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Tiger G
2nd May 2013, 19:47
Hi,

A Norwegian air ambulance driver does a good balancing on a crash barrier :-) Big show off !!


LiveLeak.com - Air Ambulance Lands on Crash Barrier in Norway

Anthony Supplebottom
2nd May 2013, 19:53
That's what we're there for, to perform the "extraordinary" and to do things our brother plank drivers can't! :E

newfieboy
2nd May 2013, 20:20
I lose count some days of all the hover exit, toe in, front of one skid on a rock kinda landings I do in a day as a utility pilot in Canada. Especially on fires. Nothing new there.

rotornut
2nd May 2013, 20:47
Cool but might want to check the skids for damage.

Grenville Fortescue
2nd May 2013, 20:50
Not necessary. The 135's skids are fairly sturdy and for the curvature of that barrier to inflict any damage on the underside of the skid it would have needed to start bending first or there would have needed to have been some forwards or rear movement while in contact and which there really didn't seem to be.

SASless
2nd May 2013, 21:39
Given the choice of landing as shown in the video or doing the far more boring but a little bit safer method of landing in an open area down the road a bit....I always opted for the boring way. But then....I am not a Hero Saving Lives kind of thinking guy.... just a Helicopter Pilot providing safe efficient medical transportation thinking kind of guy.

Peter3127
3rd May 2013, 00:23
I am guessing that landing to the right and parallel to the barrier was just too risky ..... :confused:

Non-PC Plod
3rd May 2013, 09:47
I guess air ambulance is not a Cat A operation in Norway?

JimL
3rd May 2013, 10:08
There is no such thing as a CAT A operation.

Jim

jayteeto
3rd May 2013, 10:33
you can break rules to save life as long as you can justify it later

SASless
3rd May 2013, 11:37
you can break rules to save life as long as you can justify it later

If you survive.....or do not kill someone in the process!


The "We are saving lives" attitude kills people in the EMS business....on a regular basis!

tottigol
3rd May 2013, 13:27
Wow! I can list every single post in this thread a true statement.:E

Nubian
3rd May 2013, 19:47
you can break rules to save life as long as you can justify it later

What makes this is illegal?

SAS,

If you survive.....or do not kill someone in the process!

O'boy, I must have been lucky many times (a day) as a utility pilot flying a helicopter like a ....... helicopter

Just to ecco Newfieboy; nothing new!

jayteeto
3rd May 2013, 19:51
Sasless, do me a favour! Every now and then a job requires a landing like this. We have a distinct lack of regular deaths in the UK, unlike the USA record. We don't go around killing people here. We sensibly risk assess and only do things when the risk is ACCEPTABLE. if I thought I might damage someone then it wouldn't happen. This doesn't mean we will never have any accidents, we just do not push crazy limits.

SASless
3rd May 2013, 21:14
jay,

Unless the photo is completely deceiving....just down the road in the back ground....the valley opens up and I would bet you a doughnut to a dog dropping (you can hold the stakes in your mouth if you wish) there is a common ordinary flat and open spot adjacent to the road where a normal landing could be made. The Patient could be transferred to that spot by ground and then air lifted to the Trauma Center.

If your Risk Assessment allows for a such a precarious landing....why even have such a system in place.

Otherwise....perhaps....you would have grasped the merit of not taking the risk of adding to the situation by pitching the helicopter into the middle of Emergency Crews at an already bad scene should something have go wrong with the landing.

Matari
3rd May 2013, 22:33
Here is the pilot's explanation, in Googlese translation:

But county road was narrow, mountainside above steep. Wherefore helicopter crew think creatively:

In the video from a freelance photographer John Øysteinsberg can see how the helicopter barely put runners lie down crash barrier on the narrow county road, before the doctor jumps out and moves towards car wreck.

- What you see in the video, is about the same we do if we for example have to land on a rock in the mountains or on the cab roof. Sometimes we have to be creative to come up with the patients, said flight operations manager Erik Normann Air Ambulance to VG.

- To land on the barrier is not exactly the first thing you learn in pilot training. But that's why we have very high standards for who gets to be pilots with us. Norway has a challenging geography, that we experience every day, says Normann.

- Watch the video that there is some movement in the helicopter. That's because it blew quite fresh that day. And photographer as movies, is under the high-voltage wire. In addition, we must think about how close the patient we can land. There are some decisions that need to be taken quite quickly in such situations, says Amdal.

Emergency Helicopter Landing (http://translate.google.com/translate?hl=en&sl=auto&tl=en&prev=_dd&u=http%3A%2F%2Fwww.vg.no%2Fnyheter%2Finnenriks%2Fartikkel.ph p%3Fartid%3D10109810)

SilsoeSid
3rd May 2013, 23:39
Google Maps 'Slåttavik' and I think it looks like that particular stretch of the 714. (could be wrong)

Mind you, this was just a drop off to get a doctor on scene wasn't it? It's not as if they were loading the patient, stretcher, medics & doc etc!

