BOISE, Idaho - A flight nurse who had his head and right arm sucked through the broken window of an air ambulance at 20,000 feet said the hard shell of his headset frame may have saved his life.

Chris Fogg, 41, suffered lacerations on his head that required 13 staples. A chunk of flesh was also ripped from his arm.

But the nurse for Ada-Boi Critical Care, a business owned by his family, said the headset he uses to talk to the pilot during patient transports likely kept him from being knocked out from the original impact when the window exploded. One second he was chatting with the patient and pilot, Fogg said, the next he was hanging out the window, looking backward toward the tail of the plane.

"It (the headset) took the major brunt of the blow going through the window. I think that's what saved me from having severe injuries. If I had been knocked out, I think I would have been pulled completely through," Fogg told The Associated Press on Monday. "I was struggling with every ounce of my being. My left arm was keeping me from going out. I was holding the wall."

Courtesy Photo

Inside of plane where Chris Fogg almost flew out.

The plane, a twin-engine Piper turboprop flown by a pilot from a Boise charter aviation company, was 18 minutes out of Twin Falls on a 2 1/2-hour evening flight to a Seattle hospital last Wednesday. It was climbing to 22,000 feet. Fogg had just reached for water bottles for the patient and the pilot when the window blew out; he hadn't yet fastened his seatbelt.

"I have a vivid image of the tail, and of my headset whacking the fuselage of the plane, because it was still hooked up (inside)," said the resident of Meridian, a suburb of Boise.

Fogg said he struggled to finally break the seal his body had formed against the window frame and pull himself back into the cabin. By then, he was bleeding heavily from the head and arm wounds.

The pilot, from Conyan Aviation in Boise, didn't immediately return phone calls seeking comment.

Fogg said the pilot reacted quickly: When the plane lost cabin pressure, he put it into a steep dive to 10,000 feet, an altitude where Fogg would be able to get enough oxygen to survive. The patient was already breathing oxygen.

"They (pilots) train for this very thing," Fogg said. "When he (the pilot) noticed there was a loss in cabin pressure, he went through the normal procedure."

The plane made an emergency landing about 20 minutes later at the airport in Boise.

A different plane was used to transport the patient to Seattle, about an hour after the first landed, Fogg said, adding the patient is doing fine.

Though Fogg, who has been a flight nurse and EMT since 1983, returned to work the day after the accident, he hasn't flown since. Sleeping has also been difficult.

"Definitely the biggest struggle of my life," he said. "It's better today than it has been. I've had nightmares about my head going though the hole. You know when you fall? It's that kind of dream."

The cause of the window failure was not immediately known. The Federal Aviation Administration is investigating, as is the National Transportation Safety Board.

"(Window failures) are not something we hear of very often," said FAA spokesman Allen Kenitzer, in Renton, Wash. "It is quite rare."