised that no call to that effect were being made (compare it with the American 383 and British Airtours 28M).
JammedStab: I think you are referring to the BOAC B707 which dropped an engine into the Staines reservoir and made a successful landing back at LHR on the then runway 05. Showing my age here! The 707 in those days had separate LP and HP fuel valves, the former on the engineer's panel - and yes, that item was missed but resulted in valve position lights being retrofitted to the aircraft to obviate a recurrence. More modern types combine the two valves functions.
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As an aside I note that it seems some think not enough opprobrium is being heaped on the LAS Crew....I haven’t seen anyone here being uncritical of at least some of the crew actions in the LAS case, so I have to ask is there a standard amount of ***** we are required to chuck at crews post accident, or is it a sliding scale dependent on airline?
This incident wasn’t an optimal crew performance, but when such s**t happens in real life, I can’t imagine much is all that optimal to our colleagues who end up having to deal with it. A lot of people analyse events from the comfort of their keyboard and think back to their last sim - “well I dealt with it much better”.
Yeah. In a simulator.
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Wiggy are you a TC? Very good posts.
Lets not lose sight of the proximate cause of this incident,the engine failed. I’m not entirely sure where the blame if any lies for that but it certainly wasn’t with the captain. He just happened to be in the wrong place at the wrong time.
The fact that everyone survived is testament to a job done well enough.
Some of the cabin crew btw were faced with a v difficult situation. It was perplexing, time critical and dangerous. They paused considered risk v benefit then actioned their tasks effectively. Very impressive.
Lets not lose sight of the proximate cause of this incident,the engine failed. I’m not entirely sure where the blame if any lies for that but it certainly wasn’t with the captain. He just happened to be in the wrong place at the wrong time.
The fact that everyone survived is testament to a job done well enough.
Some of the cabin crew btw were faced with a v difficult situation. It was perplexing, time critical and dangerous. They paused considered risk v benefit then actioned their tasks effectively. Very impressive.
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747 double eng fail
747 volcanic ash
747 slats retracting from JNB
737 rudder hard over
777 loss of thrust ( capt BA38 saved that one)
747 en rte NBO ROD 29,000fpm recovered single pilot at night didn’t pop a rivet
A320 loss of all airspeed indications
i could go on.
Wiggy are you a TC?
Don’t think I’ve ever read an accident report ever, regardless of Airline/operator were there has been nil criticism /observations of the crew actions...and I include some of the high profile “hero status” accidents...
In the LAS case I don’t think anyone (inside or outside BA) has ever claimed the evacuation checklist was actioned in an optimal manner....
Comparing incidents on the line with sim performance and timings - Sim performance is the “ ideal”, and it darn ought to be good, after all you know it’s coming somewhere during the recurrent..... in the real world plug into the mix startle factor, touch of fatigue/midnight on the body clock, less than forthcoming comms from external observer (cf. AVR4000’s excellent post about the crews mindset initially and the subsequent need to change it.) there’s scope for erosion..there’s something about plans of campaign not surviving first contact with the enemy that might be appropriate...
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the middle part of the SULLY movie spent all its time with the NTSB and others wondering why he didn't just land at any of the nearby airfields...
Maybe they should change sim sessions so you're in there for 2000+ hours then suddenly pull a scenario. Then see how perfect the drill is..
G
Maybe they should change sim sessions so you're in there for 2000+ hours then suddenly pull a scenario. Then see how perfect the drill is..
G
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I’ve been a ‘Trainer”, but not with my current outfit..
Don’t think I’ve ever read an accident report ever, regardless of Airline/operator were there has been nil criticism /observations of the crew actions...and I include some of the high profile “hero status” accidents...
In the LAS case I don’t think anyone (inside or outside BA) has ever claimed the evacuation checklist was actioned in an optimal manner....