IMHO, even if there was a drop off point a mile or so down the road, the vital minutes it would have taken for the Doc to get on scene, could have made all the difference. ( 1 mile @ 3mph = 20 mins)
Yes they may have well been able to get a vehicle to pick him up from down the road, but we simply don't know basic facts such as whether comms were available etc etc.

I wasn't there, so without any further real information coming forth, I say....Well done :ok::D


Oh yes;
Unless the photo is completely deceiving....just down the road in the back ground....the valley opens up and I would bet you a doughnut to a dog dropping (you can hold the stakes in your mouth if you wish) there is a common ordinary flat and open spot adjacent to the road where a normal landing could be made.

Of course, there is, however...take a look at the wires going straight through that 'common ordinary flat and open spot adjacent to the road' :rolleyes:

Matari
4th May 2013, 00:47
A few more pictures here to give some context to the scene:

Car of the rock-newspaper Sør-Trøndelag (http://translate.googleusercontent.com/translate_c?depth=1&hl=en&prev=_dd&rurl=translate.google.com&sl=auto&tl=en&u=http://www.avisa-st.no/nyheter/article7490887.ece&usg=ALkJrhjoc1VOcdQgcLb-4E-RxESn_7Tfuw)

SASless
4th May 2013, 02:07
1.0 Mile at 60 MPH equals One Minute plus loading time......or even 2.0 minutes at 30 MPH.


( 1 mile @ 3mph = 20 mins)


Having done one skid rooftops at night on NVG's....it is not the difficulty of the maneuver that is in question....it is the Risk/Gain issue.

Please do remember very few EMS transfers (Damn Few actually) get done by helicopter at night in the UK....so just how critical is a few minutes in your system. If you discard the need for timeliness at Night...why get your knickers in a knot over a few minutes in the daylight?

skadi
4th May 2013, 06:23
According to Mataris link, the helicopter with emergency doctor arrived before the ambulance car! So it was eventually important for the patient to get quick access and drop the doctor in the shown manner.
The norwegian HEMS system is the same as p. e. in germany: Primary goal ist to get a doctor to the patient as fast as possible rather than bringing the patient to the doctor/hospital

skadi

SilsoeSid
4th May 2013, 08:10
Sasless,

By dropping off the Doc at the scene (along with the bag & rucksack he can be seen carrying in the vid) rather than a mile down the road to an even dodgier wire ridden clearing , c20+ minutes of the 'Golden Hour' was saved.

Yes he could get as you say, get there quicker by vehicle after landing at a clear landing site...but only if;
a. There is a vehicle available.
b. There is a clear area in which to land in.
c. Messages get passed

Having done one skid rooftops at night on NVG's....it is not the difficulty of the maneuver that is in question....it is the Risk/Gain issue.

Well done you (pat on back smilie)
IMHO the vid shows that the dynamic risk assessment made was correct, and the gain by getting the Doc to the patient so soon is immeasurable.


You ask the question; "...Please do remember very few EMS transfers (Damn Few actually) get done by helicopter at night in the UK....so just how critical is a few minutes in your system. If you discard the need for timeliness at Night...why get your knickers in a knot over a few minutes in the daylight?"

Ok then!...Firstly;

What is the Golden Hour? (http://airmedical.net/2011/10/12/what-is-the-golden-hour/)
So, when international air ambulance services speak of the importance of the golden hour, they are not referring to a grandiose or mystical period of time that just happens to be exactly the length of an hour, but to an ever-changing (but well-defined) window of time in which a critical-care patient needs to reach appropriate healthcare for his or her best chance at recovery, reversal, and preservation of quality of life.

Secondly;

At night, Police helicopters are available for life threatening casevacs.
Regular air ambulances do not, afaik, carry out their 'normal role' because of the extra equipment required to satisfy safety regulations.

Hampshire & Isle of Wight Air Ambulance (http://www.hiow-airambulance.org.uk/page.cfm/the-trust/the-service)
Landing on unknown terrain with the risk of unseen hazards, like telephone or power cables, would be unsafe. After the evening rush hour, our roads are usually less congested allowing comparable response time by land ambulances.


But of course, you knew all this already....didn't you :rolleyes:

merlin_driver
4th May 2013, 08:15
There is a curious paradox among pilots (not just helicopter ones), which is:

a) criticize openly and heavily the work of other pilots, most times without having enough information to do it;
b) be extremely annoyed when a) is applied to them.

