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Airport Disasters Medical Response and Management

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This was an Aerospace Medicine Board Review Lecture developed by Dr.Tripthi M. Mathew for presentation at the 86th Annual Scientific Meeting of the Aerospace Medical Association, May 10-14, 2015, Orlando, FL.

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Airport Disasters Medical Response and Management

  1. 1. Airport Disasters Medical Response and Management α Ώ Alpha & Omega Healthcare Management Consulting © Tripthi M. Mathew, MD, MPH, MBA, PhD President & CEO/Sr. Medical Director Alpha & Omega Healthcare Management Consulting May 14, 2015 ,Panel LXXXII-Aerospace Medicine Review Board #3 Operational Aerospace Medicine ,Management and Administration The 86th Annual Scientific Meeting of the Aerospace Medical Association , May 10-14 ,2015 Orlando, FL
  2. 2. About the Author Alpha & Omega Healthcare Management Consulting © 2015α Ώ Dr. Tripthi Mary Mathew received her MD degree (7 yr program) from the former Soviet Union (Georgia & Belarus), MPH (2 yr full-time) degree from Drexel University, MBA from University of Warwick, UK and PhD in Business Management with Distinction from Ashwood University, Texas. She has an Offer for Master of Laws (L.L.M) at the University of Nottingham, UK Dr. Mathew has over 10 years of experience in the healthcare industry in various sectors: Private, Public (Federal, State and Local), Academia and Non-profit. She has made several presentations and has authored articles, chapters and book. Dr. Mathew is Board Certified in Aerospace Medicine, General Medicine, Public Health and Preventive Medicine by the International Board of Medicine and Surgery (IBMS). She was nominated as a member to the Global Advisory Board of the American Academy of Project Management; the Editorial Advisory Committee of the Nations Health-American Public Health Association’s Newspaper and is a member of the Harvard Business Review Advisory Council Dr. Mathew is a member of the World Medical Association, European Medical Association, Aerospace Medical Association, International Committee on Insurance Medicine, American Academy of Insurance Medicine and member of 50 groups and associations on Linkedin.com She has presented at UTMB, Principles and Practices of Aerospace Medicine Course, 2013, at the International Congress on Aerospace Medicine, Israel, 2013 and at the 85th Aerospace Medical Association meeting, 2014. She drafted/updated Air Sickness and Traveler’s Diarrhea section of ASMA’s Medical Guidelines for Airline Travel. She is currently involved with research on aerospace safety, air and space law, and developing a genetic aerospace database. She is also developing a lecture/course on medical tourism with the International Board of Medicine and Surgery. Dr. Mathew is a trained and certified UAV/Drone recreational pilot (FAA Wings Pilot Proficiency Program).
  3. 3. Alpha & Omega Healthcare Management Consulting © 2015α Ώ Disclosure Information 86th Annual Scientific Meeting Dr. Tripthi M. Mathew  I have no financial relationships to disclose.  I will not discuss off-label use and/or investigational use in my presentation
  4. 4. Organization of Presentation  Learning Objectives  Airport Disasters (Definition, classification, statistics)  Airport Disaster Movies  Airport Safety & Standards- FAA & IHR Regulations  Management of Airport Disasters (Airport Emergency Plans, Medical Response/Planning, wildlife hazard mitigation)  MOC Questions -Dispersed in between the presentation and handouts  References/Resources for Further Study Alpha & Omega Healthcare Management Consulting © 2015α Ώ
  5. 5. Learning Objectives • 1) The participant will be provided with an overview of airport disasters, medical response and management. • 2) The participant will be able to review some of the Aerospace Medicine Board MOC like questions pertaining to the topic of Airport Disasters, Medical Response and Management. Alpha & Omega Healthcare Management Consulting © 2015α Ώ
  6. 6. Airport Disaster Movies  Airport (1970)  Airport 1975  Airport’77  The Concorde, Airport 79 Which one is your favorite? Alpha & Omega Healthcare Management Consulting © 2015α Ώ Source: Source: Crippa. Disaster Movie World. IFC celebrates 40 years of Airport. 2010. Internet. http://disastermovieworld.com/2010/11/10/ifc-celebrates-40-years-of-airport/
