West Mids Air Ambulance going night flying?

[Nige321]

BBC news link here... (http://www.bbc.co.uk/news/uk-england-19697924)

Midlands Air Ambulance wants to buy night helicopter

Staff at the Midlands Air Ambulance have announced plans to buy a helicopter capable of flying a night.

The charity, which has been running a land ambulance for calls received overnight since April, is waiting for approval from the aviation authorities.

Fundraising director Jason Levy said the new helicopter would cost £1.6m a year to run and about £4.5m to buy.

The service runs three helicopters and it is hoped the new one could start operating in September next year.
'Public phenomenal'

The charity covers Gloucestershire, Herefordshire, Shropshire, Staffordshire, Worcestershire and the West Midlands.

Mr Levy said: "We rely heavily on the generous funding from the public who have been phenomenal in recent years - this is our 21st anniversary."

He added the three helicopters they use, which are all leased through current operator Bond Air Services, cost £6m a year to run.

Assistant chief ambulance officer Steve Wheaton said: "There is definitely a demand for a night aircraft as the night car has been called out 388 times since it started running in April."

[[email protected]]

Best they get the CAA to agree to NVG, single pilot ops into field locations then or the night car will still get used a lot.

[Helinut]

The CAA have just published the standards for exactly that.

I gather there will be a number of HEMS going night ops. I believe East Anglia have announced similarly. All the ones I have heard of so far seem to be really operated by Bond.

I wonder to what extent they will operate in built-up Brum at night? I have not got around to reading the CAA bumph yet, so not aware what limits the CAA will impose in terms of congested areas.

http://www.caa.co.uk/docs/33/SafetyDirective2012001.pdf

[[email protected]]

The CAA safety directive is only 2 pages in not very detailed - it makes reference to conducting HEMS using NVIS iaw JAR-OPS 3005.(j) which simply states [(j) Night VFR operations with the aid of
Night Vision Imaging Systems (NVIS) shall only
be conducted in accordance with JAR-OPS 3 and
procedures contained in the Operations Manual
for which a specific approval is required.]


JAR-OPS 3 gives a minimum cloud base of 1200 ft and 2500m min vis for night HEMS and talks about requiring any operating sites to be illuminated (by the helicopter) sufficiently to identify obstacles. It doesn't seem to specify if both pilots (on a 2-pilot crew) or the other crew member (on single pilot ops) both need to be using NVIS and there doesn't appear to be a minimum light level for NVIS ops dictated.

One requirement for night HEMS pilots is that they complete 30 mins IF (either in the aircraft or in a synthetic trainer) in the preceding 6 months - I do hope no operator would stick to such a ridiculously low requirement. IIMC on NVG can be very disorientating so your IF skills need to be polished and 30 mins in 6 months just isn't enough.

Fortunately the majority of HEMs pilots seem to be ex-military so the NVIS skill set will already be there but single pilot NVIS ops is going to be testing.

[Special 25]

Testing indeed - And for what purpose???

Night HEMS is already well established in the US, and the safety record is abysmal.

Here in the UK, 80% of the landmass is within 30 minutes ground ambulance time from a hospital (and lots much closer than that). Areas without short travel time to a hospital tend to be remote hostile terrain such as the Highlands, Snowdonia, Yorkshire Dales etc where single pilot NVG is probably a bad idea anyhow. Leave that sort of thing to the Military.

Hospital transfers perhaps have more merit

[Helinut]

I tend to agree with both of you. I will be holding my breath once the night ops start up (and keeping my fingers crossed). I am not an ex-mil pilot but I have flown night HEMS and CASEVAC with police units. It just stands out a mile as the most hazardous flying I have ever done.

I got the distinct impression that the CAA FOI were very much aware of the risks, and were trying to put it off. I suspect they only moved because Europe said they had to. I recall that one of the FOIs gave a presentation a few months ago, setting out their planned requirements. Can't recall the detail.

The link talks about a risk assessment to be produced by the operator.That might be a difficult document to get accepted by the CAA.

I worry that the charities just think you need to provide (pay for) the extra kit and you turn night into day :rolleyes:

I believe you are right about inter-hospital transfer being a more sensible starting point. That is not HEMS, of course. As the NHS moves to fewer tertiary hospitals with trauma centres covering large areas, there is a REAL value in looking at this. Wales would be a good place to start: big rural area, lousy roads low population density (except for worried sheep). It can only really sustain a very small number of true trauma centres and truck transit times need a calendar rather than a stop watch.

It is the usual problem though: different budgets. I cannot see charities and communities being real happy on having their funds spent on these flights and the NHS is worse than skint. They cannot even afford helipads in many cases.

[[email protected]]

This also raises the issue of co-ordination - some areas of UK have very good relationships between SAR, the ARCCK and Air Ambulances - some do not and it is not unusual to end up with 2 or more air assets going to the same job. That is just about manageable in daylight - although centralised tasking would be the way forward when the ARRCK moves to the MOCC at Fareham - it could be far more dangerous at night.

The night low flying region extends to 2000' in some of the areas the Midlands AA operates in - are they just going to rely on see and avoid or hope that TCAS saves them? They need a way to plug in to the military low flying system or the ability to request a TDA from the ARCCK.

[timex]

Heard on the grapevine it will be 2 pilot Ops, Police do single pilot Ops but with the addition of FLIR and Nitesun for HLS recce's.

[Shaerms]

The Scottish Ambulance Service have been doing night inter hospital transfers since 2001 with two Bond EC 135s based at SECC Glasgow and Inverness.

[Helinut]

Just read a reasonably informative article about what East Anglia are planning, in Waypoint AirMed & Rescue (Iss 40 OCT 2012). Bond are also the operators here. They will be operating single pilot with NVG for pilot and front paramedic. New cabs, presumably with NVG compliant lighting. They are talking of the fitment of specialist avionics and wire detection kit.

Interestingly, the article infers that a significant use WILL be inter-hospital and tertiary transfer. E Anglia will have only one full trauma hospital at Addenbrookes, apparently.

No hills in E Anglia which must be a +.

2 pilot would be great, but with the current crop of types would be difficult to arrange.

Crab, you raise an interesting issue about coordination. You write like it is only a problem for the civi-HEMS interlopers into "military" airspace. Police heles have been operating in that same airspace for many years too. The airspace is mainly open FIR, and not owned by anyone, but it would be good to improve coordination.

In the past I have been involved in trying to get such coordination improved. It is amazing how difficult it is to get some people to cooperate in such things, and I never really understood why. Perhaps one of the few benefits of NPAS will be to aid such coordination.

