Airline

Time To Recover

2016-01-28 Seconds are frequently all we have.

When things start going bad on a flight deck, pilots may waste precious seconds denying that it's happening. It doesn't have to be.

Most pilots say that it won't happen to them but accident data suggests otherwise. This denial process is quite common, even with some airplane warnings, it just doesn't usually end in tragedy.

"the airplane knows, well before a crash, that problems are developing but gives no warning"

You're sitting there trying to make sense out of something that shouldn't be happening, or rationalizing a warning that's blaring, because, well, you sure don't want to go around. You see the field, the buildings, the traffic or whatever it's warning about, or maybe you don't know why it's blaring. For example, it's saying "Wind Shear" in snow—that doesn't make sense—we don't get wind shear in snow.

People marvel at how pilots can sit there quietly but it's not like there's an enemy attacking. The disaster is unfolding in relative comfort. Even if there's a warning, you haven't likely rehearsed reacting to that warning out of surprise. That fact, that we don't rehearse some of these scenarios, is a failing of training programs, largely because of legal requirements.

In simulators we are never given surprise terrain, traffic, or other warnings where we're expected to recover to a safer course immediately. That's a shame.

Yes, we get these warnings, but we know when they're coming. We can see the traffic or the terrain on our displays. It should be done during normal maneuvering, while focused on something else, and it just happens. Yes, that's a false warning but we're trying to get people to react to the warning NOT worry about whether it's false or not. You're getting vectored for an approach and get a terrain warning out of the blue. You're expected to react immediately. Same thing with windshear, pull-up and traffic warnings. We should be getting basically erroneous warnings and practicing reacting then asking questions later. It's *NOT* negative training if that's the expected reaction!

We still have to think, of course. If we're flying level while getting vectored for an approach in Chicago and get "Pull up, Terrain" then we can pass it off as erroneous. But that's EXTRAORDINARILY rare. In my 20+ years of flying with these warning systems it has never happened. What HAS happened is pilots ignoring warnings and NEARLY balling it up.

At my airline they are improving training immensely in certain ways by allowing the practice of decision making at least in one area, the rejected takeoff. I haven't flown the new profile but am rather looking forward to it. Rehearsal is the key to success if you want humans to respond quickly to threats.

Situational Awareness

Being aware is good whether you're crossing the street, driving, or especially flying. Here is one way to look at it.

1. In the Green

You're "In the green" while things are proceeding as planned and there is attention to spare. You can look around, make sure upcoming frequencies are set, that the energy state is good (not high and fast), that the flight management system (FMS) is displaying useful pages, that the airplane is properly configured and maybe even glance at the cool landscape while looking for stray paramotor pilots.

Normal activities are being done far enough in advance that they can be stopped while dealing with interruptions like air traffic controller instructions, flight attendant requests, unusual sounds, etc.

2. In the Yellow

This is when a situation requires nearly full attention and immediate action. While cruising along at 31,000 feet the controller says "cross 35 miles southwest of MYTOE at 12,000 feet at 250 knots. You immediately bump into the yellow while you work the change because it requires immediate and full attention. It's normal to go into the yellow like this and we manage it pretty well.

It's mostly unplanned changes. If we already had the crossing entered (as we should if it was charted), there would be no going into the yellow. That's because when we programmed it during cruise we could STOP programming due to a an interruption. This is why it's so helpful to stay at least one step ahead on changes. For example, if you're going into an airport where they commonly change runways, have the approach frequency for the other runway in standby. This is called "Staying ahead of the airplane."

We want to minimize our time "in the yellow" to get back to the green monitoring role.

Being high on an approach is another good example because the airplane doesn't slow down AND go down very well. All attention is focused on getting into "the slot" (on speed, on glidepath) by 1000' above touchdown. This is common and, to be honest, is usually kind of a fun challenge, like a good stiff crosswind. San Diego is famous for this. They leave you high on downwind then clear you for the approach. It can either be a low-stress affair flown conservatively or can be a butt scrunching stress inducer. Sometimes air traffic control makes it worse with something like "Airline 123, cleared for the visual runway 27, make short approach."

3. In the Red

You're now violating a flying law, a physics law, and/or will soon crash. One euphemism is "undesirable aircraft state," for example, balled up in a burning hulk beyond the seawall. Thankfully it's usually something less dramatic like flying beyond a waypoint. But it may be that you're lined up on the wrong runway or, far worse, line up for the wrong airport.

What gets missed is how we can go from green to red in the blink of an eye. Single mistakes can immediately put a flight into the red. That's a really important thing to remember. One moment you're fine and the next moment you're way too slow. Or at least you REALIZE you're way too slow.

Deny Deny Deny

Some things we humans don't do well with; trauma is one of them. A common reaction is deny, deny, deny. As a bad situation unfolds our first reaction is "no, this isn't really happening." Precious seconds drift by unnoticed.

The best solution is training, especially if we can evoke similar emotions and uncertainties in the scenario. That's tough, of course, but not impossible. For example, lets say you get a warning system squawking about terrain. You've been flying for years and have never heard it in real life or, worse yet, you've heard it before but it was daytime and you didn't have to do anything drastic. Now it's night. A clear night, to be sure--you see what you think it's squawking about, and so you deny that's it's really serious and press on.

That reaction, where the pilot doesn't respond right away, is amazingly dangerous. Yeah, most of the time he'll be right, he'll miss the building, but wow, what a bummer if it was squawking about a building he DIDN'T see!

Solution

We like to harbor the delusion "that would never happen to me." And that's true—most of the time.

Throw in fatigue, maybe some slightly unusual cockpit dynamics, etc., and the possibility grows. U.S. pilots like to brush this one aside as if these pilots where not used to flying visuals but that was a tiny part of it.