  7. 7. Definition and Disaster Classification • Natural (Dense Fog, Mud slides, Floods, Earthquakes, Snow storms) • Wildlife Disasters (e.g. Bird Strikes) • Human factors- Unintentional/Accidents (Collisions/Plane crashes due to spatial disorientation) • Intentional/Man Made (Terrorism/Bomb threats) • Other (e.g. Contagious Infectious Diseases) *Disaster is defined as that which produces casualties in numbers and rapidity, sufficient to overwhelm community function/resources. Multiple Patient Incident (<10 patients, can be transported to a hospital within 15 to 30 min) Multiple Casualty incident (involves upto 50 victims, seldom last not more than a few hours) Mass Casualty Incidents (true disaster, that involves hundreds to thousands of victims and lasts hours, days, or weeks) Alpha & Omega Healthcare Management Consulting © 2015α Ώ
  8. 8. Airport Disasters Statistics (Involving Aircrafts) • 10 worst Taxi Accidents • 10 Worst Takeoff Accidents • 10 Worst Initial Climb Accidents • 10 Worst En route Accidents • 10 Worst Approach Accidents • 10 Worst Landing Accidents *The most likely cause of Airport Disasters is due to a)Pilot Proficiency Factors b)Physical Factors affecting the aviators c)Mechanical factors involving the aircraft d) Environmental factors causing spatial disorientation Alpha & Omega Healthcare Management Consulting © 2015α Ώ
  9. 9. *Airport Disasters (Global) Statistics Fig. 1. Ten Worst Taxi Phase Accidents (1935-1983), with number of fatalities, location and date Alpha & Omega Healthcare Management Consulting © 2015α Ώ Source:FlightSafetyFoundation, NTSB,Lastupdated29April2015 Note: *The pie charts include both commercial and military transport accidents (airports and aircrafts)
  10. 10. Airport Disasters (Global) Statistics Cont’d Fig. 2. Ten Worst Landing Phase Accidents (1969-2010), with number of fatalities, location and date Alpha & Omega Healthcare Management Consulting © 2015α Ώ Source:FlightSafetyFoundation, Lastupdated28April2015
  11. 11. Airport Disasters (Global) Statistics Cont’d Fig. 3. Ten Worst Take Off (1962-2008) Phase Accidents, with number of fatalities, location and date Alpha & Omega Healthcare Management Consulting © 2015α Ώ Source:FlightSafetyFoundation, Lastupdated28April2015
  12. 12. Airport Disasters (Global) Statistics Cont’d Fig.4.Ten Worst Initial Climb Phase Accidents (1962-1989), with number of fatalities, location and date Alpha & Omega Healthcare Management Consulting © 2015α Ώ Source:FlightSafetyFoundation, Lastupdated28April2015
  13. 13. Airport Disasters (Global) Statistics Cont’d Fig.5. Ten Worst Approach Phase Accidents (1972-1998), with number of fatalities, location and date Alpha & Omega Healthcare Management Consulting © 2015α Ώ Source:FlightSafetyFoundation, Lastupdated29April2015
  14. 14. Airport Disasters (Global) Statistics Cont’d Fig.6.Ten Worst Enroute Phase Accidents (1974-2014), with number of fatalities, location and date Alpha & Omega Healthcare Management Consulting © 2015α Ώ Source:FlightSafetyFoundation, Lastupdated28April2015
  15. 15. Taxi Take off Initial Climb En route Approach Landing 1. Low Visibility Runway Incursion Engine Separation Loss of Control Icing Loss of Control Loss of Control Failure to follow AD and SBs Loss of Control Runway excursion 2. Runway incursion Low visibility Runway Incursion Low visibility Loss of Control Failure to follow AD and SBs Cargo door failure Loss of Control Loss of Control Turbulence Runway excursion 3. Engine Loss (burst into flames) Wrong takeoff configuration (flaps/trim) Loss of control Shot down from the ground Loss of Control Sabotage Fuselage Failure Loss of Control Low visibility Controlled flight into Terrain- Mountain Runway excursion 4. Collapse of right landing gear Wrong takeoff configuration (flaps/trim) Loss of control Windshear/ downdraft Loss of Control Mid air collision Loss of Collision Insufficient rest/fatigue Controlled flight into Terrain- Mountain Runway excursion 5. Collision (taxi and takeoff) – military aircrafts Centre of Gravity Outside Limits Loss of Control Loss of Control Forced Landing on runway Loss of Control Runway excursion Table1. Ten Worst Global Airport Disasters Cause (by Phase of Flight) Alpha & Omega Healthcare Management Consulting ©α Ώ Source:FlightSafetyFoundation, NTSB,Lastupdated29April2015