[jayteeto]

Gone are the days of the majority of HEMS pilots being ex-military, things are changing fast. I am sure the training will be robust enough to set a high standard for single-pilot NVG flying knowing the individuals involved in the set up. The ac will have all the kit needed to operate into fields.
Weather limits are a red herring, they are not a factor. Like any other flying that I do, if the weather is good enough, I go. If it is not good enough, I don't. What's the problem???
In my past RAF life, we were allowed to do NVG flying with a Navigator in the LHS. What difference would it make to have a suitable trained paramedic?
Finally something I agree with comments made here. Continuation Training. There needs to be regular useful training when using NVG into fields.

[Bertie Thruster]

Wonder if the required LHS 'NVG' paramedic will still be a 'pax', not limited by any FTL scheme?

[[email protected]]

Shaerms - as I understand it, this is not about inter-hospital transfers (although that may be a part of it) it is about operating by night as AA do by day ie any field location/road/roundabout/playing field.

Helinut - it is not that I view civi/HEMS/Police as interlopers into mil airspace because that isn't true - but you have to agree that mil FW traffic is a big threat and deconfliction at night is going to be more problematic. The need for deconfliction just within the mil is why there are allocated regions in the UK at night, just to keep mil vs mil apart.

Jayteeto - I can't wait to read the safety case to the CAA that says 'weather limits are a red herring, they are not a factor' - hilarious. Yes you had navs in the LHS but how much training had they had compared to your paramedic? Can't tell you were a Puma pilot;)WIWOP:E

How many of the AA trusts are going to understand the requirement for and cost of constant currency training?

Bertie - very good point - paramedic in the LHS on NVIS giving obstacle clearances/recces into field is hardly pax!

[PANews]

The first fully compliant airframe has been delivered to EAAA [at the recent BGAD show] and training has started.

The Waypoint article jumped the gun a bit so some of the detail is slightly off the mark [they did not have a document to work from simply because it did not exist until after they published] but it is minor.

There are now three AA declared for Night HEMS, two have ordered [EAAA and Midlands] the third [North West] declared today. BASL were miffed when AA's went off buying their own, thereby cutting them out of the 'lotsa money' lease frame but the new model with Night HEMS appears to be about keeping them in the fold even when the ownership goes to the charity.

I would guess [no more] that having BASL as 'Night HEMS central' will offer significant savings in training costs to those AA's going this way. Placing the onus on BASL to provide the Night HEMS capable pilot will probably reduce the required number of such pilots. The unknown question though will be the left hand seat Paramedic as he will certainly be of the specific AA.

Early days.

[MightyGem]

The night low flying region extends to 2000' in some of the areas the Midlands AA operates in - are they just going to rely on see and avoid or hope that TCAS saves them? They need a way to plug in to the military low flying system or the ability to request a TDA from the ARCCK.
How active is the fixed wing night low flying region these days? Given that when I was serving, the rotary region was south of a line that(approx) ran East/West just to north of London.

It's not been too much of a concern while 99% of our flying was in the Liverpool CTR, but we are now operating all over Cheshire and a lot of North Wales.

I've not seen any signs of LL fast movers yet. Are they still about?

[Shaerms]

Crab. I was only stating that SAS have done the night inter Hosp stuff for a while now. Sas are Scot Gov funded for 2x ec135 along with 2 fixed wing King Air. As far as I am concerned this is as far as any Ambulance service should go at present. NVG training and its currency upkeep would require a lot of initial training and flying hours, most likely coming out of a charity budget. It would also require either a spare aircraft or for one to do training on shift for this.

[Vie sans frontieres]

When under pressure to achieve a task, whether self-induced or applied externally, there's always a danger that the limits will get pushed. With only one genuine aircrew member on board there's nobody of sufficient standing to act as a voice of reason and question whether the HEMS pilot should actually be attempting a transit, approach or landing. Multiply the risk factor by about five for NVG operations. Jayteeto asked what's the difference between a navigator and a paramedic in the LHS. I do hope that was a fishing trip.

[[email protected]]

Mighty Gem - the North-South divide is still pretty much the same but the areas are allocated to those that want them so that RW can fly in the northern areas (if you book far enough ahead). I'll try and find out what the usage figures are for you.

What is actually required is a system like CADS which is used by Middle Wallop, Odiham and Benson where your planned route is plotted on a computer which then allows deconfliction by the various OC nights of those units.

A centralised co-ordination centre (the new ARRC) would then be able to tell you who was where and have visibility of both mil and civ traffic, if necessary establishing a TDA (as the ARRCK do now for many SAROPs) to give you protection.

Shaerms - I know things are different in Scotland for AAs, is there still centralised tasking or has that disappeared in turf wars?

[SASless]

Single Pilot NVG EMS flying has been going on in the United States and other places for years. You reckon a few questions to those that have been doing it for some time might be in order or do NVG's and Helicopter flying at night in the UK have its own unique factors that negate any experience base the experienced operators have developed?

[Vie sans frontieres]

Refer to post 5

Night HEMS is already well established in the US, and the safety record is abysmal.

[jayteeto]

Crab, what is your beef with weather limits. I don't understand why you think it is hilarious?????? What safety case are you on about?

They will give us limits, we will use them, no problem. Who cares if it is 1200'?? If it below limits, don't fly. :confused: If needed, do what we do by day, either don't fly, go instruments or in extreme, land.

[[email protected]]

I don't have a beef with weather limits though your post suggested you did.

As far as I am aware, in order to get an AOC you need to persuade the CAA you are fit and proper to hold it and that will include a safety case to evidence the integrity of your proposed operations. I would suggest that somewhere in there will be a mention of weather limits and minimum light levels that you intend to operate to.

If all pilots were capable of making the right weather decision every time we wouldn't have weather-related accidents.

Anyway, aren't you out of a job if the Liverpool ASU closes?

[Bap70]

I'm sticking my neck out a bit here, but I think several of the posters on this thread are being a bit unfair in their assumptions of the skill set of some (I can't speak for all) H.E.M.S paramedics. Vie sans frontieres comment of "one genuine aircrew member" is a case in point. Whilst I am in know way alluding that H.E.M.S crewmembers/paramedics have the level of training of military navigators, many have years of left seat experience and thousands of H.E.M.S missions into un surveyed sites (albeit daytime) under their belt. Whilst I am personally still undecided on the wisdom of UK Night H.E.M.S, I think we should wait to find out more about the level of NVG initial & continuation training before completely discounting the idea.

[Helinut]

Bap,

I understand what you are saying and to an extent agree with you. However, I am not sure that the appropriate "risk management strategy" is to count the bodies to assess whether we have it right.

Adequate continuation training and currency is such a key factor and one that is difficult to achieve and sustain in a commercial organisation (or one that gets its funding from charitable sources).

It can be done. I believe that the arrangements for the CG-SAR contract has an agreed substantial monthly flying training budget. It seems to me that the only way this can happen is if the aviation provider convinces the person who holds the purse strings that it is essential. Perhaps the CAA could or will exert pressure too?

[SASless]

Is it the NVG Flight Safety record that is abysmal or the Non-NVG Safety Record? You might want to check your facts before you make a blanket statement as you did.

