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Illnesses happen on airplanes, too! I was reminded of this today.

We were in Calgary and we had just pushed back from the gate on our way to San Francisco when we got a call from one of our flight attendants. A passenger had taken to feeling ill and the flight attendant needed a moment to evaluate her.

The flight attendant smartly moved her up to an open first-class seat and though the passenger stated that she felt a little bit better, she was still not feeling well.

That statement made this a very easy decision for me. “Back to the gate!”

In My Mind

My thought process was “better here, on the ground and near the gate, rather than at 37,000 feet with the nearest airport 150 miles away.” This almosthappened to me once flying from Atlanta to Colorado Springs but luckily there was a doctor on board and the flight attendants administered oxygen and the passenger responded. We still had the EMTs meet us at the airplane and the passenger was taken off the airplane in a wheelchair but we didn’t have to divert. Close call.

So, once we committed to returning to the gate, a new set of priorities takes over. Notify operations and dispatch, get EMT/Paramedics to the airplane, keep the ill passenger comfortable and keep the other passengers informed.

Quick thought, one thing that I’ve been amazed at while flying for the airlines is that so many things unseen have to happen seamlessly to get one airplane off the ground and to the destination. One thing breaks down in the process and there goes your on-time departure. I’m always amazed at the complexity of the process.

Setting Priorities

It is no different when you switch from “go fly mode” to “emergency mode.” Things again have to happen in a particular order in order to work. So once we decided to return to the gate, I had my responsibilities, the first officer had his, the flight attendants had theirs, the gate agents had theirs, and the EMT had theirs. We first notified operations who collected the information about the passenger and passed it onto the EMTs. If it works right, it should only take a few minutes for the EMTs to get to the airplane and assess the passenger. All the while, everyone is busy doing “their” jobs. Then, after the passenger is either cleared to fly or removed from the flight, now it is time to get back to “go fly mode” and head for the destination.

From my perspective I have to decide whether I still have enough fuel or do I need to take on more. What about the bags? Has there been a change in the weight of the airplane that needs to be considered? What about weather? If we have already de-iced/anti-iced, do we need to do it again. Is my flight plan still active? How are the passengers and my crew doing. There is a lot to consider and it takes team work to get it done. Ultimately the captain makes the final decision but you have to have input from your crew if implementation is to be successful.

So this particular passenger was removed from the flight and we were notified that the passenger would be taken to the hospital for evaluation. Yeah, that could have happened at 37,000 feet and we would have been a lot worse off than we were now…i.e., the passenger would have had to suffer longer and we would be more than just an hour behind schedule.

Time To Re-Evaluate The Decisions

Now once we were finally airborne it was time to evaluate the events that had occurred and see if there was something that we could have done differently. To me it seemed that this was a fairly simple exercise, but I did score poorly on two accounts:

It was then that I realized that we needed a checklist when something like this happens. I found the acronym SAMPLE which provides a nice beginning guideline for evaluating the situation:

1. Signs and Symptoms
2. Allergies
3. Medications
4. Past History
5. Last Oral Intake
6. Events Leading Up To the Present Illness or Injury

Then, once I saw everything working out, I should have switched my attention sooner to getting the airplane airborne again. As it turns out, we usually do an automated manifest that calculates everything for us, but in this instance, there was a data mismatch so we had to do a manual manifest which takes minutes longer. I didn’t see that one coming but I will remember it for the next time.

It Is a Team Effort

A lot of credit goes to my flight attendants, they did their jobs very well. One of my flight attendants did a quick water service for the passengers while we were waiting, which I know the passengers appreciated. When we got to San Francisco, everyone seemed very appreciative for our efforts and that is always appreciated by us.

Anyway, I hope this entry provides some insight into what happens when you have an illness (emergency) on your flight. I feel I got off easy on this one, but maybe it happened for a reason. Maybe someday I will have to pull upon what I learned and practiced today on some future flight where the decisions will not be so clear cut. Regardless, that is basically what flying…and life, if you want to take it that far…is all about. Learning from your experiences and applying them to your life as necessary.