  16. 16. Table1. Ten Worst Global Airport Disasters Cause (by Phase of Flight) Cont’d Alpha & Omega Healthcare Management Consulting ©α Ώ Taxi Take off Initial Climb Enroute Approach Landing 6. Collision Runway Excursion Windshear/ Downdraft Loss of control Shot down from the ground Loss of Control Controlled flight into Terrain (Ground) Runway excursion 7. Collision (military) Low visibility Runway incursion Loss of Control Loss of situational awareness Controlled flight into Terrain (Ground) Shot down from the ground Loss of Control Navigational Error Controlled flight into Terrain- Mountain Uncontained Engine Failure Forced landing on runway 8. Runway Incursion Landing or takeoff on wrong runway Loss of Control Loss of situational awareness Controlled flight into Terrain (Ground) Controlled flight into Terrain- Mountain Flight crew under qualified Controlled flight into Terrain (Ground) Improper flap/slat usage Loss of Control 9. Collision (Taxi and Takeoff) Overloaded Runway excursion Improper flap/slat usage Loss of Control Navigational Error Shot down by aircraft Loss of Control Controlled flight into Terrain (Ground) Windshear/ Downdraft Loss of control 110 Collision Loss of Control Runway incursion Wing Failure Loss of Control Controlled flight into Terrain- Mountain Insufficient rest/fatigue Controlled flight into Terrain-Mountain Source:FlightSafetyFoundation, NTSB,Lastupdated29April2015
  17. 17.  There was a total of 10,005 deaths from 1935 to 2014 in the six phases (Taxi-467, Takeoff-1443, Initial Climb-1452, En route-3200, Approach-2064, Landing-1379) among the ten worst accidents globally. This includes both accidents that occurred at military airstrips and other airports, involving either military aircraft or commercial airlines.  From the 10 worst accidents globally from the period 1935 to 2014, among the six phases of Flight, the en route phase had the most (32%) fatalities (3200/10,005), and the taxi phase had the least (less than 5%) fatalities (467/10,005).  The Tenerife (Los Rodeos) Airport, Spain had slightly higher fatalities (on Taxi, Initial Climb and Takeoff) in comparison to other airports. There were two separate accidents at that airport in 2 different years. The first one was on 3 Dec, 1972 when Convair lost control due to weather conditions of zero visibility on initial climb phase of flight and crashed killing 155 occupants (148 passengers and 7 crew). The second is the deadliest accident in global aviation history. It was due to the collision of two airlines (Panam at the Taxi phase and KLM in the Take off phase) on March 27, 1977, killing a total of 583 occupants from both planes.  Loss of Control was the most (29%) common reason for accidents in all phases of flight (26/91) and the most common (47%) reason for accidents in initial climb phase of the accident. There was no loss of control in the Taxi phase of accident.  Runway excursion was the most common (31%) reason among the 10 worst accidents in the landing phase. This confirms the findings (runway excursion is the most common reason of accidents in the landing phase of flight) in the literature. Results Alpha & Omega Healthcare Management Consulting © 2015α Ώ
  18. 18. Question # 1 Name One Airport Disaster Movie a) Airport b) Airport’80 c) Airport’69 d) Airport’67 Alpha & Omega Healthcare Management Consulting © 2015α Ώ
  19. 19. Question # 2  Which is the Deadliest Airport Disaster in Global History of Aviation? a) LaGuardia Airport Disaster of 2015 b) Tenerife Airport Disaster of 1977 c) LaGuardia Disaster of 2009 d) Los Angeles Airport Disaster of 2014 Alpha & Omega Healthcare Management Consulting © 2015α Ώ
  20. 20. MOC Question # 3 Which species is considered to be the most dangerous to aircraft and to air safety, with regards to bird strikes? a)Hawks b)Seagulls c)Geese d)Ducks e)Eagles Note: According to FAA, Birds' make-up 97% of the reported strikes, mammals about 3% and reptiles less than 1%. Alpha & Omega Healthcare Management Consulting © 2015α Ώ
  21. 21. Airport Safety & Standards  14 CFR Part 139 (Federal airport certification regulation), 2004 (FAA’s final rule)  International Health Regulations (IHR), was developed by the World Health Organization in 1969  Sanitary Airport  A sanitary airport is an airport, designated as sanitary by the local health administration of a State. The health administration shall designate a number of sanitary airports in its territory, provided they meet the provisions of article 14 and the conditions of paragraph 2 of article 18 of the IHR. (Source: International Health Regulations, 3rd annotated ed, Geneva, WHO, 1983) Alpha & Omega Healthcare Management Consulting © 2015α Ώ