That the US HEMES safety record is bad is not in dispute.....but doing a "Lessons Learned" exercise might be worth while to determine if the fielding of NVG's has made a real difference or not.

Also....the factors that play into the horrible safety record are worth looking at with a view towards not re-inventing the wheel British Style.....far better you avoid the pitfalls by looking elsewhere in the World to see how they have done it both good and bad.

You are starting from Square One or Twop in this process while others are well beyond that in the implementation of Night EMS and NVG civil flying.

Mistakes result in fatalities in this business. Why try to make your own when you can learn from others.....even if it is only "Let's not do it that way!". If you think holding a UK/JAR/EASA (...or whatever it is called this week) ATPL, being blessed by the CAA, and having come up with your own way of doing things makes you bullet proof.....you are in for a rude shock. This is not offshore flying over known routes and destinations with decent weather reporting and forecasting. Local conditions and the irregularity of EMS operations at night make it an all togehter different kettle of fish.

No matter how good the other Front seater is....unless he is a rated pilot, current and proficient, in actuality and not just on paper, they cannot fly the machine if needed to. Sure they can tune radios, look for traffic, obstacles, and perhaps even read a map, but having real Pilot skills can be a blessing.



JT.....


They will give us limits, we will use them, no problem. Who cares if it is 1200'?? If it below limits, don't fly. If needed, do what we do by day, either don't fly, go instruments or in extreme, land.


The rub is when the weather is close to the limits....not when it is good or below limits. Weather forecasting and more importantly....interpertation of the weather becomes critical.

Add the lack of visual acuity at night....none of us are Owls....and the risk of IIMC becomes all too real. Again.....look Westwards while discussing these issues as there is great food for thought over here.

[Vie sans frontieres]

I don't have the numbers in front of me but I think the UK HEMS accident rate is mercifully low, especially when compared to that of the USA. Do you think that there might be a connection between that low accident rate and the lack of night flying? If it ain't broke, don't fix it.

If, as Jayteeto says, the numbers of ex-military pilots flying HEMS in the UK is much lower than the past, the risk involved by introducing NVGs into the mix is magnified further. For all the veteran pilots with 500+ hours on NVGs or, as Bap70 described, paramedics with thousands of missions behind them, there'll be just as many who are just finding their feet and feeling pressured to get the job done because the other guys do. Do you think the tasking authority or the management or the fundraisers or the public or the media will know which ones are on duty on any given day? Will they hell.

Do yourselves a favour and stick to daylight. Bats and prats and all that.

[[email protected]]

Just think of how many extra land ambulances, paramedics and doctors the £4.5 million purchase cost and the £1.6 million running costs could provide:)

[homonculus]

Helinut has mentioned the important word - 'essential'.

Primary HEMS in the UK has been shown to prevent death in only one situation - the severe isolated head injury where the aircraft carries a doctor that can anaesthetise the patient. The cost per life saved exceeds heart transplantation but the life is saved.

Leaving aside the use of HEMS to achieve government delivery targets, the other major benefit is to reduce transport times in the injured. If I fell off my horse in an isolated area and had a fracture and it was cold I would welcome the sight of a helicopter. It will lessen my suffering but it wont save my life.

The number of such situations at night is very low. Most trauma at night in the UK is from road traffic accidents and either land ambulances can arrive rapidly or the patient is entrapped so transportation is delayed.

At a time when the Kings Fund has just said the required £20 billion in healthcare savings cant be achieved, introducing night HEMS for the odd head injury is balmy.

Interhospital night transfers are different - we set up a national service in 1987, but the reality is that such transfers have become much less common in England and Wales with the exception of neonates who have a perfectly acceptable land based system for their clinical needs.

[Bertie Thruster]

It is very difficult to objectively quantify the use of a helicopter but I have witnessed 3 successful resuscitations where the HEMS crew (2 paramedics by the way) were first on the scene by at least 30 minutes. Obviously not 'double blind scientific proof' but those 3 dead people were happy later.

People in the UK are happy to put their hands in their pockets to fund HEMS operations. They like air ambulances. Thats why there are 18 UK charities funding 25 helicopters. It's what the people want, whether you like it or not!

[JB-123]

Please don't feed the troll

[jayteeto]

Liverpool ASU closed yonks ago. I am one of Bonds finest now (nearly 3 yrs). The company are trying to do this properly and professionally. They are using experienced personnel who are familiar with single pilot NVG and are fitting the cockpits out (unlike the Mil bodges) with compatible kit. I hope our charity want to join in with this, although I quite like permanent dayshifts!
As for pilots making sensible weather decisions, there goes the history of aviation.
As for saying how many more doctors and ambulances the money could buy? The answer is absolutely ZERO. If the politicians had this money it would be soaked up in red tape. We Dont just save lives Homon, we get people to hospital quickly, this can improve outcomes and recovery times. The current success is in getting cardiac patients from remote areas for PPCI treatment as quickly as possible. Often over an hour quicker than by road. The people putting money in the tins like that......

[John Eacott]

It should also be worth looking at Australian HEMS, which (on the Eastern Seaboard) are almost exclusively Single Pilot, night, IFR and NVG with a qualified crewman in the LHS. Accident free to date (exclude those single engine/single pilot/NVFR of many years ago) the operators have matured a professional and competent set of standards that have proven the concept.

In Victoria (5 x HEMS) the qualified crewman is also expected to assist the Paramedic, so for the departure and Med 1 to hospital it is truly single pilot. Most are also Government funded contracts as part of the Healthcare budget for each State. With the greater distances required to be flown the majority of machines are 412s or AW139s.

[Turkeyslapper]

Just to add to the above comments...our operation in Oz utilises the crewman in the front left most of the time rather than being used as a paras helper (they have a doctor for that:E)...the crewman is trained to act as a "non flying co pilot/ mission coordinator) so I guess its a "multi Crew" operation as opposed to single pilot as such. I believe CASA also stipulates NVG training and qualification requirements for such crewmembers (stand to be corrected though).

Exception to that would be for winch operations where he is in the cabin....looking forward to the comments on that:ok:

Cheers

[Vie sans frontieres]

Like a Wessex navigator then. That wheel just keeps on turning! :ok:

[M609]

t should also be worth looking at Australian HEMS, which (on the Eastern Seaboard) are almost exclusively Single Pilot, night, IFR and NVG with a qualified crewman in the LHS. Accident free to date (exclude those single engine/single pilot/NVFR of many years ago) the operators have matured a professional and competent set of standards that have proven the concept.

Same story in Norway as well as far as I know. They have used NVG since 2002 (-ish) with zero incidents so far. The network of GNSS/RNAV approaches to the hospital helipads are quite impressive as well IMHO. (I think they matter, given the distances we have between hospitals over here.)