The Airplane Knows

The airplane knows, well before a crash, that problems are developing but gives no warning. The the flight management system knows where it is, where it's going, airspeed, configuration (flaps, gear, spoilers, thrust, etc) and landing runway.

If a pilot steers towards the wrong runway why not have it say "Runway, Check Runway"? If the crew just got a last minute runway change they can cancel it, otherwise they go-around. There have been some close calls with airliners landing on the wrong runway, occasionally at the wrong airport. These were conscientious crews who, no doubt, thought there was no way that could happen to them. The warning system doesn't have human factors, like denial, it just reports the facts.

The computer already has the current thrust setting, airspeed and trend. It could give an "airspeed" warning long before a dangerous condition develops. If the throttles are idle, and airspeed is decaying, a warning could be issued before it drops below the current target speed, giving PLENTY of time for the pilots to throttle up.

If the throttles are up but just not enough, airspeed decays slowly. The warning would wait longer to avoid nuisance alerts. Like all warning systems it must avoid, at all costs, giving false alarms.

We already have the really cool enhanced ground proximity warning system to give alerts, lets do more.

Asiana Boeing 777 SFO Crash

While watching a training video on the Asiana 777 crash in SFO I was surprised to see that, although they were initially scrambling to get down, the airplane did, in fact, get into a stable approach and the crew would have likely considered themselves "in the green" albeit briefly. There were many factors that contributed to this accident but one factor warrants more emphasize: there were a matter of seconds to act after getting "into the red." Secondly, a more advanced warning system could have pulled them out of their denial phase with a warning for which they are trained to react.

 

The colors indicate the pilots' perceived level of situational awareness. They started high and fast but managed to get it onto profile albeit a bit late. Things were coming together but for one little omission. The autothrottles were inadvertently turned off. That meant that the aircraft continued to slow while the autopilot kept increasing pitch in a vain attempt to stay on glideslope. By the time someone acted, it was too little too late.

This problem, where the autothrottles were off when the pilots thought they were on, is not unique and has killed people before. It's almost certain that an "Airspeed" warning 7 seconds earlier, which the system could easily be programmed to give, would have saved this aircraft and a Turkish Airlines 737.

I can hear it now "at some point we must let pilots be pilots." That's bullshit, frankly—a sentiment that should be screamed from the hulking wrecks of observed consequences. Of course we need to have sound stick and rudder training but that RARELY causes accidents. It didn't cause this one. It doesn't, in fact, cause many at all. The reality is that humans make terrible monitors. Let's deal with that.

Also, there will ALWAYS be cultural, fatigue, cockpit dynamics, etc, and we should always be trying to reduce them, but history has shown that our best improvement in the last 20 years, ***BAR NONE*** have come from improving the human/machine interface.

These changes, along with training to incorporate them, will help pilots be warned, and then be more primed to act, to recover to a safer course.

 

Nearly every jet out there flies in cruise with about 3° nose up attitude. That is also close to the attitude it flies on a stabilized approach regardless of weight. Heavier loads mean higher airspeeds but the nose up angle will be near 3° when using normal flaps.

If it gets much higher than this something is wrong. We all know that while sitting around talking about it but none of us has likely ever experienced it. We all *SAY* what we would do, and I'm sure the Asiana pilots would have said the same thing.

False Warnings

I've had three or four of these. I'm just as likely as the next guy to go through a denial phase so I try to rehearse that, if I get a warning, react now, ask questions later.

Boston: "Windshear"

While approaching to land in Boston in an empty airplane (we were ferrying it there to get it in position) with nice weather, we got a windshear warning at 400 feet. It made no sense, there was no convective activity or even gusty winds.

"well, lets go around" and we did.

We asked for the winds. They were "240 at 11" or some similar benign value.

The next approach we briefed that, if we got the warning again, we would land anyway and, sure enough we did get the warning. Landing was uneventful and we wrote the airplane up on arrival.

Kansas City: "Windshear"

There were probably snow squalls and we were at maybe 1500' when we got the warning. The First Officer was flying.

You just don't expect windshear in snow.

Probably 3 seconds of no action before I said, "well, go around" and she did. Even my voice probably had a tone of "well, that's probably bullsh*t but lets do it."

El Paso, Stick Shaker

Many years ago, in El Paso, we arrived at the jetway to find a broken angle of attack vane was bent, apparently by the jetway. We had contract maintenance came out who, working with our own maintenance, "removed" the vane, pulled some breakers, and signed it off as deferred.

While taxiing out we briefed that there was some possibility of getting a stall warning (stick shaker) if anything was amiss with what they did down there.

Sure enough, just after rotation a stick shaker came on. We climbed up, cleaned up, got the autopilot on then pulled the appropriate stick shaker circuit breaker.

Talk about distracting. But in this case, having briefed it DRAMATICALLY reduced our anxiety.

Chicago: "Climb Climb"

Just after takeoff, we get handed off to departure. He calls traffic at our 9 O'Clock and asks if we have him in sight. We did. Leveling at 3000 feet we got a warning from the onboard collision avoidance system to "Climb, Climb." We eased it into the requisite climb then, at 3300 feet the warning stopped. We told the controller that "we're climbing for an RA (Resolution Advisory)" to which the annoyed-sounding controller bitched "you said you had the traffic."

Yes, but we are REQUIRED to respond and for a very good reason. The alert-causing traffic may be a different airplane. That has happened and resulted in very close calls.

Of course it probably was the airplane he pointed out but we reacted properly.


© 2016 Jeff Goin & Tim Kaiser   Remember: If there's air there, it should be flown in!