Comparing incidents on the line with sim performance and timings - Sim performance is the “ ideal”, and it darn ought to be good, after all you know it’s coming somewhere during the recurrent..... in the real world plug into the mix startle factor, touch of fatigue/midnight on the body clock, less than forthcoming comms from external observer (cf. AVR4000’s excellent post about the crews mindset initially and the subsequent need to change it.) there’s scope for erosion..there’s something about plans of campaign not surviving first contact with the enemy that might be appropriate...
The lack of ATC information also made it "less urgent". My own mindset would be like:
"OK, we have an engine failure, fire warning came on but we did the suppression already and NO INFORMATION from ATC when we stopped either so it's a failure and we will taxi clear of the runway in a few minutes so engine 2 can be kept running."
The lack of an ATC call would certainly give the impression that NO FIRE could be seen. It is reasonable for a crew to expect a call about visible flames if there are any, either from ATC as a reply to their "stopping" message or by other aircraft in the vicinity or a combination. This crew acted pretty much the way it could be expected from a lack of appropriate information, i.e. "keep the engine running for taxi, assess the situation and taxi clear of the runway when things are checked".
It could even have been that way that the crew did decided to taxi clear of the runway before stopping due to their mindset under the circumstances (lack of radio calls about fire could very well produced a mindset of getting clear, especially if a taxiway were in a convenient location as they slowed down).
The focus should be on providing pilots with tools for situational assessment, i.e. the ability to know the environment outside the aircraft and make appropriate decisions based on such knowledge. It is pretty natural to consider "taxi clear" or even "taxi to gate" after an engine failure, both due to the risks of evacuation but also for passenger comfort.
Evacuation can't be the "supposed default action" just because of an engine failure, i.e. that the absolute first thing that should be done is the evacuation checklist immediately after stopping on the runway without any other information than "engine failure, fire warning came on a few seconds later".
A camera located in front of the nose gear (showing the landing gear and engines) and another one on the tail (showing the engines, wings and top of the fuselage) would provide all information needed, right away. The most appropriate course of action would be:
1. Engine failure or fire - throttle to idle, fuel cutoff, ignition off, fire handle pull
2. Assess situation (using the camera system and other sources such as ATC)
3. If serious fire: Evacuation checklist, shut down remaining engines
4. If minor failure: Keep other engine running, taxi clear of the runway when appropriate
If step 1 and 2 happens at the same time (i.e. the crew knows about the fire already while they are braking) - evacuation checklist immediately when the aircraft comes to a complete stop.
I can't blame the BA2276 crew for their attempts to assess the situation rather than just ordering evacuation when they had no idea about the conditions (it is pretty evident that their first clue were the visible smoke rising above the fuselage and it took a while before it happened since the plume was dynamic during braking and the major development started after they had stopped, this is also visible on the in-cabin video). It shows the aircraft accelerating normally, suddenly it shudders heavily but nothing particular is seen first, they stop and after a couple of seconds black smoke rises in front of the wing and the callout "Ladies and gentlemen, please remain seated" can be heard.
The crew couldn't see anything particularly amiss until the smoke become visible and the lack of ATC information certainly did slow them down.
Even the American 383 did show a bit of the mindset issue when the number 1 was running when the doors opened (seems like the pilots also thought about taxiing clear of the runway). It is very audible that the engine is idling when the first passengers went out of the L1 door before it spools down and stops.
It is appropriate to arrange ways for a crew to get the information needed to do a prompt evacuation decision when needed.
There is another video of BA2276 commencing take-off where the engine failure can be seen and it doesn't look dramatic at first; it is possible to see smoke being emitted but the aircraft slows down and stops without something that would indicate the need for immediate evacuation. The fierce fire became visible after stopping when the plume became static and the fuel started to flow onto the runway.
Edit: It is pretty interesting to notice that even when they called "Speedbird 2276, mayday, mayday, request fire services" - there was still no information from the ATC regarding fire despite the smoke now being way more serious. When they made their mayday call a decent exchange of information would have been: "Speedbird 2276, fire services are on their way, there's a lot of smoke on the left side of your aircraft".