[homonculus]

Valid point about being a freebie Jayteeto but not quite accurate. The DoH funded 42 whole time posts at the London for HEMS. Most charities rely on NHS or other taxpayers money for pads, fire support, etc etc. I think the current situation with primary helicopters has worked out well with minimal money being diverted from the NHS even though your comments about outcome are not true.

My point is that there is really little benefit from going to night time operations. There will be some additional costs to the NHS. Agreed helicopters are sexy so the charities will get money in tins but the evidence is this costs other charities. I come at this purely as a doctor aware the UK has a poor standard of healthcare relying increasingly on charity for research and innovation. I don't want to rob Peter to pay Paul

[MightyGem]

Thanks Crab.

where your planned route is plotted on a computer

We don't have any planned routes, we go where we have to.

[[email protected]]

Hmmm, qualified crewman in the LHS Vs paramedic shown how to use NVG - I know which model I would choose but what qualification/licence is there under CAA/EASA regs for that position?

As Vie points out - the single pilot element of night ops isn't new - it's who is in the LHS that is important.

Lots of rural areas are difficult enough to find LSs in by day - for more so by night and actually the same is probably true of urban areas.

Mighty Gem - my point was that with central coordination, your taskers would know where you were going and input that to the system which would then (in a perfect world) highlight any other conflicting activities.

Jayteeto - you didn't get the drift of my smilie ref costs then.

[jayteeto]

Ahhhhhhh! A bit slow.....

[onesquaremetre]

Officials look for answers in Iowa helicopter crash (http://qctimes.com/news/local/officials-look-for-answers-in-iowa-helicopter-crash/article_55961c44-5660-11e2-8084-0019bb2963f4.html)

The helicopter was equipped with the latest in helicopter EMS technology, including night vision goggles, a terrain warning system and a satellite tracking system

Someone please tell me that those responsible for the introduction of night HEMS in the UK are taking a close look at the statistics coming out of the United States. I'm not pre-judging the outcome of the investigation into this crash in Iowa but the accident rate is grim beyond words.

[jimf671]

I am not against NVG ops for air ambulances and indeed I applaud the work of our friend at Luftambulansetjenesten in Norway and also look forward to SAS Air Wing getting EC145T2 with NVG in 2014. No, the problem with NVG ops for air ambulances is when the charitable income of the organisations paying for these aircraft rely on them showing off.

[ShyTorque]

I've flown and taught military NVG operations. We never flew single crew on NVG, even in stabilised aircraft. The reasons are, or should be, obvious to any experienced helicopter pilot.

[Regain]

I'm more of a lurker on here these days but couldn't let that one pass. Which military? Not the Army then. Gazelle, no SAS, single crew NVG. NI, Bosnia, other places.

[onesquaremetre]

Regain

Don't say that too loud, you'll give people ideas. You were in a disciplined environment where everyone was subject to exacting selection, initial training, examinations, continuation training and standardisation. Is every HEMS pilot?

[jayteeto]

The RAF DID do single pilot NVG. When a navigator sat in the front.
A suitably trained paramedic could pass the information required to the pilot. The most important thing is the quality of the training, ie dont be tight and make sure you give quality continuation training. I have a shedload of NVG instructional time, some hems pilots are not ex-military and are short of night flying time. They will need a quality training course and careful supervision, however it is a goer!

[ShyTorque]

The RAF DID do single pilot NVG. When a navigator sat in the front.

NAVIGATORS....in the front? That gives away your youth, JT.

Now, back in my day, they made us strap things to our heads that looked like NVGs but they were just a box with two toilet roll tubes with green lenses on the end.

Seriously though, the major concern about NVGs is that proper training, a properly compatible aircraft and suitable SOPs are needed and they are definitely not a "strap on and press on VFR in any weather" solution that some seem to think they are. The ground always has a 100% win rate in any scrum with a helicopter.

[SilsoeSid]

Gazelle, no SAS, single crew NVG. NI, Bosnia, other places.

That may well be so Regain but not to unrecce'd, unlit, ad hoc landing sites! ;)
In addition to onesquartemetre's post, a minimum of Master Green IR, Above Average standards checks and with time to brief and plan with a good map appreciation for things like wires, masts and obstacles. Not to mention properly fitted helmets, a good on base servicing backup and currencies to maintain.

Throw in the age of the average air ambulance pilot and factor in the probable use of spectacles and it all starts to add up. http://www.ramcjournal.com/2000/feb00/manton.pdf

Further on the matter here http://www.pprune.org/rotorheads/197551-night-vision-goggles-nvg-discussions-merged-31.html and the question has to be asked, if Police units equipped with NVG still have to have the camera and Nitesun requirements for ad hoc landings at night, how does a 'cash tight' air ambulance without that kit maximise safety in order achieve the aim?

I do wonder why air ambulances are so desperate to operate at night, when to have to have an extra crew on standby covering 24 hours will add quite an extra expenditure, or is it just to extend slightly into the evening periods of darkness and still leave any later evening and early hour jobs to the rozzers?

http://www.pprune.org/rotorheads/477047-hems-europe.html, latest replies to thread suggest NVG only to prepared sites.


Be good to hear the CAA's side of the discussion.

[onesquaremetre]

Jayteeto, is it being pushed by the publicity men, the management and administrators, the trustees, the aircrew or the donating public? How many of those groups are fully appreciative of the depth to which the donating public are going to have to dig to make safe night HEMS in your area a reality?

[[email protected]]

Sid, from your linked paper, it seems sad that the AAC at Middle Wallop have not managed to procure at least one Hoffman box for setting up NVG. Each of our SAR flights has one and (although I have to nag people a lot) they do get used. Once a pilot knows how to set the goggles up properly they generally have far fewer issues with re-focussing or fatigue.

[SilsoeSid]

No surprises there then!
Interestingly though, "The main reason for readjusting the goggles was that the flying helmet had moved,"
Doesn't this bring to our attention that even with the squippers being readily available at a military base, these problems are going to be there regardless of the focusing kit that the air ambulances decide to purchase.
I even use to get a refit after I had my haircut.

[jayteeto]

Nobody in our area is 'pushing'. Remember this while you discuss. If a landing site is outside limits by day, we land elsewhere. By night will be the same, pilots should only land when they are comfortable. We all know the need to set up kit correctly. Personally, if my helmet needs a refit, I would not operate until it was done. Everyone here is assuming that facilities will be crap, why? No likee, no flyee.

Its called Captaincy!

[onesquaremetre]

No likee, no flyee. Its called Captaincy!

It certainly is. If only everyone was immune to external pressures that affect their decisions. See accompanying threads on EMS crashes for details.

[Thomas coupling]

I've been out of police/hems ops for 5 yrs now so a bit rusty:{
Presumably JAR 300.5d is still the main ref for hems?
Presumably there is still a perceived difference w.r.t. rules between a HEMS responding helo and an air ambulance?? I can fully appreciate why the latter takes a lot of pressure off the CAA w.r.t. safety/crew concept/nvd etc.

