Drawing Lessons From a Disaster

Three days ago an engine explosion on Southwestern Airlines Flight 1380 caused a sudden cabin depressurization. Oxygen masks dropped as designed, but as reported by the New York Times, photos showed that many people had the mask over just their mouth, and not the nose and mouth as instructed. The conclusion? Passengers didn’t pay enough attention to safety instructions.

Although that is probably true, I don’t think reminding people to pay attention is really the answer.  As a physician, I have to re-certify in CPR every year. It’s not just the knowledge, it’s practicing it and getting muscle memory. Even with that, my skills surely deteriorate as I rarely have to do CPR now, and practice makes perfect. The key point is that passengers don’t get to practice. If you’ve ever taken a cruise, you know that shortly after you board, they have you actually go your assembly point and actually don a life vest. They don’t have you watch someone put on a vest, and they don’t point to where you should go.

As a medical student in the Air Force, I had the opportunity to take altitude chamber training. This is where you are in a chamber where the oxygen and pressure simulates being at high altitude, such as 25,000 feet. You then take off your oxygen mask to learn how you are affected by hypoxia (low oxygen). You are supposed to observe a few of the effects, then put your mask back on. I remember noticing some of the changes with curiosity, then someone tapping on my shoulder and telling me I had passed out. When I told him I hadn’t, he asked me who put my mask back on. At that point I realized that I had passed out, and it drove home the point of why they tell you to put the mask on yourself first, before helping your kids or anyone else. Otherwise you may pass out, then you are not in a position to help anyone else.

The article quoted a retired flight attendant as saying it didn’t matter that people didn’t have the mask over their nose as they could breath through the mouth. Although that’s true, that doesn’t mean they necessarily did. Many people breath through their nose most of the time, and in a high stress situation they may not necessarily realize that the mask is not covering their nose, or if they do, that they should breath through the mouth.  A better option might be to make the masks shaped more like a mask designed to cover the mouth and nose. You know, kind of oval shaped, not a circle.

It certainly not possible to put everyone who flies on commercial planes through altitude chamber training, but actually practicing putting on a mask would make people more proficient if they needed to do so in an emergency. On an airplane it may not be practical to do so because of the need to clean the masks, but in the terminal they could put booths where people could practice putting on masks, that could be cleaned and reused, and life jackets  to practice putting on, all while waiting for their flight. They could encourage participation by giving people who do so coupons for a snack or to be eligible to win a prize each flight.

About Daniel Ginsberg, MD, FACP

I'm an internal medicine physician and have avidly applied computers to medicine since 1986, when I wrote my first medically oriented computer programs. So yes, that means I'm at least 35-years-old!
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3 Responses to Drawing Lessons From a Disaster

  1. Delores Tulfo says:

    Does the 2nd sentence say the mask was over the nose AND mouth? Isn’t that correct?

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