Then there is the pprune thread response checklist:
1. Make slightly ironic remark about subject at hand, without explicitly criticizing it
2. Wait for outraged response from another poster
3. Make comment on poster's company/country/experience/writing skills/etc to annoy him further
4. If poster questions your judgement/experience/etc resort to the argumentation: "I/We do it like this in my company/country, therefore this is THE ONLY WAY it can be done"
5. Return to 4.

As they say where I live: "There are many ways to milk a cow".

Btw, nice flying skills, landing on that rail, that is something I don't do often, and it's hard.

Merlin

Non-PC Plod
4th May 2013, 08:33
JimL

"There is no such thing as a CAT A operation."

It may be different now, but what I am referring to is in my dim and distant memory in the UK police air ops manual, there used to be a clause which required any air ambulance (as opposed to casevac) job to be flown in a way which allowed equivalent Cat A performance, with minimum specified "D" distances for landing sites, and takeoff/approach paths clear of obstacles. I was saying that the rules may be different for Air Ambo ops in Norway.
I don't think its that difficult to put a skid on a crash barrier - I did similar things many times under military rules. Its just that as a civvy I would have been shown the door rapidly if a video like that came to the notice of the chief pilot, because it would have broken our rules.

RVDT
4th May 2013, 09:57
And of course not forgetting the wires that seem to run directly over the site!

500 Fan
4th May 2013, 14:57
Merlin Driver, thanks for authoring one of the better posts to appear on PPRuNe for a while. :D

Putting the skids on the crash barrier might be risky but if it gets a doctor to the seriously injured in a timely manner, it is worth the risk.

500 Fan.

P6 Driver
4th May 2013, 17:12
Merlin Driver wrote
There is a curious paradox among pilots (e.t.c)

I have to disagree - on this web site, its among many others also! If only the pilot of this helicopter had had the foresight to check if all was OK on PPRuNe before the flight...:rolleyes:

Grenville Fortescue
4th May 2013, 17:15
If only the pilot of this helicopter had had the foresight to check if all was OK on PPRuNe before the flight.

He would never fly.

wde
4th May 2013, 17:42
so here is my grenade into the debate:

If I ran this operation, the pilot would be looking for a job.

Air Ambulance operations need risk avoiders, not risk takers.

And I ask - where did the helicopter land to fly the patient to hospital?

Too many of our American brethren think and act as if it is OK to risk 3 lives to MAYBE save one. This is the mission of the Coast Guard, not Air Ambulance.

This scene appears to show that the land response unit don't know how to set up a scene to allow for a helicopter to land.

And much research on "the golden hour" has been shown to be specious -

The attitude "gotta get there" has killed over 500 people in the helicopter EMS business in the US over the past 20 years. I wonder how many offshore rig operations would still be using helicopters to fly there people back and forth if the offshore helicopter industry had killed the same numbers.

Safe aviation operations require sound decision making that results in accepting risks ONLY when there is no better solution.

My $0.02.... Fire away ...

wde

Smokeyboy
4th May 2013, 17:53
And I ask - where did the helicopter land to fly the patient to hospital?
Victim taken to hospital by road ambulace. Minor injuries. Helidoc first on scene with qualified medical personel. Victim had to be extracted by fire. Fire dept. in Norway have no EMT's.

Anthony Supplebottom
4th May 2013, 18:16
If I ran this operation, the pilot would be looking for a job.

What an over-reaction!

All this guy did was to hover over a road barrier in order to give himself greater rotor clearance. No big deal. I think the driver should be commended for getting the doctor in there so effectively.

PPRuNe members sometimes complain about the level of bureaucracy now associated with flight operations but if some PPRuNers were running civil aviation I think it would be even worse. Mountains made from molehills me thinks!

We should be looking at ways of giving helicopter operators greater freedom and fewer restrictions. This broken record of "its wrong to take risks to save lives" is just that, a broken record. Everyone knows that a professional pilot (in any field of operations) must exercise sound judgement and for EMS pilots I would have thought this would feature among the ABC's of being a helimed pilot. But being careful and sensible doesn't preclude the kind of operation we saw on that video. It was a simple relatively low-risk event.

newfieboy
4th May 2013, 18:47
Quote:
If I ran this operation, the pilot would be looking for a job.

Best ya don't come visit Canuckland then....landing on a big H a la airport....f@&$ing luxury mate.

SASless
5th May 2013, 00:05
So....lets see here.....Minor Injuries, Patient taken by road ambulance after being extracted from the vehicle (how long did the extraction take?), No EMT's in Norway, sounds like there is no radio comms between ground units and the helicopter (or am I wrong on that?), No LZ was set up for the helicopter (Are Ground Units trained and equipped to do that?), Where did the helicopter land to retrieve the Doctor?

The level of care provided is far more important than just time alone. The Golden Hour is not etched in stone and really does trend along the curve that is based on both timeliness and sophistication of the care provided.

What level of equipment is the aircraft equipped with, what does the Doctor carry in his Trauma Bag, and how much can he do by himself?