It's a shame the Scottish model isn't extrapolated into the rest of the UK. The CAA must be very very close to carpet authorising of night AA now - no???

With modern cockpit configured a/c, modern Gen IV goggs, good CRM and a seasoned paramedic, I don't see why the CAA shouldn't give a night ticket to single pilot ops for AA.

HEMS may need tweaking though??

[I saw an earlier post about the accident in the US re NVD etc. The OP queried taking a closer look. The answer to their accident rate has been thrashed out several times and the culprit there is: press - on - itis. No issues with single pilot ops/equipment, I would suggest. Totally different mentality over there (the yanks have their work cut out for sure resolving company pressures to launch in bad weather).

The UK is years behind w.r.t. Night ops/NVD full stop - not just ambulance work. Look at all the other countries that already dabble with it.

My ten penneth worth: The CAA don't have enough bods on seats to process these applications fast enough:ugh:
Together with E Mids, we introduced new gen (not old gen Bolkow117 nvg) NVD into police ops in 2000 (ish). 12+ years on and still no night ambulance NVG.

If anyone can crack this, BASL can.:ok:

[Al-bert]

NAVIGATORS....in the front? That gives away your youth, JT.

Now, back in my day, they made us strap things to our heads that looked like NVGs but they were just a box with two toilet roll tubes with green lenses on the end.


Ah, they were PNG ShyT, I remember them well from NI circa '76 but I was also flying single pilot NVG with a Nav 'up the front' in '97. Training, crew coop, local knowledge (it helped enormously) and properly compatible lighting worked well. :ok:

[ShyTorque]

PNG they were. Our Sqn SOP was always two pilots though.

The later ANVIS goggles are much better, of course, especially when coupled with an (essential, in my opinion) IR searchlight.

But preferably single pilot only for "nav assist" i.e. in transit and not for ad-hoc landings when wires are potential hidden killers.

[topendtorque]

I even use to get a refit after I had my haircut.Been a while since then has it Sid?

[jayteeto]

the UK is not the USA. I am aware of history, Bond captains are encouraged to be captains. I have been always been supported by management when I have made captaincy decisions. As long as they are justifiable, safety comes before commercial. I have no desire to night fly again, but am confident it will be safe, even single pilot.

[Al-bert]

especially when coupled with an (essential, in my opinion) IR searchlight.


IR Searchlight.....why, we could only DREAM of such things! You were lucky!
Mind you, even scarier than single pilot NVG (ANVIS) was the original SOP when they gave the goggles (one pair per aircraft only) to the nav and he was supposed to talk the pilot to the casualty (SAR). Try that round the back of Lochnagar with cloud on't tops! :eek:

[SASless]

If only everyone was immune to external pressures that affect their decisions

Actually those are the easier ones to ward off as they are "external" and easy to see and avoid.

It is the "Internal" pressures that get most folks as they are not observable and thus all the harder to see and avoid.

Combine the two....and that is where Mayhem is introduced into the HEMS/Air Ambulance business.

Now a for what it is worth......just what is it that makes the UK and US so different on this business of single pilot night NVG HEMS/Air Ambulance flying thing? Why are you folks going to be so much more successful at it? Certainly your weather reporting is much less effective than ours, your Airports are usually closed for use at night, and your accident stats for other operations compared to ours are not much different.

I see a disaster coming or am I wrong here?

[Thomas coupling]

SASless: Are you serious? Presumably you are talking from an American viewpoint?
If that is the case: Where have you been these last 10yrs+.

US EMS is endemic with press on itis. Everyone knows that and it has been debated time and again on this forum.

You've already read this:

http://www.ntsb.gov/doclib/reports/2011/AAR1104.pdf

C'mon - you're having a laugh, aren't you?:ugh:

[SASless]

TC....is there something in the British blood....DNA or something that makes ya'll see better in the dark or something?

Yes....our Helicopter EMS industry has a terrible record....not one person denies that.....and I am one of those who have been saying so from the very early days of the business.

What I am asking you guys and ladies to do....is explain to me in detail....how you are going to do the same tasking....without making the mistakes we have...and in too many cases continue to make.

Charity or not....you have to justify your existence or you will be gone.

That comes in the way of "flights done", "patients carried", "dispatch rate", or some such method of measurement. That means you have a "need" to get out and fly. You may deny it....but it is there.

What is it about the UK system.....IFR route structure, localized weather reporting, aviation infrastructure, CAA Policies, the Law....Pilot Training....that is going to make your way superior to the US way.

Those are the questions and yes....they are very serious....and deserve a serious answer. If you cannot....guess what the result is going to be?

You seem very certain you guys have it "right" and we have it "all wrong"....so please lay it out for us over here in the USA.....show us the path to redemption will you?

C'mon - you're having a laugh, aren't you?


Nope....this is a deadly serious conversation....as I don't think you lot will be as safe as you think you will....and fly.

[Thomas coupling]

SASless.

Ooops, you really are not clued up here, are you. Your "US" model (the one which has been debated by both you and your country folk, time and time again) which is riddled with crashes - stems from ONE main cause. ONE which stands out head and shoulders above all other causes of crashes for night EMS: Corporate pressure.
Corporate pressure to make the patient KPI's / pressure to make a profit / dispatch rates and so on.
The knock on effect invites poorly specified helicopters, single pilot ops, low experience pilots.
The ultimate cause, fairly and squarely in the cross wires is the pressure to force a low timer, airborne in marginal weather, in non stabilised, single engined aircraft similar to the one taht stoofed in IOWA on the 3rd. If ever there was a crash that pulled together all the reasons for the EMS industry in the USA to suck: This was it:ugh:

And guess what, SASless - in answer to your question as to why we won't go the same way in the UK - we have a totally different mindset to HEMS/AA. I would wager a years salary that the press on itis, a lot of your EMS crews experience, simply won't happen here.
The pilots (often there are 2) are high timers. The aircraft are twin engined (and NO, I am not comparing single Vs twin - but twins tend to come with all the bells and whistles associated with expensive multi engined helos), there are no dispatch competitions and above all, the aircraft aren't ambulance chasers where they get paid for every patient they rescue/save. They are charities, the pressure changes.
In addition, the CAA regulate a lot closer to the coal face than the FAA does. They run a very tight ship over here, not much seeps between the cracks. In the US, I suspect in the land of the free, you are free to do mainly what you like within reason - no? How often do these EMS outfits get audited?

The "US" model - thankfully, remains a US model (not just u/s). It stays over on your side of the pond, bud:ok:

[SASless]

Out of all that.....you have said "Profit is not the driver" and "the CAA is stricter (or words to that effect)".

Now tell me about the weather reporting, access to Airports after hours, IFR Route Structure, Radar Approach Controls, and other aviation infrastructure that is different and more useful to you than our system in the USA.

