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For the pilots.......
Aircraft accidents are useful analogies for ICU incidents, so I find the study of such incidents interesting, and useful. In several accident reports, the pilots fail to respond appropriately to "stick shaker" in an incipient stall. As a non-pilot, why? I would have thought that it would be drilled in (if altitude allows) stick shaker--> nose forward--> THEN work the situation. In several incidents, the pilots seemed to have tried to work the situation first, or even pull nose up, before taking action to increase air-speed.
This is NOT a criticism, I'm just trying to understand. Is it a training issue? Panic? Am I missing something? In explanations, feel free to assume intelligence but ignorance. |
I did a number of aircraft accident investigations.
Oddly enough, accidents like the one you mention generally fall into two distinct categories: Either boredom, inattention (routine/inexperience) or high workload/stress (already engaged with another emergency/lost comms/lost nav, etc.) It is amazing what cues pilots will ignore. All military pilots are drilled incessantly: Aviate, navigate, communicate. In other words, fly the damn airplane first. It is funny you mention ICU and aircraft. I also did a lot of operational flight test in the Navy which meant I dealt with a lot of human factors issues: Presentation of data to the pilot, keystrokes to get to primary pages (early glass cockpit stuff) location of switches, circuit breakers, etc. We did exhaustive "crew station working groups" in simulators, part task trainers, etc. in order to try and get the sequence(s) right to help avoid pilot error and streamline the pilot workload. Every time I have been to an ICU (Mom/Dad, etc.) I am struck by how haphazard the flow is...to my untrained eye nothing seems intuitive. I also noticed that from hospital to hospital there was little standardization. As a systems engineer, you'd think that standardized procedures and ICU set up would be in place. Best and good luck. |
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If you are sick you go to the hospital, if you want to get really sick you stay there for a while.
When my father was in the hospital (cancer) on his way out many years ago, I actually caught the nurse giving him the wrong IV meds meant for another patient. I don't think much has changed for the better. |
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There are lots of things to cause problems in the ICU but one of the largest is that patients there are often in dire straits...aircraft analogs would (should) not be flown. For most people, there were no mandatory annual inspections or repairs.
Another is that the people working there go home despite any terrible events. They have emotional skin in the game but typically not their own hides. So, training after school often takes a back seat to their personal lives. We could go on and on about differences but having worked in ICUs and flown as pilot in command, I think standardization in healthcare can only go so far. People are not mechanical things. |
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