Airway emergency - what would you have done.

Could SHE have held the yoke while you climbed in back and gave her the
heimlich? I suppose if not the problem would be exacerbated, but it's another
reason to consider something along the pinch-hitters thing - enough traning for
your wife and kids to land the plane safely if something happend to you.

Or in this case, even to her.

I'm glad it turned out all right. I can't even imagine how I'd feel if it were
me, and it didn't.

Jose

--
(for Email, make the obvious changes in my address)

In article , G.R. Patterson III
wrote:

EDR wrote:

You have rudder peddles, use them!

I don't have any of those, but I *do* have some rudder pedals.

Thanks, at least I didn't spell it "petals".

Jose,

Thanks for the suggestion. This might have worked! I doubt I
could have climbed into the back seat. But, I may have found a
workable position if I hadn't had to keep one hand on the yoke. In
her physical state I believe she may have been able to control the
airplane for a very short time. I was hoping for some "out of the
box" input like this. I was also hoping to get others thinking about
situations they may face that they hadn't previously considered.
She has been through ground school, and I was hoping to get her
through a pinch hitters course but she unfortunately isn't interested.
She still likes to fly and we've been through other trips since this
long cross country.

Every flight an adventure!
Tag, you're it!

"Teacherjh" wrote in message
...
Could SHE have held the yoke while you climbed in back and gave her
the
heimlich? I suppose if not the problem would be exacerbated, but
it's another
reason to consider something along the pinch-hitters thing - enough
traning for
your wife and kids to land the plane safely if something happend to
you.

Or in this case, even to her.

I'm glad it turned out all right. I can't even imagine how I'd feel
if it were
me, and it didn't.

Jose

--
(for Email, make the obvious changes in my address)

Dave,

Obviously, you've provided some expert feedback. Thanks for the
reply. Your first paragraph is pretty much how I handled it, and
thank God I never had to progress too much further. I did try back
blows, which may or may not have been wise. I felt pretty helpless
even with the training I've had. In this case the back blows made no
difference. Every time I attempted to move myself into a position to
help if needed, I had problems controlling the airplane in the rough
air. I might have been able to keep my left hand on the right side of
the yoke and wrap my right arm around her waist, slide my fist up and
provide some modified thrusts. Don't know if I'd have moved much air
with that one armed procedure. It was if that candy was cemented in
place!

Every flight an adventure!

"Dave S" wrote in message
ink.net...
I would have asked her 1) are you choking? and if she nodded yes I
would
have asked 2) can you talk? and if she nodded no then I would have
intervened. OTherwise as long as shes moving air in SOME form or
fashion
I would let HER focus on clearing the obstruction and ME focus on
setting down somewhere if it didnt immediately clear.

If intervention were warranted (assuming a front seat passenger), I
would have attempted one or two modified abdominal thrusts (with
similar
direction and force as a heimlich). One or two thrusts will not
cause a
total departure from controlled flight in my opinion, and it might
provide enough effect to dislodge the obstruction. Thrust or two..
verify the plane is in control.. thrust again.. etc.. if it doesnt
clear
within a few moments of thrusting then its unlikely you will clear
the
obstruction in the air with lay skills. At that point, its purely a
personal decision what do do next.

Dave, RN, EMTP, PPSEL

"JJS" jschneider@REMOVE SOCKSpldi.net writes:

While flying between Gallup N.M. and Winslow, A.Z., my passenger
pulled out a peppermint candy, handed it to me and retrieved another
for herself. I popped mine in my mouth, took a gulp from my water
bottle and went back to enjoying the view. Shortly thereafter, my
passenger starts gagging. When she had tossed the lozenge in her
mouth we hit a bit of turbulence and the candy tried to enter her
windpipe whole. A look of distress crossed her face as I quickly
realized what had happened. Her involuntary gag reflex went into
overdrive as she struggled to breathe. A feeling of helplessness
crossed over me as I realized we were 35 miles from the nearest
airport and it would be several minutes at best before we could land.
Even if I set the airplane down on I-40 it would be at least 5-6
minutes. That would lead to me risking the lives of others. With no
autopilot and while flying in rough air, an attempt at the Heimlich
maneuver would undoubtedly lead to an out of control aircraft over
mountainous terrain. What would you have done.

I haven't yet seen any suggestion of finding smoother air; might that
have been possible more quickly than landing somewhere? Seems like
that would let you put more attention on the medical emergency
(especially if the smoother air happened to be *higher*).
--
David Dyer-Bennet, , http://www.dd-b.net/dd-b/
RKBA: http://noguns-nomoney.com/ http://www.dd-b.net/carry/
Pics: http://dd-b.lighthunters.net/,http://www.dd-b.net/dd-b/SnapshotAlbum/
Dragaera/Steven Brust: http://dragaera.info/

David,
I think this is another excellent suggestion worthy of
consideration. Climbing would possibly have worked, especially in a
higher powered airplane. IIRC, we were westbound at 10,500 when this
took place over fairly high terrain. My little Cherokee 140 doesn't
climb very well at that altitude. My thought was to get lower to get
it on the ground quickly if needed. If I was flying something like a
182 then perhaps I'd have had more options. Your suggestion was one
that never entered my mind, but should have at least been considered.
Thanks.

What did I do wrong? Well for one thing, no one mentioned calling for
help. How about this... I never called FSS and let them know of our
predicament. I didn't think the situation progressed far enough. On
reflection, that may not have been very smart. FSS could have had an
ambulance enroute to or waiting at the nearest airport or in the
vicinity of the area I decided to land at on the interstate. As I
was losing altitude over high terrain the possibility of losing radio
contact with help was increasing. Why do we as pilots sometime wait
until the situation is nearly unsalvageable before we take action? Is
it embarrassment? The fear of having to pay for services whether we
use them or not?