You have to fly somewhere, by some means, under someone's control, and be granted Clearances to fly and land.

Tell me about that.

Oh....and I am certainly not wishing our system upon you.....I just don't want to see you make the same mistakes we have and do here.

[vortexadminman]

Wot he said!!! Thomas that is. But no we dont need permission to fly or land ( providing not in controlled airspace, and we stick to rules about landing sites):O

[jayteeto]

we have enough airports, we are not under commercial pressure.
Sasless, let's not be UK arrogant, we MIGHT have a pressonitis accident here. I am saying it would not be because of the scandalous commercial pressure over there. The conditions for night AA are much more favourable, the weather is less extreme, as is the terrain. met forecasts are not that bad!
the UK is not utopia, but I genuinely believe we should give nvg a try, closely monitored, followed by a review by the CAA.

[Bladecrack]

You have to fly somewhere, by some means, under someone's control, and be granted Clearances to fly and land.

SASless - I flew HEMS on Xmas day in the UK, in a rural region with limited wx info, controlled airspace inactive, all airports closed, no ATC, fuel available at home base or other regional AA units only. Whats new? Thats pretty similar to most weekends here really where we are on our own while on a mission with the exception of Amb control who I wouldn't rely on for any help. The unit I work at have been operating for over 10 years accident free. That says something don't you agree?

I agree totally with what Jayteeto says, we have different attitudes, training, equipment, and environment to the US, we just make the best of what we have. No disrespect to US EMS pilots intended, I am sure they do their best under difficult conditions.

BC

[SASless]

Blade.....how do you conduct an instrument flight with those factors at play?

Here we have to have a weather report and forecast for the route of flight, takeoff point and destination, an IFR Clearance, a filed flight plan, and the ability to talk with ATC while inflight. Add in flight following requirements and all of a sudden it gets a bit complicated.

How about in the UK....can you operate IFR in the situation you described?

Can you fly IMC without an ATC Clearance and Traffic Separation?

At what height does controlled airspace begin where you fly....when the area is below VFR Minimums?

What Instrument approaches are available and what approaches are you authorized to perform and to what minima?

Is all Night flight conducted under IFR?

What fuel reserves do you have to maintain for a Night Flight?

If you go IIMC...what is your SOP....Alternates....Alternate Weather Minimums?

[Helinut]

SASless,

I think there are some big differences which will help to reduce the chance of problems in the UK:

It will be small scale(we barely do any helicoper flying here, except offshore). As far as HEMS goes, it seems that at present only 1 HEMS operator and 2 HEMS trusts have advanced plans to go night.

It will stop around midnight: no 24/7 ops

The CAA don't really want it at all. (It is just that they no longer have policy control). They will make it as difficult as possible.

Our HEMS heles operate in tiny areas, which make a number of risk factors easier to manage.

There actually is not much pressure (or need) to use heles at night. So the pressure to go or "press-on" is reduced. Just call a truck and the casualty will be in a hospital a few 10s of minutes behind a HEMS ETA. Not worth taking much risk at all, for that benefit.
[There really is not much demand for carting patients/casualties around at night in a hele in the UK. We do virtually no inter-hospital transfers at night, even though they have been legally possible for years, prior to these new rules: Such UK flights are NOT defined HEMS: unlike I believe in the US].

Mind you, time will tell. We have made our own mistakes in the past (don't tell TC I said that). Having fixed things we tend to forget them. [Strathclyde Police EC135 IIMC x 3 + crash: BASL]. We probably act a bit quicker to fix stuff than the US HEMS industry has in the past, which must be in our favour.

[M609]

NLA in Norway had a couple of nasty "VFR" night accidents (fatal, sh*t wx) in the late 80s, early 90s. (Believe last one was 91)

BO-105, single pilot, no NVG, no practical way of doing IFR.

That to me as an outsider is a more similar operation to the US way of doing things (outlined in topics here on pprune) than the HEMS operation they do now in 2012.

H24, NVG, coupled auto pilot, some kind of "TCAS-light", dedicated IFR route structure in parts of the country, GNSS approaches - not the same thing.


It´s all about funding right?

There are believe it or not (for you US readers), some upsides to "socialist healthcare systems", in that no one has to make a profit. I´m sure the HEMS service in Norway is extremely expensive, both the helos and the fixed wing side, but they DO get the job done, and in some rather nasty wx/terrain/dark places.

I see no reason that the UK should not manage to get a safe night time operation, even if the wx is dodgy most of the time. (Would be nice to visit the UK once without it raining...... ;) )

[Bladecrack]

SASLess - to clarify, by HEMS I mean an unplanned urgent tasking requiring an immediate departure, (under VFR) as opposed to a pre-planned Air Ambulance tasking which may be VFR or IFR.

Helinut - I disagree with several of your points, there are more than 2 trusts planning to start night ops in the UK. During his last visit, our CAA ops inspector talked at length about future night ops and how it would work, was generally very positive, and seemed very happy with the operator's proposed plans for crew training etc.

We operate in a large rural area, small by US standards, but one of the largest regions in the UK, meaning emergency resources are very stretched at times. From scene to the nearest hospital can easily be over an hour by road, so by air will make a substantial time difference. The demand for inter-hospital transfers, both day and night will soon increase as smaller hospitals close and services are centralised to major trauma centres. This is one of the main driving factors behind the plans for UK night ops.

[[email protected]]

Helinut - you might not do many hospital transfers at night but we do - because you guys aren't available at night. The SARF completes a great many medtransfers at the request of the NHS.

Sasless - you can fly quadrantal FLs IMC above 3000' in UK (with some exceptions) in class G airspace and most airfields with an ILS will either be open or you can use their approach aids out of hours because they don't usually get turned off. You might only get a basic service or traffic service using SSR but apart from the climbout and descent, the quadrantals provide vertical separation.

There is often no-one to talk to in the wee small hours in UK at helicopter altitudes but IFR can be done quite safely. Most large airports stay open, even if the first radio call wakes up the only controller on duty;)

[SASless]

Thank you Crab....you reminded me of what I seemed to recall. In the UK...the sidewalks get pulled up after Sunset when it comes to aviation pretty much.

On the "closed" airports....do you have pilot controlled lighting and approach aids so that a Pilot can key his VHF radio and turn on the runway lights and such?

How does one know which Approach Nav Aids are active after the Airport is closed?

Now I do grasp the Class G Airspace thing.....and flying Quandrantals...but I submit to you and others....that is neither "Controlled" or "IFR"......it is IMC and Un-Controlled IMC.

I will grant you also that 3000 feet in most parts of the UK will see you clear of terrain as well.

Somehow....I see flying IMC in Uncontrolled Airspace, with no "Clearance" (organized traffic separation), no contact with ATC, and showing up at Airports that may or may not have Lights or Approach aids working and not having anyway to ascertain what the existing weather is at those places, to be something Commercial Operators might want to shy away from.