Lots of variables folks....I would suggest some thought ought to be given to what is being said....in the American usage of the phrase "Emergency Medical Service", which includes both Patient Transfer and Scene Response....we apply a single standard to those Operations as we see them one and the same.

You Brits divide the two and apply differing standards....for whatever reason.

Yes, you don't seem to Kill off yourselves as often as our folks do...but then we operate 24 Hours a day with well over 800 aircraft in the Fleet. Care to tell us how many Aircraft in your fleet and how many Night Operations you conduct each year?

You "Life Savers" out there need to remember People ride in ground ambulances when you cannot or do not fly them. People die every day...and putting yourselves at unnecessary risks does not make you anymore the Hero....just a lot more likely to hurt yourselves and others.

The belief you do it "better" is a myth.

You do less of it and in the daylight.

Who we should look to for counsel are the Canadians. They seem to have found the happy middle ground on all this. The Australians do a pretty good job of it too.

pilot and apprentice
5th May 2013, 01:09
We have no idea what happened here other than a snippet of video a few seconds long.

All we saw was a fairly benign hover exit that put a medical professional on scene. I fail to find any fault based on what is presented, and I'd be inclined to say job well done.

The rest is just conjecture. Whether one of us would do the same would be determined by being there, that day, to make that call. When discussing the hypotheticals, I'd hope we could all be civil.

jayteeto
5th May 2013, 10:37
Man......... how do you know that area down the road is suitable? Minor injuries, ok, he shouldn't have done that landing if he knew it was minor injuries....... he DID know that, didn't he? Or did he rightly assume the patient needed him? I didn't realise from the video that the service had a vehicle, with comms, ready for him down the road.
Where are all these accidents we are told about? 99.999999999999% of the time, I have a safe option. In the UK we have an exemption that allows us to take a risk, LEGALLY, if the circumstances warrant it. Strangely enough, one of my only times to use it was on a similar road to this one. The patient lost limbs, but survived. I like to think my actions helped that.
SASLESS, I always look to use a safe site, many times I have not landed because the risk was high, I am not a cowboy, but this video is not that bad. It is an increased risk, balanced on the perceived needs of the patient. If he had come back to pick the doctor up, THEN I would criticize him. Doctor delivered is mission accomplished.

jayteeto
5th May 2013, 10:47
In addition, the role of the HEMS aircraft is not to transfer the patient to hospital, so why ask that stupid question? We get appropriate care TO the patient. A transfer is a bonus.
Secondly, who says we do it better than the Americans? We operate in a far less hostile environment normally.
You mention night flying, we don't do it for a reason. The trial is happening, wait for the results.
Those who say sack him don't know the rules, this would be legal in the UK. Can you sack someone for operating inside the rules.

skadi
5th May 2013, 11:17
@SASless
So....lets see here.....Minor Injuries, Patient taken by road ambulance after being extracted from the vehicle (how long did the extraction take?)That the difference between european and US system. HEMS is often the first on scene and its the doctors decision, wether the patient needs medical assistance by emergency doctor or ambulance personell. So its the regulation here in germany too. This cardriver was trapped in the car and extricated by the fire brigade, they dont evaluate the medical condition, its the doctor who has to do it. F. e. there might be an internal lifethreatening injury like splenic rupture, which could only be diagnosed by the doctor...
Those landings are not daily business over here, but i dont think its right to bash this. Probably I would have done the same in this situation. I have done over 10000 HEMS-missions up to date and well over 90% of them were landings in unprepared landingsites.

skadi

SASless
5th May 2013, 13:07
Two thirds of my EMS flights were to "Scenes".

At every Scene we had radio communication with the ground units.

The Ground Units were all trained to set up Landing Zones, had equipment to mark the Landing Zones (Especially at Night), had a LZ Ground Guide with Radio, which required a lot of effort, cost, and training. Fire Brigade unit(s) were almost always on site to support the Ground Medical Crews.

On more than a few occasions we arrived before the Ground Medical Units and were "First Responders" and carried out the landing without the assistance of a trained LZ Coordinator.

The Med Crew usually consisted of a Nurse and Paramedic with advanced qualifications and direct contact with a Trauma Doctor when needed. The Aircraft were licensed and equipped for Advanced Life Support.

The goal was to stabilize the Patient and get them to the Trauma Center as quickly as possible.

As we discuss this business of EMS flying, we have to remember the level of care that can be provided is limited by two things really...capability of the Medical Crew and Aircraft, and the Procedures they can apply under their Protocols (SOP's).

A comparison of the various systems used around the World would be interesting to determine which affords the maximum utility and most useful care for the Patient with the least risk to the EMS Crew and Aircraft.

Availability of resources and Manpower prompted by funding sets the limits.