Joe Schneider
8437R

"David Dyer-Bennet" wrote in message
...

I haven't yet seen any suggestion of finding smoother air; might
that
have been possible more quickly than landing somewhere? Seems like
that would let you put more attention on the medical emergency
(especially if the smoother air happened to be *higher*).

The modified maneuver I was thinking of was flying with your feet (I
routinely use the rudders to maintain heading and bank on long XC's),
twisting towards the passenger seat and reaching across with the left
hand (as if to punch.) and thrust in/up between the navel and the
bottome of the sternum with the left hand/fist.

As with any kind of abdominal thrusts, you run the risk of laceration or
perforation of abdominal organs. However, these risks rarely (in my
mind) outweigh the immediate risk of death from a completely obstructed
airway.

Back blows really dont do a lot to increase intrathoracic pressure (and
blow out the obstruction) but may help shake loose the obstruction. They
are not recommended in the management of adult or child airway
obstructions by any credentialling organization that I'm aware of, but
the American Heart Association still teaches their use in the treatment
of infant obstructed airways.

If an ADULT has completely passed out and is unconscious from a total
airway obstruction (which is a truly grave situation) then blind finger
sweeps of the mouth and throat are part of the treatment regimen (Take a
CPR course sometime). In my experience with the average adult, you can
reach far enough back to feel the opening of the windpipe (* DO NOT DO
THIS ON SOMEONE WHO IS RESPONSIVE.. they will bite your fingers off!)

Again, I am limiting my interventions to what they lay person could be
expected to provied, and I must ask that this not be considered "medical
advice" but rather an opinion, and an encouragement to get proper lay
training in dealing with possible emergencies. American Heart and
American Red Cross are both excellent resources; for an introduction to
the more professional aspects of emergency health care you can check
with a local junior college or state board of health regarding First
Responder or EMT training in your area.

Dave

JJS wrote:

Dave,

Obviously, you've provided some expert feedback. Thanks for the
reply. Your first paragraph is pretty much how I handled it, and
thank God I never had to progress too much further. I did try back
blows, which may or may not have been wise. I felt pretty helpless
even with the training I've had. In this case the back blows made no
difference. Every time I attempted to move myself into a position to
help if needed, I had problems controlling the airplane in the rough
air. I might have been able to keep my left hand on the right side of
the yoke and wrap my right arm around her waist, slide my fist up and
provide some modified thrusts. Don't know if I'd have moved much air
with that one armed procedure. It was if that candy was cemented in
place!

Every flight an adventure!

"Dave S" wrote in message
ink.net...

I would have asked her 1) are you choking? and if she nodded yes I

would

have asked 2) can you talk? and if she nodded no then I would have
intervened. OTherwise as long as shes moving air in SOME form or

fashion

I would let HER focus on clearing the obstruction and ME focus on
setting down somewhere if it didnt immediately clear.

If intervention were warranted (assuming a front seat passenger), I
would have attempted one or two modified abdominal thrusts (with

similar

direction and force as a heimlich). One or two thrusts will not

cause a

total departure from controlled flight in my opinion, and it might
provide enough effect to dislodge the obstruction. Thrust or two..
verify the plane is in control.. thrust again.. etc.. if it doesnt

clear

within a few moments of thrusting then its unlikely you will clear

the

obstruction in the air with lay skills. At that point, its purely a
personal decision what do do next.

Dave, RN, EMTP, PPSEL

I think this story points out the need for pilots to have some
rudimentary first aid training. It has been 20 years since I took a
class, and I feel somewhat less than prepared. Heimlich is one thing,
but there are other scenarios that could pose a much greater problem.

I'm in the middle of creating a good long-distance first aid and
survival kit right now, and in doing research it surprises me the things
I never thought about. (http://www.aeromedix.com has some great
articles and products---no affiliation, just a happy customer!) One of
the things I really hadn't thought about was my first-aid skill set,
which can not be purchased.

And I'm surprised no one has asked---what happened on the airway!? I'm
assuming the passenger dislodged the candy from her windpipe.

"JJS" jschneider@REMOVE SOCKSpldi.net wrote in message
...
[...] I tried hitting her on the back hard enough that I
knew she'd kill me if she lived through the ordeal.

Ack. Thank goodness you didn't wind up lodging the obstruction in even
further. Remember: gravity is at work, even inside your body. Knock
something loose that's inside your airway, and the most likely place for it
to go is down.

The last thing a person having trouble breathing needs is a whack on the
back. At least, not until you turn them upside down. I'm surprised with
all your emergency medical training, no one's mentioned this.

The traditional Heimlich is done from behind, of course, but it seems to me
that with a strong enough arm, especially with a partial obstruction, you
might have had some luck from the side. Just get your fist in good under
her diaphragm (not, not THAT diaphragm...this is serious you guys ), and
push hard and quick, in the same motion you'd use from behind.

It would at least be worth a try.

Barring success getting the thing out quickly, I can't imagine flying all
the way to an airport, even one nearby. You should have appropriate landing
sites below you nearly all the time. A passenger choking seems to me to be
just as serious as an airplane on fire, and would warrant an emergency
descent to an off-airport landing so that proper first-aid (e.g. a real
from-behind Heimlich) can be given.

Pete

On Sat, 15 May 2004 19:51:00 GMT, EDR wrote:

You tricycle gear pilots need to learn what your feet are for.
You have rudder peddles, use them!

You're saying that once in the air, there is some kind of perceptable
difference between a taildragger and a trigeared airplane? My
experience has been that once in the air, tri geared or not, the
required rudder use is no different one from the other.

Corky Scott