Am I right in thinking this might be a recipe for problems?

Along with the lack of "Profit Motive" by the HEMES/AA operators and pilots....it would appear the UK method of funding Aviation Infrastructure needs looking at as well.

How many AWOS systems are there in the UK?

Who pays for installing them....and do the owners charge Operators/Pilots for using them?

Where do you get your weather reporting from after hours?

[Helinut]

My experience of ILSs ooh is that the mil leave them on (informally and helpfully), and civi airfields turn them off (elf & safety and legal liability). I am sure that there will be exceptions to those generalisations. [Based on lots of police night flying in most parts of the UK]

It may be permissible (under mil rules) to use ILSs for SAR left on but unmonitored, without ATC, traffic and weather information. Not at all sure that would satisfy EASA Ops. JAA/EASA OPS3 does NOT consider hospital transfer as anything other than normal pax transport. Full AOC/CAT standards.

Crab - re: the use of SAR heles, I am sure you are right, (I know you are right) but that just strengthens my point. Why would HEMS cabs be used at cost to the charities, if you are providing the service already at no cost to the NHS? Little incentive to take on a service already provided by someone else. Sure this area may grow, but not this decade.

[SASless]

Crab,

Military rules are far different than Civvie Rules.

Using Navaids, approach aids after closing hours won't pass muster with the CAA I fear.

Thus, in planning a night flight with any kind of questionable weather would mean having a legal IFR destination and Alternate....that meet the requirements legally.

How does a Civvie Operator get around that small obstacle?

If you go IIMC....you do need a way to find a cup of Tea!

[TeeS]

Helinut

Please don't continue to spread the still widely quoted view that: JAA/EASA OPS3 does NOT consider hospital transfer as anything other than normal pax transport. Full AOC/CAT standards. Neither JAR or EASA mentions anything about where the patient is going from/to - the HEMS decision is based purely on medical requirements.

Back when Hippocrates was in medical school, inter-hospital transfers were treated differently to 'primary missions' but that went out of the door with the introduction of JAR.

Cheers

TeeS

[jayteeto]

some places have limited night air traffic control, others have tons of it. London info is open if you need to talk. our area has two international airports open 24/7 with another couple nearby. IF we got caught out weather, we would be ok. NVG would be possible in our area. If the weather is below limits by day, we don't fly, why does night change that. We don't do IFR hems generally.

[SASless]

Neither does the American System (using the UK definition of HEMES.....what we would call "Scene Flights"). It is the inadvertent IMC Ops that VFR crews experience that seem to be the real issue.

Off thread someone suggested he felt the US EMS Accident rate was not all that bad as a rate.....considering the sheer number of flights being performed.

That may be.....but we seem to be able to replicate the causes for fatal accidents with great frequency.

In a perfect world there would be no accidents as we could prevent them all....but then this is not a perfect world by any means.

I would prefer the Industry embrace change....cease killing folks the same old way over and over....and find new ways to do that. At least we could be seen as being innovative instead boringly repetitious.

[homonculus]

Great set of posts. I agree the UK should be able to operate at night to a higher safety record than in the US

But

Why?

The vast majority of night primary HEMS will be trauma. Night trauma is different aetiologically to day trauma. RTAs with seriously injured ocupants more commonly involve remote areas and entrapment but are in the main covered by prehospital care doctors. The Sheffied audit on the London HEMS showed the only real benefit was the delivery of doctors on scene but we already do that at night. Although we often struggle logistically to deliver enough emergency crew to the scene initially that is not the same as struggling to have adequate vehicles to transfer. Indeed my main issue on scene is utilising my ambulance crews, fire support and police and I regret to say dealing with a helicopter would more often be a burden than a benefit.

Against this dubious need is my concern that night HEMS will be a higher risk than day HEMS whatever rules apply. The significant increase in costs will have to be raised from charities what only okay we're reporting to the prime minister that they were struggling.

However pro rotary we are, I do believe there are better uses for limited funds than night HEMS. But that is just a trauma doctor's view

[jayteeto]

Agreed 100%

[Al-bert]

Helinut said Crab - re: the use of SAR heles, I am sure you are right, (I know you are right) but that just strengthens my point. Why would HEMS cabs be used at cost to the charities, if you are providing the service already at no cost to the NHS? Little incentive to take on a service already provided by someone else. Sure this area may grow, but not this decade.

Before I finally 'touched down for good' in '99, night medevacs were on the increase. Something about reduced hospital beds, reduced ambulance services etc etc. My last few shifts saw me flying to Newcastle twice and London a couple of times, call outs usually came just after midnight. Because of weather (icing all levels and cloud base mostly below 300ft) a trip from Valley to London was flown at 200ft on NVG down the Irish sea and up the Bristol Channel before I was able to climb to a sensible altitude (both Severn bridges went above us). Worst thing was we had to return the same way (total 6hrs flying) because we had the only transplant surgeon and specialist nurse with us from Bangor. Medevacs were charged for at, I believe, £4500 per hour; medevacs, or rather Hospital Transfers, were the only ops that were charged for. :hmm:

ps. before the wise words of safety, captaincy, risk factors head my way I did initially refuse the task. I was, in the end, only obeying orders! :ouch:

[SASless]

Al-bert,

Would you have done that flight sans Goggles?

Could you have done that flight sans Goggles?

Reason for asking.....I am a very strong supporter of incorporating NVG's into the HEMES Mission as being required equipment for Night Flying.

What are your thoughts on that idea?

[Al-bert]

SAS......good question...probably could have, wouldn't have liked to sans goggles, shouldn't have anyway! And FYI we were a four man crew, in a Seaking Mk3 therefore search radar, dedicated and competant radop, radar height hold, winchman to make coffee (joke!) ;)

[homonculus]

Fantastic pilots

But

Why????

If you were just moving a transplant surgeon it was a total waste - there are loads in both Newcastle and London

If you were moving a patient god only knows what a surgeon was doing on board as a surgeon is fat use in caring for a sick patient in a helicopter - that is the role of an intensivist

I appreciate you were following orders and I suspect those taking the decision did so in the belief they were helping mankind not to mention making some dosh, but I can't think of ANY possible justification for such a flight on medical grounds

Doubtless the doctors would have been totally ignorant of the risks and I suspect the surgeon has dined out on how he flew under bridges

It just goes to show that no matter how much safer we believe we are compared to the US we lack the ability to assess the real benefit and need. We put machines and crew at unnecessary risk and thank our lucky stars we got away with it

[Thomas coupling]

Homonculus,

Who are you responding to?

Injuries/transfer of organs/equipment/specialist treatment (burns/children/head injuries/bends) - don't care if it's day or night???

Are you against air ambulance/hems in general because I don't understand where you are coming from w.r.t. the difference between day or night transits.