In rural Texas we worked with Volunteer Fire Departments/Rescue Squads and found them quite Professional just as their big city equivalents although their experience and knowledge base was not as deep in most cases. Most of our Flight Paramedics were Ground Paramedics and worked part time for us and full time for the Ground Units.

Our Flight Nurses worked in the Trauma Center when not on Flight Duties.

The occasional flight with a Doctor aboard was more for training the Doctor to understand how working on a patient in a Helicopter differed from inside the Trauma Center but also allowed cross training and monitoring the Medical Crew.

Many EMS Pilots undertake Paramedic Training as well.

My criticism of the video action is not directed at the individual Pilot....but at a system that forces such kinds of flying be done in order to carry out the Operation. If being critical stimulates some thinking about how to do things a bit different but a lot safer happens....score one to me.

If you think just because the Rules allow you to take on more risks "Legally"...and therefore think it is just fine to do so....you need to re-think what you are saying. We get to be old at this game by not taking UN-NECESSARY risks. We are not "Life Savers"....whether the Patient lives or dies is really not in our hands. By means of our skill, training, and experience....and that of the Medical Crew...there may be a positive outcome but if that happens is pre-determined by external forces... call it Fate, God, Luck, Timing or whatever you care to use. The US Coast Guard fully understands that they cannot save everyone every time....so why should EMS Pilots and Medical Crews think otherwise?

Not every Patient that gets to ride in an EMS Helicopter is going to survive...that is something you have to get used to. Watching them go on the way to the Trauma Center is a hurtful thing but a sad part of the job sometimes.

5th May 2013, 15:27
We are not "Life Savers"....whether the Patient lives or dies is really not in our hands. If, as seems likely in this case, you get the doctor to the patient before anyone else turns up then you probably are a lifesaver.

If there is no-one else on scene (medically trained) and there has been a major smash, you have no way of knowing how critical the casualty may or may not be - wouldn't you want to assume the worst case - and a quick flyby of the scene would help assess the likely mechanism of injury and possible severity of the injuries.

In this case, I really don't think the guy did anything wrong and, as has been mentioned, we are making armchair decisions after the event without any of the operational information.

SASless
5th May 2013, 17:09
While you are doing the Fly By....are you looking for all the possible landing areas and trying to sort out the "Best" one considering all the usual criteria...wind, barriers, obstacles, uneven ground, slope, footing, wires, fences, access to the scene?

If you land the Doctor by doing a one skid hover landing onto a Rock and the Patient dies....are you a failure?

If the flight was similar to this one....the Injured person only had minor injuries...and his evacuation by ground was delayed due to the extraction process...would there be the Urgency that forbids a five minute delay fetching the Doctor from a nearby but safer landing site.

Should not the SOP's start with that notion to begin with....determine if the aircraft can land to the ground safely at the immediate scene....if not proceed to the nearest suitable location.

Crab...you could drop off the Medical Team by Winch....Civvies don't have that option. You also have different rules and regulations than do the Civvies. Don't try to apply your situation to those that don't have comparable limits.

skadi
5th May 2013, 17:18
While you are doing the Fly By....are you looking for all the possible landing areas and trying to sort out the "Best" one considering all the usual criteria...wind, barriers, obstacles, uneven ground, slope, footing, wires, fences, access to the scene?

As we dont have marked and prepared landingspots on scene in most of the cases, this above mentioned procedure is a must!
One additional point: big dogs :E
skadi

jayteeto
5th May 2013, 20:12
Oh well, my 25 year, accident free career and reputation as captain sensible has been wrong all along. These on scene HLS organisers must help. We have.................. none of them. 99% of the time we would be landed and gone before they arrived.
I absolutely love the idea of being able to assess injuries from 500ft. I have seen dead people in cars with minor damage and have seen people step out of vehicles that were next to destroyed with no injuries.
With so few injuries and accidents in the UK, just what are we doing wrong?

SASless
6th May 2013, 02:00
Reckon your system could bear some improvements?

heli1
6th May 2013, 05:14
INITIATIVE ......the one big difference between British/ European and Americans who don't know how to use it......and the fact that they probably think Norway is a town in Oklahoma !

6th May 2013, 07:24
Now that made me laugh out loud heli1 :ok::ok:

jayteeto
6th May 2013, 09:23
Off to the airport to visit mickey mouse in florida. Two weeks, knowing the great british public are safer without me there.
M-I-C-K-E-Y-M-O-U-S-E!

skadi
6th May 2013, 09:35
Jayteeto, have a nice holiday in florida, but keep clear of those HLS organisers over there! They might be not friendly :}:}:}

kxF2PLLSyAs

skadi

Anthony Supplebottom
6th May 2013, 09:47
Looks like the kind of landing site SAS could manage, except of course there should be one or two more police cars surrounding the extremities of the landing area, an enormous white "H" and a windsock! :)

SASless
6th May 2013, 10:01
What was that Prick's Major Malfunction?