Well, till next time…Be Safe…

Jeffrey

P.S. So have you ever had a medical emergency or otherwise? I would love to hear about it. Leave your experience in the comment section below.

And if emergencies are your thing, then here are some products you might be interested in:

• 121.5 Real-Life Emergencies Video – Gripping, edge-of-your-seat action, with real pilots in real trouble!
• Handling In-Flight Emergencies – Most in-flight emergencies can be safely resolved if the pilot has the proper training and mental attitude. Don’t pass this book up!
• Jeppesen CRM – Exploring the Human Element Video (DVD) – This video explores United Airline’s human factors training program. I saw this video in flight school during my CRM training. Very enlightening!

Jeffrey is a captain at a regional airline and flies the CRJ-200, CRJ-700, and the CRJ-900. He has over 4000 hrs of flying experience in many different airplanes and is a Gold Seal flight instructor to his credit. He has recently written “The CRJ200 Quicknote Study Guide” that simplifies the systems of the CRJ200 into a easy-to-understand, downloadable eBook. Click here to get your copy today!

I just finished a four-day trip. In some ways it was a very good trip, but several unique things happened.

The first thing out of the ordinary was that one of my flight attendants got sick and took herself off the trip.

The second thing was that during one of our legs, my flight attendants had to administer oxygen (O₂) to a passenger that was having difficulty.

Here is a little history…I have been with SkyWest for 5 years. Two of those years I’ve been a captain. In all that time, I have never had to have a flight attendant taken off a flight. On this trip, one of my flight attendants (FA) was sick when the trip started and got sicker as the trip went on. On the third day of the trip, my FA didn’t show up at the van at our scheduled departure time. I called her room and she was coughing like crazy and had told me that she had called in sick and would try to join up with us for the overnight. I was a little peeved. Being the captain, someone should have called me. As it turns out, crew support were the ones that were suppose to call me but didn’t. No matter, I got over it. After returning to ORD, I talked to the FA and she was still coughing like crazy. We discussed that the best option was for her to stay in the hotel and let the company get her home in the morning, but crew support stepped up and got her home to Colorado Springs that night.

The second incident involved a passenger.

During the flight, a passenger started twitching. Who knows why! Maybe it was her medication or maybe it was the pressure changes.

Here is a fun fact of know-and-tell. Cabin pressure climbs in the airplane when we climb to make it comfortable for the passengers. Our airplanes fly between 12,000 feet and 39,000 feet above mean sea level (MSL). Since people can’t breath at those altitudes, the cabin is pressurized. But the deal here is that the if we were to maintain pressure within the cabin that matches the pressure at the originating station, the difference between the originating station pressure and 39,000 feet would cause the cabin to explode. It’s a matter of physics. So anyway, lets say we start at sea level and climb to 39,000 feet — obviously you can’t maintain sea level pressure at 39,000 feet, so the cabin pressure climbs so that the cabin doesn’t explode because of the difference between the outside atmospheric pressure and the inside cabin pressure. Basically, the cabin pressure climbs to a pressure of somewhere between 7,000 and 8,000 feet above sea level but varies according to the field elevation of the airport you are landing at.

This can be difficult for some passengers.

Passengers that are not acclimated to higher altitudes can have problems, like this woman on my flight.

Oxygen (O₂) usually takes care of the problem though. — To make sure that the woman was completely OK, which we figured she would be upon landing, we still had EMT meet us at the airplane.

Either way, it was a unique experience and a good learning experience for me and my crew.

To Your Flying Success…

Jeffrey

Jeffrey is a captain at a regional airline and flies the CRJ200, CRJ700, and the CRJ900. He has over 4000 hrs of flying experience in many different airplanes and is a Gold Seal flight instructor to his credit. He has recently written “The CRJ200 Quicknote Study Guide” that simplifies the systems of the CRJ200 into a easy-to-understand, downloadable eBook. Click here to get your copy today!