If I would see an aircraft on fire like that I would certainly call the crew and report it, especially when it is pretty evident from the lack of evacuation AND one engine still running that they don't really understand the situation.
It is almost painful to hear the lack of fire communication from ATC in this case, it is like crew were "expected" to figure everything out on their own. It is pretty clear that ATC saw what's happened since they started to issue go-around commands and closed the runway but not a single word about the fire being serious.
Since the fire was located between the engine and fuselage, such information is important since looking out of the flight deck windows would produce a "normal" view of the wing, without anything amiss.
Last edited by AVR4000; 23rd Jun 2018 at 17:23.
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A weakness of the DODAR structure favoured, I understand, by BA, is that ‘diagnose’ must follow the absent ‘gather’...
Regarding ATC: Controllers are warned not to interrupt flight crew who may be busy, but always stand ready to answer an enquiry. If the commander needs information about the state of his aircraft it is entirely his responsibility to seek it, whether that means opening the window and looking out, asking the cabin crew, or asking ATC.
This is not the only recent high-profile BA event in which the commander has not sought the necessary information as diligently as he should have done, in my opinion, and it’s one of the reasons why I favour other operators when travelling.
Regarding ATC: Controllers are warned not to interrupt flight crew who may be busy, but always stand ready to answer an enquiry. If the commander needs information about the state of his aircraft it is entirely his responsibility to seek it, whether that means opening the window and looking out, asking the cabin crew, or asking ATC.
This is not the only recent high-profile BA event in which the commander has not sought the necessary information as diligently as he should have done, in my opinion, and it’s one of the reasons why I favour other operators when travelling.
Father D B
T-DODAR is a favoured structure by some in BA for some non-normals, in some circumstances..pattern matching and rule based decision structures are allowed, as is Airmanship/common sense.... ..
I take it in gathering information to form that opinion you read the full NTSB report on the accident in which it states that after the aircraft stopped the Relief F/O looked through a flight deck side window, saw a shadow of what he thought might be that of smoke, reported that fact and the basis of that information the same First Officer was dispatched aft by the captain to gather information on what was visible from the cabin?
T-DODAR is a favoured structure by some in BA for some non-normals, in some circumstances..pattern matching and rule based decision structures are allowed, as is Airmanship/common sense.... ..
If the commander needs information about the state of his aircraft it is entirely his responsibility to seek it, whether that means opening the window and looking out, asking the cabin crew, or asking ATC.
This is not the only recent high-profile BA event in which the commander has not sought the necessary information as diligently as he should have done, in my opinion, .
This is not the only recent high-profile BA event in which the commander has not sought the necessary information as diligently as he should have done, in my opinion, .
Last edited by wiggy; 23rd Jun 2018 at 18:12.
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I do not know if Father Dick Byrne is a troll or whether he just has a very poor grasp of flight deck procedures, air traffic procedures and what actually happened on that day in LAS.
DODAR would not have been an appropriate tool for that situation and was not used.
As for “Controllers are warned not to interrupt flight crew who may be busy,” I think any controller reading this would tell a pilot that they could see flames if they thought the pilot was unaware, even if they knew they would be busy.
As for the safety record of the airline concerned. If I am correct their last long haul fatal accident was as mentioned a Boeing 707 almost 50 years ago where 4 passengers died. A brave stewardess who went back into the smoke to try to rescue them also died. I wonder if all of the other long haul operators Father Dick Byrne apparently favours have been operating since that time without any fatal accidents too.
DODAR would not have been an appropriate tool for that situation and was not used.
As for “Controllers are warned not to interrupt flight crew who may be busy,” I think any controller reading this would tell a pilot that they could see flames if they thought the pilot was unaware, even if they knew they would be busy.