You are correct that night transfers/flights will require additional and more costly overheads because of the environ. BUT there is still the same demand at night as there is during the day. SO provided the public pay for the service (via charities) then so be it, let's get on with it.
Some of these charities are very very rich, coining in, in excess of millions/year - easily.

The public have a soft spot for air ambulances, let's maximise the benefits.

[SASless]

t just goes to show that no matter how much safer we believe we are compared to the US we lack the ability to assess the real benefit and need. We put machines and crew at unnecessary risk and thank our lucky stars we got away with it

Politely rephrased.....One has to be alert to the possibility that risking a crew and aircraft unnecessarily exists in all such operations.

Isn't that what you really meant to say HOM?

[TorqueOfTheDevil]

We put machines and crew at unnecessary risk and thank our lucky stars we got away with it


One has to be alert to the possibility that risking a crew and aircraft unnecessarily exists in all such operations.


Which brings us back to the old truism of 'the only way to remove risk totally is to cease flying completely'. The sorties which Al-bert describes may have been hard work for the crew, but that doesn't make it reckless (or unnecessary) risk-taking.

And a SAR crew is better placed to judge what is or isn't high risk because there are four full-time aviation professionals on board, any of whom can and will speak up if they have concerns about the way things are going. No offence at all to paramedics/police observers etc, but a true-blood pilot/crewman will in almost every case have a better understanding of the aviation aspects of the missions and the self-assurance to offer his/her thoughts. The NTSB report which TC highlights is a case in point.

[[email protected]]

The only way to avoid single pilot night HEMS IIMC crashes (as so many of the US ones seem to be) is to have strict weather limits and actually adhere to them.

If the pilot says no then remove the financial pressure to fly the mission and accept his decision as final.

[homonculus]

SASless - correct

TorqueoftheDevil - I fully agree an SAR crew is best placed to decide whether a flight can be undertaken. However they are not qualified to know if the reason it is being requested warrants it.

TC - sorry, I wont cross swords with you on aviation, but I will on medicine. Trauma at night is different. We have to go back to the mid 80s to a time where secondary transfers to regional centres were supported. Head injuries are now treated in primary centres. Equipment is not needed to be moved in the night. And organ transfers are now contracted out to fixed wing services. I had been moving most children in the south but most of these have now transferred to land transfer despite the availability of air transportation.

What is being considered here is primary HEMS - road traffic accidents in the main as people dont ride horses on moors or go rock climbing at night!!!! It is different

No I am not against air ambulances - I have spent the last thirty years one way or another doing research and supporting them in my role as a doctor in this field. but that does mean I have a responsibility to point out the limitation of need.

Finally, I wont bore you but the medical and nursing manpower situation is such in England and Wales that this idea would put considerable extra strain on hospitals which cannot be relieved by charitable nor NHS money, and might compromise other services.

I realise this is getting off thread a little - ie can it be flown safely - and I am happy to discuss further if you pm me

[Al-bert]

Hom,
the sortie I described in a little detail should NOT have been flown, but then again, the liver that was waiting in London may have gone to someone else (perhaps more deserving but less well connected?). I'm assuming that the highly qualified medical escort that came with the patient in some way reflected his status? Despite his somewhat hippy and dishevelled appearance (the patient, not the Dr!) he was AWFULLY well spoken.
I was effectively ordered to fly the mission (I have no idea how high that decision was taken) but after turning it down once due to weather I was asked COULD I do it - I could, and did.

[SASless]

The only way to avoid single pilot night HEMS IIMC crashes (as so many of the US ones seem to be) is to have strict weather limits and actually adhere to them.

Describe the limits you would put in place to do that please.

Now that you have set that limit(s)....tell me how you ensure the Weather forecasts are accurate and take into consideration local weather phenomenon peculiar to very small parts of the area you are going to fly in. (mountains, coastal plains subject to Sea Fog, Valley's with streams and rivers in them, and other isolated weather problems).

As has been argued over and over before....you can set make all the rules you want....set all the weather minimums you wish (on paper), but the devil is in the details.....actually making all those rules and minima work with the reality of flying.

[homonculus]

Al-bert

You just did your job and did it well.

You don't say how long ago it was. Nowadays all organs are coordinated across Europe and indeed worldwide. Out ability to keep the organ until it is plumbed in has advanced. And transplant surgeons are no longer revered as gods - I recall one such gentleman who used to keep a kidney in the boot of his car. When stopped for speeding he would yank it out and shove it at the traffic officer. Little did they know his wife got a new one each Saturday at Dewhurst when collecting the Sunday roast.

Anyhow, nowadays we know where the organ is going well in advance. The patient has time to travel in. And the organ is moved by contractors. Not as exciting but then it is pretty simple work. The clever bit is the prevention of rejection and the work done by immunologists and biochemists - mostly British

[Al-bert]

Hom, thought I had said - Jan '99 :rolleyes:

[MightyGem]

tell me how you ensure the Weather forecasts are accurate
Is that even possible? How often have you seen weather that bears no resemblance to the current TAF?

Had a read of the HEMS section in the NPAS(the UK's National Police Air Service) the other night, and if I recall correctly the night weather limits were 3000m viz and 1200' cloudbase.

[ShyTorque]

Doesn't really matter what the cloud base is if you lose control after inadvertently entering it. Obviously, a TAF or METAR is only a piece of paper. It only takes a small local weather variation to cause a nonsense of either.

The real issue is how the pilot recovers from a deteriorating weather situation.

[SASless]

3000 meters.....just shy of two miles....night....dark area no lights natural or manmade....drizzle/mist....actual visibility is what.... you say?

Add NVG's....(keeping the same weather minimums)....same situation....what is the real visibility?

For VFR flying....looking outside and controlling the aircraft by means of visual ground reference (at night in the USA...requires sufficient light reference) means visual cues sufficient to see and control the aircraft....no matter what the stated vis that is contained in the TAF.

I see the TAF being one of the hurtles one has to get over to be able to fly.

If the numbers on the TAF are lower than that required by SOP, REG, AOC, OpSpecs.....one does not fly. If they agree or exceed the minimum numbers then one gets to make a decision to Go or Not Go. The closer the numbers are to the Minimum....the less interested I am in going flying especially at night.

Some issues like temp/dew point spread and wind speed.....all by themselves can decide if I go or not. Fog being a ground based weather event....kills helicopter pilots. Low ceilings and excellent Vis are a different story....as one can see something. It is the not seeing that gets us. Like not seeing the cloud bank or Fog Bank you are about to run into....or that set of Wires....or the Hill....or Mast.

[ShyTorque]

SASless, you're preaching to the converted.

NVGs are obviously a good aid (I used to be a UK military and civilian NVG instructor) but unfortunately if you allow them to take you into reduced naked eye visibility you are likely to still need an IFR fallback plan because you'll probably be further into IMC than you would have been without them. There's the catch.