ATSB report on Cessna 182 crash Qld 29 Aug 2022.

[red750]

Plan continuation bias - read report

[turboplanner]

7 hours ago, red750 said:

Plan continuation bias - read report

New buzzwords for an old and continuing problem.

[facthunter]

Press on, mentality.  Nev

[facthunter]

"Plan Continuation Bias" is a bit esoteric. Usually the sign of a "New Broom" making their Mark. It doesn't exactly jump out at you and make a natural fit. Like all the various names for the Artificial Horizon. AH is still the best. 

  Turn and BANK is wrong. Turn rate (a gyro) and slip (or skid) is correct.   Nev

[skippydiesel]

"Turn and BANK is wrong. Turn rate (a gyro) and slip (or skid) is correct. "

 

Despite being slightly/or more incorrect, many terms/slang has been adopted to describe a particular system/part/condition/etc. For the most part the user(s) know what is actually being described/meant. Context playing a big part in understanding. 

Certainly correct terminology is important, in certain circumstances eg when trying to convey a particular concept but for the most part, as long as there is a clear understanding  
"looser"  language will suffice.

Language is part of culture, hence the Australian phrase of endearment/friendship "You old bastard"  -  likely far from the truth - well understood by Australian's  and completely misunderstood by all other English speakers  - would you have it any other way??.😈

Edited December 23, 2023 by skippydiesel

[facthunter]

The Instrument doesn't indicate BANK. . Reduce confusion by using the correct terms. Lack of clarity and flying don't mix. Flying also requires discipline including self discipline. You have "standard phrases" in RT to reduce confusion, not to sound like a   Top  Gun. . Boring as this might sound, the rugged Individualist really has no place in a safe system.   Nev

[RFguy]

2nd paragraph

"The Cessna had departed from Dalby toward forecast en route weather unsuitable for visual flight, despite the pilot only being qualified for flight in visual conditions."

 

I stopped reading there...

[turboplanner]

3 minutes ago, RFguy said:

2nd paragraph

"The Cessna had departed from Dalby toward forecast en route weather unsuitable for visual flight, despite the pilot only being qualified for flight in visual conditions."

 

I stopped reading there...

Good point to stop.

Fully trained, fully recent pilots in IFR rated aircraft do it safely all year long in RPT.

It's a bit like getting out of Hyundai Getz and into an aircraft without any training. Everyone knows you push the syick to go down, pull it bak to go up, bank with the feet; what could be hard?

 

 

[facthunter]

Knowing which way is UP and trusting your trustworthy instruments and knowing where the rocks are.   Nev

[Ironpot]

Condolences to the families and apologies for any distress this discussion may cause but the Aviation community do need the discuss this accident.

 

2 hours ago, RFguy said:

2nd paragraph

"The Cessna had departed from Dalby toward forecast en route weather unsuitable for visual flight, despite the pilot only being qualified for flight in visual conditions."

 

I stopped reading there...

That’s not the full story - he held a MECIR and had 8 renewals. He knew how to fly on instruments in an emergency. Furthermore the aircraft was IFR approved and had an autopilot. He had the latest TAFs and METARS and maybe somewhere abeam Toowoomba he knew it was time to climb to LSALT, talk to Amberley Approach and declare a problem.

 

Was this just a case of “ hold my beer”?

 

[turboplanner]

25 minutes ago, Ironpot said:

Condolences to the families and apologies for any distress this discussion may cause but the Aviation community do need the discuss this accident.

 

That’s not the full story - he held a MECIR and had 8 renewals. He knew how to fly on instruments in an emergency. Furthermore the aircraft was IFR approved and had an autopilot. He had the latest TAFs and METARS and maybe somewhere abeam Toowoomba he knew it was time to climb to LSALT, talk to Amberley Approach and declare a problem.

 

Was this just a case of “ hold my beer”?

 

If you go back through the last 30 years ATSB reports, quite a few were similar.  IFR rating and Currency flights are required to fly in IMC. 

...........and that's a full stop.

You can go further back over cases reported in the Aviation Safety Digests There's this type of accident, the type of accident where a raw student gets into IMC and tries to fly his way out, the person who is keeping the wings level and smashed into the side of a mountain because he didn't know he had to do a LSALT survey before he started the flight, and so on.

 

 

 

[KRviator]

50 minutes ago, turboplanner said:

If you go back through the last 30 years ATSB reports, quite a few were similar.  IFR rating and Currency flights are required to fly in IMC. 

...........and that's a full stop.

You can go further back over cases reported in the Aviation Safety Digests There's this type of accident, the type of accident where a raw student gets into IMC and tries to fly his way out, the person who is keeping the wings level and smashed into the side of a mountain because he didn't know he had to do a LSALT survey before he started the flight, and so on.

