Safety and Justice/Working the system

Safety and Justice/Working the system

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Doctors ready for a shock


There was a patient with a particular heart rhythm disorder. The treating doctor thought that this was of type A, although in doubt that it could be type B. She consults her supervisor. The supervisor agrees with her interpretation of the symptoms that it is indeed like a type A disorder. This requires treatment with a different kind of medication than type B.

Anyway, type A medication is administered. The patient’s heart however stops. Everyone is getting ready to intervene and re-animate the patient. However, the heart of the patient suddenly starts pumping again and regains a normal rhythm. It was a type A; the medication was correct.

Time-out procedure successful


During a routine “time-out-procedure” before a surgical operation it is discovered that not all material necessary for the operation is present. The operation is cancelled and rescheduled despite the production pressure.

Stable approach

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The crew had completed the landing checklist and were stable and established before they reached 1000 ft.

Reduce thrust in time

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The pilot could see they would be coming in high and fast, so selected to reduce thrust early and extend flaps early and started the landing checklist already.

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