Interview question - part II

[TIS]

Tis,

Just so you know, the FA crew is trained in CPR, First Aid and, if the airline has them, AEDs. I said the word, "doctor" because that is what I would have preferred. (I am not talking a PhD here, i.e., Dr. Phil ) However, it can be any "trained" medical professional, such as an MD, DO, RN, or a Paramedic, (only those can use the EMK in the cockpit) or even an EMT. Medical license needs to be asked for to use the EMK. This is important in real life, not necessarily this scenario, as I had a woman who said she was an RN, when she really was just drunk and wanting to feel important!

I think the whole reason for this question is not just to address technical skills, but also CRM. They want to see if you can work as a team with everyone onboard; not just your fellow pilot.
Kathy

In order –

I know that the FAs are trained in CPR (as are the pilots) - on an airliner. This is not necessarily the case aboard a corporate aircraft and people have heart attacks on those too. In addition, aboard aircraft that only have one FA, that FA’s most pressing duty is safety and can be far better addressed if another individual can be drafted to help – as you well know from your experiences.

The contents of EMKs vary quite a bit too. What’s in them, as I understand it, depends on the liability (cost and otherwise) the company chooses to assume. Also, an EMK wouldn’t even be required on a Part 135 charter.

You are correct when you say that this question is about CRM as much as the nature of the situation itself. In a situation like this, if it comes down to it, the pilots will have to ignore what’s going on in the back in favor of the safe operation of the plane. Getting a sick passenger to medical aid may well take some fancy footwork and interruptions and distractions on the flightdeck won’t help. I think it’s important to understand that from a pilot’s perspective CRM in this scenario is about marshalling resources so that the front end of the plane can be separated – not insulated, mind you - as much as possible from the back end as quickly as possible.

The captain is in charge of orchestrating all of this. My points are not so much a pathway to follow as they are some things to think about before you ever have to deal with a real live problem. I raise them to illustrate things that will be inherently obvious to a crew in a real-life situation that would alter thinking and decision making in some dramatic ways.

There is much to be gained by thinking hypothetical problems through but it is important also to understand that hypothetical problems by their very nature do not immerse the one questioned in the full context of the question. They will have to dig - even if only a little – to get to a more accurate picture of what’s going on to know how to proceed.

Technical skill and technicalities do indeed play a role in the way a pilot has to address this scenario. In some ways, those issues have to be addressed before other CRM issues can be addressed. The medical nature of this problem alters this just a bit in that the top CRM priority is in getting the victim’s needs met by people in the cabin so that the flight crew is free to do the rest.

TIS

 

[Visceral]

All that being said TIS, what would you do? I've got to assume they won't give you 20 minutes to query them on one scenario.

 

[Resume Writer]

Tis,


I assumed my answer since this is posted on a regional board, not corporate or Part 135. The main things they are looking for in this question, or any other, is your ability to think on your feet, take control of the situation, and give the best possible answer given the scenario. Everything has to be taken into account.

Let me tell you a story about POOR CRM. We had a lady who went unconscious in the cabin. I told the 2nd FA to stay with her, called the 3rd FA to get O2, and I notified the FD. I asked the Captain to get me a patch to Medlink. I left the cockpit with the Medical Information form to fill out vitals, age, etc.

When I got back to the woman, a paramedic noticed the 3rd FA bringing the O2 bottle up and assisted us. It was great, because he did all the vital assessment for us.

After getting all the information, I went back to the cockpit to speak to Medlink. The Captain never made the patch. I was stunned! He said that since his wife was a Nurse, he had a good knowledge of these situations and the woman would probably be fine.

I reminded him that company policy dictated that we contact Medlink. He still would not do it. So, I asked him to at least have the EMS people meet us on the ground. He actually put us in a bad situation legally by his failure to follow company policy and could have caused damage to this woman by not letting a medical professional make that assessment. (in addition to the paramedic that helped us.)

He never came out of the cockpit on the ground to see about the woman.

When we got downstairs for the hotel van, he asked what happened to the woman. I said, "She died."

Kathy

 

[Mel Sharples]

I think TIS makes some good points. Very well thought out.

However, do you really think most HR types at regional airlines are looking for that kind of depth, or have the knowledge to understand that?

I'm not arguing the method. I think asking for more info is good because ultimately they want to see CRM, using resources, not jumping to conclusions, etc. while always keeping the most people safe you can. My problem is that if you get overly technical with some HR rep you might lose him/her along the way and scare them. At our company, most of the HR reps doing interviews are not long out of college. They are intelligent but not as up to speed on aviation terms or the latest and greatest CRM methods. They are looking for personality, teamwork, committment to safety, etc.