As for the safety record of the airline concerned. If I am correct their last long haul fatal accident was as mentioned a Boeing 707 almost 50 years ago where 4 passengers died. A brave stewardess who went back into the smoke to try to rescue them also died. I wonder if all of the other long haul operators Father Dick Byrne apparently favours have been operating since that time without any fatal accidents too.
F D B
I read what you wrote about ATC..I also read what you wrote about information gathering from other sources.
So at LAS - “Mayday” declared, including the fire word, all called on R/T. You are right, he didn’t specifically ask ATC if they could see flames but Lord, it’s hard to be perfect sometimes..
After the call the Captain isn’t sat on his backside doing nothing, he attempts to gather information by dispatching the relief F/O into the cabin, who sees what is going on and reports back .. on the basis of that information decision is made to evacuate.
Despite or due to all the above you effectively give the entire Airline a “fail” on the basis that according to you there is a pattern of information not being diligently gathered..quite how you know about all the times there are non-normal events on BA flights where information is diligently gathered I don’t know.
Ultimately of course it is your opinion, however I think it is only fair to ask which perfect airline(s) you are prepared to fly on, so in future we can all carry out forensic analysis on their incident/accident reports.
I read what you wrote about ATC..I also read what you wrote about information gathering from other sources.
So at LAS - “Mayday” declared, including the fire word, all called on R/T. You are right, he didn’t specifically ask ATC if they could see flames but Lord, it’s hard to be perfect sometimes..
After the call the Captain isn’t sat on his backside doing nothing, he attempts to gather information by dispatching the relief F/O into the cabin, who sees what is going on and reports back .. on the basis of that information decision is made to evacuate.
Despite or due to all the above you effectively give the entire Airline a “fail” on the basis that according to you there is a pattern of information not being diligently gathered..quite how you know about all the times there are non-normal events on BA flights where information is diligently gathered I don’t know.
Ultimately of course it is your opinion, however I think it is only fair to ask which perfect airline(s) you are prepared to fly on, so in future we can all carry out forensic analysis on their incident/accident reports.
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A weakness of the DODAR structure favoured, I understand, by BA, is that ‘diagnose’ must follow the absent ‘gather’...
Regarding ATC: Controllers are warned not to interrupt flight crew who may be busy, but always stand ready to answer an enquiry. If the commander needs information about the state of his aircraft it is entirely his responsibility to seek it, whether that means opening the window and looking out, asking the cabin crew, or asking ATC.
This is not the only recent high-profile BA event in which the commander has not sought the necessary information as diligently as he should have done, in my opinion, and it’s one of the reasons why I favour other operators when travelling.
Regarding ATC: Controllers are warned not to interrupt flight crew who may be busy, but always stand ready to answer an enquiry. If the commander needs information about the state of his aircraft it is entirely his responsibility to seek it, whether that means opening the window and looking out, asking the cabin crew, or asking ATC.
This is not the only recent high-profile BA event in which the commander has not sought the necessary information as diligently as he should have done, in my opinion, and it’s one of the reasons why I favour other operators when travelling.
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I would have thought that it is both possible and useful for a single "EVAC" button to perform the required cutoffs and fire extinguishers and therefore eliminate the need for (most of) the Evacuation Checklist (or a significant part thereof). We live in an age of technology. Non?
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To think that initially the nigels came in droves to praise their crew sky high to the stratosphere. They must be cringing now. Well, their saving grace...the limelight is not on the incident anymore, everyone has forgotten.
The NTSB report into the engine fire at Las Vegas in 2015 has now been released. The reasons for the fire are pretty routine and remedies have already been implemented.
However the report does go on to criticize the actions of the Captain during the evacuation, which doesn't make for good reading either for the Captain or BA's training system.
Full report available at www.ntsb.gov
However the report does go on to criticize the actions of the Captain during the evacuation, which doesn't make for good reading either for the Captain or BA's training system.
Full report available at www.ntsb.gov