  22. 22. Management of Airport Disasters Cont’d  Certified airports -required to have a full scale drill of their emergency plan every 3 years, and an annual meeting to review the plan with all the involved parties  The Joint Commission on Accreditation of Health Organizations requires a written plan and a twice yearly drill for hospitals. Most plans use the Incident Command System (ICS) as a framework for control of a disaster. It was devised in the early 1970's  The color coded triage system (Red, Green, Yellow and Black) is internationally accepted and is usually part of a patient identification system  “Triage implies making the most efficient use of available resources” - Erik Auf der Heide Alpha & Omega Healthcare Management Consulting © 2015α Ώ
  23. 23. Management of Airport Disasters  Be aware of “Auf Der Heides” Principles of Disaster Response  Medical Planning at large airports to deal with major disasters requires a command post for the triage/treatment center  Training with ADMS (Advanced Disaster Management Simulator) to train incident commanders, command post staff and vehicle operators at all levels on airport emergencies.  Be aware of FAA’s Known “Best Practices” for Airfield Safety- for Air Traffic Controllers, Pilots and Airport Personnel.  FAA’s Wildlife hazard Mitigation program (e.g. habitat modification, proper landscaping, airport planning, by controlling land uses, away from land fills, that attract wild life can reduce bird strike and other animal hazards)  In Israel, bird radars are used to detect and predict the flight and migration of birds to reduce bird strikes (Dr. Yossi Leshem, Andre Allard Memorial Lecture at 61st International Congress of International Academy of Aviation and Space Medicine in Jerusalem, October 6-10, 2013) Alpha & Omega Healthcare Management Consulting © 2015α Ώ
  24. 24. References/Resources 1) Crippa. Disaster Movie World. IFC celebrates 40 years of Airport. 2010. Internet. http ://disastermovieworld.com/2010/11/10/ifc-celebrates-40-years-of-airport/ 2) Dove et al. A metropolitan airport disaster plan--coordination of a multihospital response to provide on-site resuscitation and stabilization before evacuation. J Trauma. 1982 Jul;22(7):550-9. 3) ETC Simulation Training Systems. Advanced Disaster Management Simulator (ADMS). Medical Training. 2015. Internet. http://www.trainingfordisastermanagement.com/applications/emergency-medical-services-training/ 1) ETC Simulation Training. Advanced Disaster Management Simulator (ADMS). Airport Training. 2015. Internet. http ://www.trainingfordisastermanagement.com/applications/airportemergency-incident-command-training/ 5) Federal Aviation Administration (FAA). Part 139. Airport Certification. 2015. Internet.http://www.faa.gov/airports/airport_safety/part139_cert/ 6) Federal Aviation Administration (FAA). Known Best Practices for Airfield Safety. 2015. Internet. http://www.faa.gov/airports/runway_safety/bestpractices.cfm 7) Federal Aviation Administration (FAA). Wildlife Management. 2012. Internet http://www.faa.gov/airports/airport_safety/wildlife/management/ 2) Flight Safety Foundation. Aviation Safety Network. Ten Worst Aviation Accidents Per Flight Phase. 2015. Internet. http://aviation-safety.net/statistics/worst 9) Heide, EAD. Disaster Response. Principles of Preparation and Coordination. 1989. CV Mosby. St. Louis. 10) Lee et al. Emergency Medical Preparedness and Response to a Singapore Airliner Crash. Academic Emergency Medicine. 2002, Volume 9, Number 3 11) National Transport Safety Board. Review of Accident Data. 2015. Internet.http://www.ntsb.gov/investigations/data/Pages/Accident-data-review.aspx 12) West, KN, Paulding,T. Aerospace Medical Association Self-Assessment Program. 3rd Ed. 2006. 13) Tenerife Airport Disaster. Internet. http://en.wikipedia.org/wiki/Tenerife_airport_disaster Alpha & Omega Healthcare Management Consulting © 2015α Ώ
  25. 25. Contact Alpha & Omega Healthcare Management Consulting © 2015α Ώ Tripthi M. Mathew, MD, MPH, MBA, PhD President & CEO/Sr. Medical Director Alpha & Omega Healthcare Management Consulting 31 Glenview Drive West Orange, New Jersey 07052, USA Alpha & Omega Healthcare Management Consulting Bon Voyage!DrMathewTM@gmail.com www.alphanomega.info http://www.youtube.com/user/ DrMathewTM https://twitter.com/TMMathew http://www.linkedin.com/in/mathewtm DrTripthiM

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