I would have told him to get Fecked....but then I have a very short tolerance of officious Pricks like him.

There is a move on by Police in this country to stop Citizens from filming them in the performance of their duties....which I think stems from so many devastating videos of them when they do naughty deeds...which leads them getting sued in Civil Court and tried in Criminal Court.

It is an over reaction to the situation....as very much demonstrated by Capt. Smart (what a perfect name for this guy!!!) in the Video. Smart Ass should have been attending to his duties and not getting in this guy's face.

Captain Smart would not want me for a Chief....as he would be the Former Captain Smart now wearing a Red Vest at Walmart or something similar.

Bottom,

Sorry Mate....no Windsocks.....just a ground guide who stands with his back to the wind....and with a radio telling you about Wires and other Hazards he sees.

Of course that doesn't mean he sees all of them.

At Night....he might even have Lighted Wands to wave about too. Not that Pilots pay much attention to them.

I have even landed to to a spot marked by Bean Bag Lights....but then what the heck...it made my job easier.

It is common knowledge you Brits like to "muddle through" and embrace that as a badge of honour of some sort....but really guys....don't you equip your Fire Brigade with a bit more than Piss Cans, Extension Ladders, Axes and a bit of Hose?

An average EMS Operation.....how does it compare to yours?


http://www.youtube.com/watch?v=DN0KvN9nCsk

SilsoeSid
6th May 2013, 10:14
I think SENsless would have Capt. Smart get a chainsaw to cut down the palm trees seen in the background. They must be well within 300ft of the helicopter landing point! Nice to see that the paramedics spend all their time after the helicopter arrives dealing with 'the cameraman' and not with the patient transfer. :ugh:

So far this thread has sacked a Pilot, based on a 40 second video, and a Paramedic in similar circumstances. One for doing his job, and the other for not... :confused:

SASless
6th May 2013, 10:35
Sid,

You might recall all US EMS Operations must comply with FAR Part 91 and FAR Part 135 Rules and Regulations along with their Operator's FAR Part 135 OPSPECS which detail the size and types of Landing Zones, the required Lighting and all that kind of stuff.

What CAA rules, JAR, JAA, EASA, or whatever the hell ya'll have to work under today...as it seems to change over there about as often as I change my underwear?

Does your Authority set forth the allowable dimensions of a landing zone?

Do you abide by those rules?

skadi
6th May 2013, 10:41
An average EMS Operation.....how does it compare to yours?

Did i see the pilot leaving his ship while in idle helping to unload the empty stretcher ?
We usually shut down the engines.

skadi

Anthony Supplebottom
6th May 2013, 11:12
It is common knowledge you Brits like to "muddle through"

We "muddle through" as you say, but we do it with precision! :p

bast0n
6th May 2013, 12:55
In them days weem never 'ad skids or crash barriers so orl wus tickety boo..........................


http://i291.photobucket.com/albums/ll301/tallbronzedgod/WessexMountains011.jpg~original

6th May 2013, 16:26
Sasless - it might be time to admit defeat and walk away from this one.

I acknowledge your viewpoint and experience of US HEMS but you are making harsh calls on pilot's professionalism without most of the required information. Shooting from the hip might be the sort of activity Capt Smart seems to enjoy but it is beneath you.:ok:

Nubian
7th May 2013, 17:01
except of course there should be one or two more police cars surrounding the extremities of the landing area, an enormous white "H" and a windsock!

or better yet....

How about making it illegal to have any emergency under other circumstances than at an airport, during daylight hours and off course when CAVOK:ok:

Sas,

This pilots greatest exposure to risk is actually the drive to and from work!

SASless
7th May 2013, 17:40
This pilots greatest exposure to risk is actually the drive to and from work!


That old Saw don't cut.

Of all the Helicopter Pilots I know who snuffed it....and there are dozens.........exactly one died in a car wreck.

The others died in Helicopters.

Some just flat disappeared never to be found again.

Perhaps all those guys were better drivers than they were pilots or something....but most died because of mechanical failures or from outside help.

griffothefog
7th May 2013, 17:56
Thank god I did my HEMS in the late 80's before common sense was force removed from the average pilot....:{

SilsoeSid
7th May 2013, 18:25
Well, that's me glad to be on SASless's ignore list :ok:

bast0n
7th May 2013, 18:45
I think it a shame that SASLESS seems to be a bit of the "Duty Target" at the moment. He clearly has enormous experience in many rotary fields, and has made a fantastic contribution to a lot of threads over the years.

You may not agree with all that he posts - but lighten up chaps - he is no fool................

PS I have no idea who he is. I would like to meet him though.

SilsoeSid
7th May 2013, 18:58
I have no idea who he is. I would like to meet him though.