That's a good point too, @turboplanner - LSALT...

I'd never really bothered thinking about it till I did my XC endo, and the instructor wanted it on the NavLog - and it makes sense for my situation. I'm equipped to survive unintentional flight into IMC, so I still have it there in my paperwork. LSALT is useless if you don't have an attitude reference though, but if you do have an AH or EFIS, then it doesn't take much to skim along your track line and pick out the highest point for each leg, and add 500 to it to keep you safe if it goes to poo.

[facthunter]

How far wide  of track do you consider and is 500 feet enough?. LSALT gives more. Flying along valleys has it's place IF you know what you are doing and the LSALT would rule that out.  It IS something but not everything.   Nev

[turboplanner]

LSALT is not important for VFR flying, because you can only fly where you can see the mountaintops, although if you're going to be flying in mining areas, Tower locations can be important because they can be in the landing strip pattern or nearby and hard to see.

 

However in a lot of IMC crashes the non-qualified pilot was able to maintain control but died by flying directly into a mountain, building etc.

IMC pilots are required to identify Lowest Safe Altitude, not for the route on the screen, but for a path 5nm each side of the direct track, so you have to survey 10 nm of mountains x the route from point A to Point B and around each airport.

 

This drawing is from CASR Part 91 General Operating and Flight Rules, Plain English Guide starting at Page 102

 

[Ironpot]

12 hours ago, turboplanner said:

LSALT is not important for VFR flying, because you can only fly where you can see the mountaintops, although if you're going to be flying in mining areas, Tower locations can be important because they can be in the landing strip pattern or nearby and hard to see.

 

However in a lot of IMC crashes the non-qualified pilot was able to maintain control but died by flying directly into a mountain, building etc.

IMC pilots are required to identify Lowest Safe Altitude, not for the route on the screen, but for a path 5nm each side of the direct track, so you have to survey 10 nm of mountains x the route from point A to Point B and around each airport.

 

This drawing is from CASR Part 91 General Operating and Flight Rules, Plain English Guide starting at Page 102

 

It is important! I think you forgot NVFR!!!! 

The illustration should be 10 miles left and right of track and it’s only applicable if you’re TSO’d GNSS equipped; otherwise you have to calculate lowest safe by reference to the aids available.

 

In practice, I think this pilot would be aware of  “Grid” LSALT as shown on the ERC (not the VFR) chart.  So just switch to ERC on your iPad/tablet and the big blue number indicates the LSALT for the grid square that you’re situated.

 

 

[Ironpot]

Apologies I didn’t want to cause a debate on LSALT.

 

Like everyone else, I try to learn something from these reports and take something a way that I can use, should I find myself in a similar situation.

 

My personal solution will not work for everybody and l’m not suggesting non-instrument rated pilots even think of using this!  Climbing to grid LSALT was 5200 (10 nm Amberley would be better and that’s 3400) but this guy would still be in cloud, and copping flak from ATS but on Autopilot and safe. ATS would’ve had him on radar and vectored him to safety somewhere. That’s what they are there for.

I can’t imagine the shit he would’ve copped afterwards. But he was retiring 2 months later! Hey ho!

 

 

[facthunter]

If you contact ATC and are on their radar, particularly they should assist you. That's a given.  Nev

[RFguy]

that's for sure, I have heard VFR pilots get into IMC around canberra on at least two occassions, and ATC vectors them out of the radio.

[skippydiesel]

4 hours ago, Ironpot said:

Apologies I didn’t want to cause a debate on LSALT.

 

 

You may not however you have already nominated 500ft as your personal LSAT - -

Although I received some flight into IMC training (a squillions years ago), I am strictly VFR and my personal LSAT is 1000 ft.

Why the excess of caution you may ask (or not)? - Simples! I figure if by some mischance, I fly into IMC, I will know (planed) that I am well clear of cumilograntatis or the occasional Telstra tower, etc that may bring me to a sudden stop. I will not be searching my map/IFB for LSAT, while trying to navigate my aircraft through cloud/smoke/etc.

By staying above 1000 ft, I  have a panoramic view of the terrain, options for an engine out are easier to see/ assess. 

In short, having a planned, personal, minimum for every flight,  gives me options.

[Ironpot]

4 hours ago, skippydiesel said:

You may not however you have already nominated 500ft as your personal LSAT - -

No it wasn’t me. 

 

Could you edit that one please.

[skippydiesel]

51 minutes ago, Ironpot said:

No it wasn’t me. 

 

Could you edit that one please.