I agree with TIS in principle. But I caution that if you get too in depth, you may lose the interviewer along the way. NONE of these questions have a easy, clear cut solution and that is the point. They want you to think, and they want you to have to pick between the lesser of two evils. These aren't meant to be the kind of thing where you say, "Oh, that's easy. Land below mins and start CPR on the taxi in. What's next?" They want to see you think, reflect, but ultimately consider safety for the masses. TIS is correct in saying you don't have enough info and that asking a few questions is good. However, like another poster said, you won't get forever to gather info and make a decision. If you take too long, the HR rep might think you are a whack job or an indecisive pilot. Doesn't mean they are right, but remember who is conducting the interview.

Now if this is a pilot interviewing you, then it is a different story...



.

 

[TIS]

All that being said TIS, what would you do? I've got to assume they won't give you 20 minutes to query them on one scenario.

I can only say what I’d do in the absence of a company SOP and and the intricacies of dealing with a particular operating dispatch department. That said, I don't need 20 minutes but I do need some additional information as follows in the order I would want to know:

- Doctor or other medical professional on board?
- Defibrillator on board?
- Portable oxygen readied for victim?
- Anyone besides FA trained and willing to perform CPR?

I’d start by having the FO inform ATC of the medical problem and to begin the process of finding the best weather, enlisting ATC’s help find it. That puts the workload on them and he is free to continue to monitor the autopilot or hand-fly the plane. I’d have him let me know when he has some alternatives.

Next, assuming the answer to the first three questions above is “yes” I’d have the doctor hook up the defibrillator and set up the oxygen. I’d ask, but would not wait for, a medical briefing and updates from the doctor either in person or relayed through the FA. If there's no doctor/nurse I’d have the FA do it and try to enlist the help of another passenger. Defibrillators don’t require training to use. They’ll tell you what to do so anyone can be easily pressed into service so that the FA is free to monitor the cabin situation at large and report to the captain.

As what I have directed is implemented, communications with dispatch will be an essential next step. They will have their finger on the pulse of operations at that moment and may well have some good suggestions to consider. Ultimately the decision will be mine as to where the airplane goes so assuming that a viable course of action, considering fuel and weather requirements, is divined from the communications with dispatch, I’d direct the FO to declare an emergency and obtain a clearance to the chosen location. I’d ask dispatch to handle all the EMT details for our arrival. I'd back that up by having ATC do the same thing but dispatch has the advantage of mobilizing the internal resources of the company directly so I think dispatch is arguably the more potent initiative to take.

With those things accomplished, where you stand is as follows: You’ve placed yourself in a supervisory position with respect to the situation in the back and you have trained professionals acting in the best interest of the victim. You have involved ATC and dispatch and enlisted their assistance. You have determined the best place to proceed to, have placed yourself at the head of the line, and have begun the business of getting there. You have mobilized the resources of your company, ATC and the new destination airport to assist you all the way through your arrival. In short, you have done all you can. Your job now is to get the plane on the ground and the victim into the waiting care of those who will take him to more advanced medical care.

How it turns out depends on many factors, not the least of which is the gravity of the medical problem that precipitated the events we’re discussing.

TIS

 

[TIS]

I assumed my answer since this is posted on a regional board, not corporate or Part 135.

Point taken.

The rest of that story is pretty egregious. You sure he knew HOW to do a patch?

That's definitely NOT the way to deal with bad things happening behind you.

TIS

 

[TIS]

However, do you really think most HR types at regional airlines are looking for that kind of depth, or have the knowledge to understand that?

Well, I guess my reaction to that question is that this is not generally an HR type question. This is a question most frequently encountered during a captains' board interview. In other words, you will most likely answer this question for technically competent company personnel.

I agree with TIS in principle. But I caution that if you get too in depth, you may lose the interviewer along the way.

I agree 100% so in the event that you are being asked this question by someone who will not know if you are answering well or not (which is what this would amount to if HR types are asking it), tone it down. Say you'd establish structure in the cabin for dealing with the problem somewhat autonomously so that you are left free to make the decisions that come with operating the aircraft most effectively and safely. Say that you'd include your external resources such as ATC and dispatch as you zero in on an appropriate course of action. Say also that once on the ground you would immediately check in with dispatch and the chief pilot to brief them on the outcome as you have personally assessed it.

Now if this is a pilot interviewing you, then it is a different story...

Exactly!

 

[Markm1811]

Call dispatch

Like most things that seemed to crop up through Indoc. Call dispatch we will take care of it. In fact in our Emergency plan we have a check list for situations including in flight medical. If dispatch is doing their job porperly we would be tracking wx throughout each flight to see if wx gets to mins. I know that i have every departure infront of me and current weather on the radar screen. if any departs get low the capt and dispatch will work together to get alts. Simple release and away you go...

 

[Visceral]

Say you'd establish structure in the cabin for dealing with the problem somewhat autonomously so that you are left free to make the decisions that come with operating the aircraft most effectively and safely. Say that you'd include your external resources such as ATC and dispatch as you zero in on an appropriate course of action. Say also that once on the ground you would immediately check in with dispatch and the chief pilot to brief them on the outcome as you have personally assessed it.

Great answer!