Mayday, Mayday, Mayday
Or
When Chicken Little is right!
By Paul Hart, ASC - BFI
Crisis and opportunity are often catalysts for reflection, discussion and change.
It was with this in mind that I eagerly accepted an invitation to co-present a seminar for the ultralight community at the EAA Copper State Air Show & Fly-In at Williams Gateway airport in Mesa, AZ this fall.Dr. Jim Walker, MD and I have been acquaintances for the last several years – we share a common and active interest in ultralight aviation, are ACS pilots and BFI’s (PFW and PPW respectively) and both have considerable experience dealing with crisis and trauma. Dr. Walker is an Emergency Physician and medical consultant to several S.W.A.T. teams in the Phoenix metro area. I bring the prospective of a 60’s era Army helicopter pilot and 25 years of service as a NJ police officer. Additional, we are both experienced trainers in our respective fields. Our common ground, flying and public service, lead us to have a number of discussions regarding information, preparedness and training relative to medical emergencies and crash survival associated with our sport. This seminar provided us the opportunity to extend these discussions to our peers and begin a process of reflection and change. Change which can add to the safety of the sport – change that can instill additional confidence between instructor and student – change that can add a degree of liability protection and save a life – your own or someone else’s.
Mentally, emotionally and physically.
The first step in successfully responding to crisis and trauma is to be prepared – mentally, emotionally and physically. Being mentally prepared is often the hardest obstacle to overcome. To be mentally prepared one must first accept that something BAD can happen. It’s not a pleasant thought and therefore most people would rather not consider it – the "it’ll never happen to me" or "it’s always the other guy" attitude seems to prevail. I like to think of being mentally prepared as playing the "what if" game. What will I do if this happens or what will I do if that happens? How will I respond and am I prepared to respond? This simple exercise allows for some thought as well as the formulation of an action plan in response to a given situation. Without some mental preparation there is a good chance that fear, panic and the inability to act appropriately will result.
Being mentally prepared also helps us to be emotionally prepared. The emotional response associated with crisis and trauma is well documented. Fear and panic, while in flight or on the ground, has serious consequences. So strong are these emotional responses they can actually render us physically incapable of acting. We have all experienced or heard of the pilot or student that because of fear panics and "freezes" on the controls or the first aid provider that becomes faint at the sight of blood or serious injury. One way to overcome or hold in check the "emotion of the moment" is to have the knowledge and ability to respond appropriately to an "emergency" situation. Mentally practicing emergency scenarios allows a sense of being in control, provides a degree of confidence and greatly increases the chances for a successful resolution to the problem at hand.
Being physically prepared requires that we take an honest look at ourselves. We must be the judges and must be willing to accept our strengths as well as our limitations. Flying is not generally considered a "physical" sport, but don’t tell that to anyone that has pushed, pulled, lifted or tugged at their respective aircraft. Physically prepared can also be termed physically fit. Are we physically fit to fly? Are we physically fit to respond to an emergency? Are we physically fit to "hike out" if we are forced to make an off field landing? Are we physically fit to help ourselves and/or others in the event of an accident? I am aware of two cases in the last several years where ultralight pilots elected to fly either against the instructions of their doctor or after sustaining an injury – both resulted in fatal accidents. As students, pilots and instructors we should all be as physically prepared and physically fit as our situation allows. As BFI’s, it is also important to have some knowledge of a prospective students medical and/or physical conditions or limitations prior to engaging in flight. Is there any reason that this person should not be flying or a condition that could cause problems once in flight? This information should and can be learned during the "pre-flight" briefing. We must also keep in mind our own limitations and fly, or maybe not fly, accordingly.
Now that we have briefly discussed some of the mental, emotional and physical aspects related to crisis and trauma it is important to talk about the specifics of medical emergencies and crash survival. The most important question is, "Are you able to take appropriate action?" Are you familiar with basic or advanced first aid techniques? Can you administer Cardio Pulmonary Resuscitation (CPR) or know the signs and treatment for shock? What are the types of injuries you may encounter and are you equipped to treat them? Can you survive if you go down "off site" until located or rescued and for how long?
Medical, physical and trauma.
Some common physical conditions or medical emergencies you may encounter and should be familiar with would include but are not limited to:
Obviously several of the above will require immediate intervention as in the case of a heart or asthmatic attack. Others may only require knowledge and preparation as with allergies or motion sickness. How many of us take the time to brief a first time flyer or student on the proper actions should they become nauseous or need to vomit while in flight? A plastic bag tucked into the front of a students shirt or jacket is an alternative to a messy clean up. Others may be sufficient enough to postpone a flight or disqualify one from flying altogether. Medical or physical conditions which may have "in flight" consequences are best discussed, understood and addressed prior to take off.
Next, consider the types of trauma we may encounter as well as the nature of the injuries associated with each. Dr. Walker has provided the following descriptions and some examples.
Blunt trauma consists of a transfer of energy over a comparatively large
surface. This is generally a crush type injury with the force damaging
underlying organs and disrupting both soft (skin, blood vessels, eyeballs)
and hard (bone, cartilage) tissues directly under the point of impact. . Blunt
trauma can explode certain tissues/organs such as the eye, kidney and liver, but is more commonly associated with bumps and bruises. For us, it can be suffered from contact of a body part with the ground, striking the frame or even a seatbelt forced into the body as a result of an accident or sudden stop.