If you're still flying bast0n, are you sure about that....?

SASless;

Of all the Helicopter Pilots I know who snuffed it....and there are dozens.........exactly one died in a car wreck.

The others died in Helicopters.


:\

SASless
7th May 2013, 19:56
I have a thick skin....and when you elect to be provocative you know in advance you will generate all kinds of responses. Some will present countering views and do so without including a personal attack, some will put words into your mouth either deliberately or because they failed to grasp the intent of your post, and some who are well known will just start with the insults and offer up drivel.

If after all this....folks got to thinking a bit about how they do things...all the slings and arrows even the odd harpoon or two were worth it.

Some Mates of mine killed themselves by making errors in judgement....and I think none the less of them....but miss them s as they were good solid folk and professional pilots.

I survived my bad thinking out of pure darn luck more than a few times.

BastOn....I thank you for the support....and perhaps one day we can share a Pint or three. Anyone that can run over a Harrier in a Wessex and tell the tale is a blessed Man. How you got the Wessex going that fast escapes me however! I want to rub your shoulder and see if some of that good fortune rubs off on me!

No matter how long you been doing this game....re-thinking how you play the game never hurts.....Complacency kills.

It is uncomfortable when your comfy routine gets jumbled up....thus I can understand some negative reaction to suggestions there might be a better way.

SilsoeSid
7th May 2013, 20:12
Thing is though, as far as this thread is concerned, for the Norwegian Air Ambulance in the initial post...there wasn't a better way!

I would have added 'IMHO', however of all the pprune -ers here and the countless others that had a looksie, only 2 have slated the crews actions, one of whom would have sacked the pilot. But hey, let's not stop the minority having the loudest voice!

bast0n
7th May 2013, 20:21
Silsoe

If you're still flying bast0n, are you sure about that....?


No, I am not still flying-(still driving a '66 Lotus Elan though) - coming up 71 - but going to the Jungly dinner on Thursday and will have a bit of a hooooly.

Looking back at SASLESS over the years - yes I would like to meet him and yes I would be happy to fly with him. He has an irreverant attitude modulated by experience and the ability to survive that I admire. My survival that he mentions was luck not skill.

handysnaks
7th May 2013, 21:17
Bast0n, I am still flying (occasionally), and I'm with you. I would like to meet sasless as well. I keep trying to find something outrageously offensive in his first post on this thread, but can't! In particular, I think he has at least tried to maintain a polite demeanour even when the swell of opinion (on this thread), was against him!

However, as some of his stateside buddies seem to imply that he's a bit slow to get his wallet out I wouldn't hold your breath waiting for his round!!
just to lighten the mood

SASless
7th May 2013, 21:27
Chuks is not a credible source!

sunnywa
9th May 2013, 15:59
To the helo driver, IMHO a great job to quickly get in and out safely to drop the doc to a patient who was in an unknown state. :D Minimum time in danger zone.

SASless
18th May 2013, 01:32
Snitched from a new thread here....but it does seem so appropriate for this one considering some of the comments made by those who scoff at well controlled LZ's.

My question is did the car run into the Helicopter or did the Helicopter set down on the Car?:E

Übersichtsseite: Hubschrauberflügel in Windschutzscheibe | MAIN-POST Nachrichten für Franken, Bayern und die Welt (http://www.mainpost.de/regional/wuerzburg/Hubschrauberfluegel-in-Windschutzscheibe;art779,7473000,D::sts19488,5751)

SARWannabe
18th May 2013, 07:53
Oops. Bet he feels a bit silly for doing that :O

Anyway, this side of the pond, we have a little less in the way of clear area space and spare resources to call on (Fire trucks by the dozen, "STAND BACK SIR, STAND BACK, WE NEED YOU 300 FEET AWAY!!" LZ Shoutsmen(?), Mobile runways etc....). That said, let's not suggest that proportional degrees of crowd control are not applied when they can be. Important jobs are undertaken regularly, efficiently, and with no disregard for proportionate levels safety, if however every landing and take-off needed to wait for the full ground cavalry to march in and shout at people the services might well be a lot less efficient. To my knowledge London HEMS, who have been doing this since 1989, and reduced trauma deaths in London and it's major ring road (M25) by more than 50%, have never compromised the life of a crew member, or 3rd party in the process.

8BBucI7Dp1g

42KX-FzDfTI

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SilsoeSid
18th May 2013, 11:43
To my knowledge London HEMS, who have been doing this since 1989, and reduced trauma deaths in London and it's major ring road (M25) by more than 50%, have never compromised the life of a crew member, or 3rd party in the process.



Flying chunk of metal tests air ambulance pilot (http://www.kentonline.co.uk/kentonline/newsarchive.aspx?articleid=23323)

http://www.kentonline.co.uk/Archive/Images/23323_0_l.jpg
THE skill of London’s air ambulance pilot was tested as a difficult landing went horribly wrong in Welling High Street.

