Question for airline pilots
 

I'm giving a talk on surgical safety checklists and time-outs, and they tell us it is based on pilots and pre-flight checks. My question is: what exactly do you check and how? How's it recorded? What happens if you find something? I guess that's a few questions. Anyone have a checklist they could send me? Thanks ppot

B

Everything that concerns my life's safetey. If I get there so will others. Specfictic items very hard to list, between outside and cockpit checks. John

Not a commercial pilot, just a private pilot. Check lists are printed sheets listing functionality visual checks essentially for all the controls, including radio, and engine(s).Everything is checked while still on the ground of course. Action, if any is dependent on what is found. It is the pilots (and passengers) lives at stake so the incentive to be thorough is obvious. If something goes wrong in the air there are other systems checklists to see if the problem can be corrected or offering solutions to get back safely to ground. In flight there are other routine checks carried out which usually are just reliant on the pilots memory to perform them, but again they can be life savers if something is amiss.

Here are two, military based.

The tradition of checklists is based on having standard procedures for each type/model of aircraft to safely operate the aircraft.

There are also "know cold" procedures for emergencies.

In flight, I never recorded following the checklist. On the ground, I generally took a test on the "know cold" procedure once a month or so.

Hope this helps.

PM if you have specific questions.

http://www.cnatra.navy.mil/ebrief/documents/01_Training_Air_Wing_One/references/COLUMN%202/TW1/TW1%20T-45C%20CHECKLISTS%20SEP11.pdf

http://www.checksix-fr.com/articles/artilces_pdf/FS/VRS/checklist_80510.pdf

A) Kick the tires
B) Light the fires.

Here is one for a 206 (Jetranger)
Bell 206 Helicopter Preflight Checklist

Awesome. Thanks guys!
(FYI at a quick glance there is no similarity, these are hard core and detailed, surgery list pretty useless sadly)

well Brian whatever you put on the list...
checking for notations like..
'this leg' & 'not this leg' should be on there somewhere OFTEN..
the Nurses and Gas folks all have something they review...
ie..don't forget the tool count..
unlike us P monkeys having parts left over sometimes...
the clowns forget a wrench or two at times..
inside the motor..
which the Nurse should catch on her post-op tool count..
but doesn't..
= $$$$$$$$$$$$$$$$$$$$$$$$

Rika

There is no cure for the human condition and mistakes. It can only be managed. Despite checklists, "wrong" surgeries continue to this day.

You just got to remember to use the checklist haha......:)
G.

sure and in the incidents most near me, it was. They turned out OK but there is only so much that can be done trying to cure human error.

Yes very true. And there is a lot of room for human error. I haven't confirmed it, but was told the year they instituted site marking for surgery, wrong side surgery went UP! I have to give a presentation later & thought this would be an interesting topic.

on it's way,

Rika

funny you bring this up. i just saw a report that the medical industry was taking another look into using checklists like aviation does but many doctors were against it. most checklist in aviation have a 'flow' where you do some required task, and then a challenge and response checklist is read to confirm everything has been done.

Two common "checklists" in aviation are "CIGAR" and "GUMP" memory aids that are not written.

Before take-off:

C-Controls. Free and correct
I-Insturments. Set gyro compass and altimiter setting
G-Gas. Plenty to make the flight plus reserves, and switched to the correct tank, dufus!
A-Attitude. Set the trim tabs for take-off
R-Runup. Check magnetos individually, cycle the prop.

Before landing:

G- Gas on the fullest tank, dufus!
U-Undercarriage. Gear down (double check, then tripple check) flaps set
M-Mixture. Back to full rich
P- Prop. Back to fine setting (first gear)

Simply doing these simple steps by memory will cover 99% of any factory checklist, and covers the important stuff.

To my mind, this is better than the current factory lists, which were obviously written by attorneys who's sole purpose is to not get sued by a dufus pilot.

To go through the entire checklist for Cessna's newest two-seater, the Skycatcher, takes several minutes.
And this airplane is as simple as they come.

For surgery, something easily remembered by all may be preferable to overly lengthy written lists.
Too bad the attorneys will insure the list is too long to be useful.

I guess you could do the same for pre and post cutting huh?

I know - ISMACT and DISCO!

Pre-surgery checklist

I- Identify Patient, is it who it should be
S - Sterile - is the patient clean
M - Mark the spot to cut
A - Anestisea, make sure they are out cold
C - Confirm they are out cold and breathing right
T- Tools, you got the right ones now count them

Closing Up
D - Dry, no leaks
I - Inspect knots
S - Scan for anything left behind
C - Count tools, sponges and what not
O - Observe Vitals


Now lets talk compensation...;)

Hi

I believe it is the way of specifying and conducting procedures that have been implemented by surgical teams, not the layout of checklists.
Instead of looking at checklists do some research on principles for crew coordination.

Did you forget to do your research??? Seriously.

Pre.

Operational.

Post.

Checklists for all three. Signed when completed by the performer, signed when validated by the control performer/auditor.

Standard Operating Procedures (SOP) for every activitiy performed.

Verbal is fine if identified and recorded and backed up.

Speaking as a surgeon, I believe the "time out" has been the most important.

jsveb, I will look into crew coordination, that is interesting. Studies have shown in the OR that if each person present identifies him/herself by saying their name out loud they are more likely to speak up if they notice a problem and complications go down.

Everywhere I've been uses the "time out" (pt name, birthdate, mrn, allergies, surgeon, procedure, preop abx, images, special equipment) but also the World Health Org has put together a check list that they showed reduced morbidity by almost 30%. These things are not nearly as complex as the lists in the links above. I think the key is getting the whole team focused on the case at hand but my suspicion is it isn't very well done most of the time.

Again, thanks for the input. What's available via google etc isn't always the real thing.

edit: wow there is an Intl Journal of Aviation Psychology

Pilots and others in critical jobs also do 'call backs' which is a repeat of the instructions back. I find it very helpful in family matters, work environments and when dealing with my mistress, my girl friend, and my call girl. Beware, the technique doesn't work on ginger wives! Bookies and dealers are not into either...