My craven apologies - Unfortunatly too much time has elapsed for me to edit that miss quote. I can only hope readers see this retraction.

[Roundsounds]

On 25/12/2023 at 7:31 PM, turboplanner said:

LSALT is not important for VFR flying, because you can only fly where you can see the mountaintops, although if you're going to be flying in mining areas, Tower locations can be important because they can be in the landing strip pattern or nearby and hard to see.

 

However in a lot of IMC crashes the non-qualified pilot was able to maintain control but died by flying directly into a mountain, building etc.

IMC pilots are required to identify Lowest Safe Altitude, not for the route on the screen, but for a path 5nm each side of the direct track, so you have to survey 10 nm of mountains x the route from point A to Point B and around each airport.

 

This drawing is from CASR Part 91 General Operating and Flight Rules, Plain English Guide starting at Page 102

 

I was taught to add 500’ to the highest terrain 5NM either side of the planned track as a rule of thumb LSALT. This helps in go / no go decision making if the weather deteriorates. The sole reliance on devices for planning reduces familiarisation with route terrain.

Edited December 26, 2023 by Roundsounds

[facthunter]

I'd prefer to use a bit more than 500', myself.  Allowable errors take 400" of that and you're usiing BARO for reference which is mandatory for separation from other A/C but not ideal for terrain as it's based on ICAO Standard Atmosphere Nev

[skippydiesel]

34 minutes ago, facthunter said:

I'd prefer to use a bit more than 500', myself.  Allowable errors take 400" of that and you're usiing BARO for reference which is mandatory for separation from other A/C but not ideal for terrain as it's based on ICAO Standard Atmosphere Nev

I agree  - 500 ft is way to slim a margine, you can lose that in a downdraft in "a blink of an eye".

[poteroo]

My particular interest here is not with the legalities of this operation, nor whether any pilot, regardless of LL experience, should be stooging around mountainous terrain in a high performance aircraft when the wx prognosis was poor. It is more about how it appears to have been carried out on the day. 

 

The Cessna 182RG was in good order, and everything was serviceable. There was far more fuel onboard than rquired. The CPL /IFR pilot had 12,000 TT, of which all but 1000 was in helicopters. He had 400 in the 182RG. He held LL approval, but only for helicopter. He was current under 90 days rule. 

 

What shocked me, was to read on p46 of the ATSB report, that the average speed of this aircraft was recorded as from 120-140kts. During the latter part of the flight it conducted turns of 35-39 degrees AoB. The ATSB belatedly, on p48,  mentions  'slowing down '  as a suggestion. 

 

Now, I thought it was common knowledge that pilots slowed the aircraft down when forward visibility began to reduce, and especially where LL flight might become a necessity. The POH for this RG182 specifies  full fine pitch, 65KIAS and 20 deg flap for Precautionary Flight - which gives plenty of margin over Vs = 54, or Vso = 50.  Personally, I'd use 70 and 10 if light, perhaps 70 and 20 if faced with any tight turning. Not only does slower flight allow you more time to manoeuvre around obstacles, but you can do it in a smaller radius turn, at a lower AoB, and with less stress.  Everyone also knows that in reduced visibility, refraction of the airborne particles plays a role, and causes the pilot to believe that objects are more distant than they actually are. A bloody good reason to be slower, and more manoeuvreable. 

 

The 182 airframe is excellent for slow flight, (trim the b... thing!), and with positive use of power in 30deg/70kt turns, it is around on the proverbial sixpence. (<500m).  At high cruising speeds, (eg, 120+), a higher AoB, (40-45 deg) is needed, and the turn radius blows out to 3x that needed for 70kts/20deg.  G forces increase, and that does not help pilot wellbeing or thinking ahead.  One of the problems with faster IAS below cloud layers is that just the slightest back pressure can cause a 100-200ft climb straight into the murk - and then you cannot see ahead. It just isn't sensible to be blasting along at 2x your preferred low level operating speed when there is marginal visibility. At 70KIAS, it takes 2.6 mins to cover the 3nm vis that you should have, but at 120KIAS - that reduces to 1.5 mins.  If you can't see 3nm, then you should be turning already. That extra minute could be worth your skin.

 

Now, we're discussing a real accident here, and I hope this post isn't taken as criticism of the pilot. I wasn't there on the day, so I don't know what really happened. But, for those of us flying RAAus aircraft - the principles remain the same. Carry lots of fuel, slow down from 100 to 60 - your aircraft won't fall out of the sky unless you misconfigure or hamhandle it. Keep out of the cloud base, make early turn decisions, and, keep your backdoor open with your entry track  easily regained if needed.