Sharp trauma is a cutting injury. Being sliced by a knife or a jagged
piece of aircraft frame are good examples of sharp trauma. Disruption of skin and blood vessels are the most frequent first aid concerns.
Penetrating trauma is a stab type wound. The skin is broken but may only show minimal signs of injury. The real danger is the possible and unseen damage to underlying tissue and organs. These would include but may not be limited to the heart, lungs, liver, spleen and kidneys.
Thermal trauma can cook or freeze the tissue. This usually results
in dramatic fluid loss and the loss of the body's barrier against the
"outside world." Frostbite and various degrees of burning are results of thermal trauma.
Chemical trauma includes corrosive (acid and base) burns, inhaled fumes that destroy lung tissue and toxic spills that are absorbed through the skin or mucous membranes. Battery acid, gasoline and other solvents or materials used in the construction, maintenance and/or operation of our aircraft should be considered in this area.
Electrical trauma has several components:
Thermal (see above)
Electro convulsive - disruption of the nerve conduction system, causing
involuntary movements and sometimes preventing the victim from letting go of
the electrical source. It also can cause loss of consciousness, seizures and
amnesia.
Fibrillation - electrical current can stop the heart's natural pacemaker and
cause the cardiac muscle to wriggle around like a bag of worms rather than
beating rhythmically -- with obvious sub optimal results.
Voltage, amperage and, in the case of alternating current, frequency all play a part
in the lethality of an electrical dose -- in general, wet is bad, as the skin will much more easily conduct the current.
It is important to understand that a victim may present one or more of the listed traumas as well as any of the medical or physical conditions previously mentioned. The time tested "start the breathing, stop the bleeding" approach should provide a first response or first aid starting point in these situations.
Am I prepared ?
Most of us in the ultralight community have spent considerable time learning about our various aircraft – we study the control systems, the engine and the flight characteristics. We understand basic flight concepts and rules of the aviation highway. We "run up" and "pre-flight". We do all that we can do to insure an enjoyable and fun experience. But have we put the same thought and preparations into maximizing our safety and survival should something go wrong or a medical emergency arise? Can we help others or ourselves?
First Aid, First Response and Cardio Pulmonary Resuscitation (CPR) classes are provided by a variety of agencies and organizations throughout the US and foreign countries. A "Basic First Aid" course can provide considerable knowledge and skill for the treatment of the various injures and medical emergencies previously discussed. -- Advanced classes are also available.
Once we have acquired the knowledge and skills to respond to an emergency situation, it is then important that we have the necessary tools to respond. Experience has taught me that there is no greater feeling of frustration than wanting to help, knowing how to help but not having the tools to help. Once again anticipation and preparation can play a vital role at a critical time. How many of us have available on our respective aircraft these tools? And what are the tools that you may consider? As an exercise for the seminar we presented, Dr. Walker and I put together the following list of items for an "onboard" flight safety kit. All items can be easily obtained and individual kits can be tailored to more specific needs as well as flying areas and conditions. Cost will vary depending on items already available and individual preferences -- $100 - $150 should get you a well-equipped kit. Mine is contained in a 4P "Handy Bag" that can be rigged with the shoulder strap and carried away from the plane if necessary – see photos. As a BFI I am also sure to point out its location and contents to students during dual flight operations.
Flight Safety Kit
*BEFORE DEPARTING BE SURE SOMEONE ON THE GROUND KNOWS YOUR INTENDED FLIGHT PATH OR OPERATING AREA -- IF THERE IS NO ONE AROUND LEAVE A NOTE ON YOUR VEHICLE WITH A DEPARTURE AND ESTIMATED RETURN TIME. RADIO CONTACT IS BEST IF AVAILABLE AND DON’T ALWAYS RELY ON CELL PHONES.
*IN THE EVENT OF A FORCED LANDING OR ACCIDENT STAY WITH THE AIRCRAFT UNLESS YOU ARE SURE WHERE YOU ARE AND CAPABLE OF WALKING OUT.
*MY MILITARY TRAINING BRINGS WITH IT THE UNDERSTANDING, APPRECIATION AND IMPORTANCE OF PROPER FLIGHT GEAR – HELMET, EYE PORTECTION, GLOVES AND APPROPRIATE CLOTHING ARE ALL ESSENTIAL IN THE EVENT OF AN INCIDENT OR ACCIDENT. THESE ITEMS ARE AS INDISPENSIBLE TO FLIGHT SAFETY AS OUR SEATBELTS AND SHOLDER HARNESSES – THEIR USE SHOULD NOT BE "OPTIONAL."
"Hangar Flying"
There should be no "conclusion" here – the point and purpose of this exercise was to stimulate thought and create an ongoing discussion. A discussion between pilots, at club meetings, with students and most importantly, a discussion we have with ourselves. The freedom of flight, as with many other endeavors, does not come without some risk. Risk is deemed "acceptable" when we do all we can to minimize it – we train, test and fly for proficiency, we maintain, repair and upgrade our aircraft, we pre-flight and post-flight. All in the name of safety and to make the risk we take "acceptable." Why then should we not invest the same efforts into being prepared for a medical emergency or crash survival? Being prepared mentally, emotionally and physically, with the knowledge and tools to appropriately react, respond and survive a time of crisis.
Copyrighted 12/7/00