Recommendation

CASA considers that the company procedures and actions of the
crew in this accident to be appropriate. It is universal practice
that crew check for fire outside before deploying slides. This was
not only carried out, but in the case of L3 the crewmember asked a
passenger to check the lower section of the slide before the crew
member initiated evacuation instructions.

Given that there was no control by crew members of passengers
once evacuated, until the crew members themselves evacuated, there
would in fact be nothing to prevent passengers evacuated from a
forward or aft slide entering the landing gear area.

Many operators, both within Australia and internationally,
provide the Pilot in Command (PIC) with two options to facilitate
the rapid removal of passengers, Such options allow the PIC to
consider the degree of urgency required in evacuating passengers
from the aircraft, while accepting that, during an evacuation,
personal injuries may occur in the rapid use of evacuation
slides.

Option one, the 'Precautionary Disembarkation,' provides for a
more orderly rapid evacuation of passengers in situations such as
bomb threats. In these circumstances, passengers are required to be
removed from the aircraft quickly although in a somewhat orderly
way, to minimize risk of personal injury. The Precautionary
Disembarkation also allows the PIC to nominate, if necessary, which
slides/stairs/aerobridge to use, depending upon the specific
situation/emergency.

The second option relates to full scale evacuations whereby all
available doors/escapes slides are to be used with the only
priority being passengers and crew leaving the aircraft as quickly
as possible. This overriding priority has been re-enforced as a
result of numerous aircraft accidents where passengers have
survived the impact, only to be overcome by smoke and fumes.

Further, integral to cabin crew evacuation procedures and
training, is the requirement for each crewmember to conduct an
outdoor inspection of their respective exit prior to opening. This
inspection will determine if there are any hazards, for example
fire/excessive smoke/water or obstructions. Should such a hazard
exist, the exit may remain closed and passengers will be
re-directed to a useable doorlslide.

In this particular accident, assuming the cabin crew at the
over-wing exit followed their procedures as required and checked
outside conditions prior to opening the over-wing doors, they may
well have determined that it was safe to operate these exits and
evacuate passengers down the off-wing slides. Had the gear fire
been more intensive and smoke and/or flames were evident, then the
crew would not have opened these exits, and instead, re-directed
passengers to exits clear of the wings.

The Pilot in Command, once the evacuation order is given, relies
entirely on the judgment of the cabin crew at their specific doors
as to the usability or otherwise of that exit.

Additionally, if the PIC has determined that an evacuation is
necessary, he/she has also concluded that the time available to get
all onboard off the aircraft is the overriding critical factor.

Based on the available information, it would appear that the
procedures and training put in place by the operator is
sufficient.

ATSB Response Status: Closed-Accepted