The helicopter was responding to a serious road accident involving a pedestrian and a bus on Saturday afternoon.

It was attempting to land in the high street when a chunk of metal flew off a nearby building, smashing into the rotor blades.

The helicopter landed under a shower of metal, its rotor blades mangled, and was grounded for the rest of the day.

Eye-witness Brenda Laning said: "The helicopter was circling around for a while before it came in very low. It was hovering for a while and the force of the wind from it was amazing.

"The buildings nearby were shaking and the roof of one of the shops nearby started to bow. A massive chunk of metal from one of the shops flew off and hit the helicopter with a massive bang."



London's Air Ambulance (http://www.londonsairambulance.co.uk/about-us/our-team/team-spotlight)
Christine Margetts, our Community Fundraising Manager and founder of that stall, talks about the Charity’s early fundraising efforts – from having her stall blown off by the landing aircraft, through to securing the first Rapid Response Car,...

SARWannabe
18th May 2013, 12:21
Precisely - a pretty tidy record if thats the worst incident in 24 years of operations, landing at ad-hoc, unsecured, unprepared, incredibly small sites. No loss of life, no injury sustained by 3rd parties or crew, and something I'm sure they've learnt a lot from. A different picture to other parts of the EMS world, and in one of the most congested operating environments. Keep up the great work.

p.s. aren't the eye witness accounts just amazing - shaking buildings and bowing roof tops, from a 902 lol

p.p.s "The helicopter landed under a shower of metal, its rotor blades mangled, and was grounded for the rest of the day" omitting "The air ambulance was repaired over the weekend and was back in operation on Monday". Cant have been that badly 'mangled' ;)

Bertie Thruster
18th May 2013, 13:07
Luck has been with them though, on occasion:

http://i70.photobucket.com/albums/i97/nmhsu/Untitled_zps66af3e64.jpg (http://s70.photobucket.com/user/nmhsu/media/Untitled_zps66af3e64.jpg.html)

1.5 mt x .5mt x 5mm aluminium 'KwikFit' board in the process of being chopped by the main blades. (blue piece still visible in the disc)

They landed safely in the forecourt but I understood the blades were 'written off'.

SASless
18th May 2013, 13:57
They could have shut the door on their way out too!:E

SilsoeSid
18th May 2013, 20:00
SASless;
They could have shut the door on their way out too!:E
Lol :)

TomAndreas-NOR
18th May 2013, 21:04
First of all, I'll disclose that I am not involved in HEMS. I am a greenhorn, having just about 800hrs of utility flying with the 350, that 800 is including flightschool. So I am as green as they come.

I am not a Hero Saving Lives kind of thinking guy.... just a Helicopter Pilot providing safe efficient medical transportation thinking kind of guy.

Bravo, I love that attitude. The base which good airmanship should be built on.

So....lets see here.....Minor Injuries, Patient taken by road ambulance after being extracted from the vehicle (how long did the extraction take?), No EMT's in Norway, sounds like there is no radio comms between ground units and the helicopter (or am I wrong on that?), No LZ was set up for the helicopter (Are Ground Units trained and equipped to do that?), Where did the helicopter land to retrieve the Doctor?

As several others have commented already, in many cases the helicopter is first at the scene. The reason is the geography and topography of Norway, with many living in sparsely populated areas, far away from EMT's. What would you do if you were first on the scene of a car wreck? 100x100feet of flat fields available, ground units 40 minutes out.

What level of equipment is the aircraft equipped with, what does the Doctor carry in his Trauma Bag, and how much can he do by himself?

A doctor can actually save a life, unlike the pilot who only facilitates his transport to the scene. (Per your first quote).

My criticism of the video action is not directed at the individual Pilot....but at a system that forces such kinds of flying be done in order to carry out the Operation. If being critical stimulates some thinking about how to do things a bit different but a lot safer happens....score one to me.

How in the world can you judge a system from watching one video? In Norway we ONLY utilize twin-engine IFR aircraft with NVG capabilities and 24hrs of service. So if you have a problem with the Brits, take it up with them. I can't see how flying single-engine helicopters at night would come out better in a risk assessment when compared to this maneuver. And these guys are grown-ups who factor in the risks and acts accordingly. From what I have read from several US accident reports, the problem with external pressure is yours.

All this being said, I understand that part of your motivation for provoking is getting people thinking, and maybe adapt a safer mindset if a flawed existed. But there is a difference between getting people thinking and getting them annoyed...hehe...maybe your wisdom would reach further if it wasn't shrouded in what can come across as disrespect. ;)

Have a great weekend!

Tom

TomAndreas-NOR
22nd May 2013, 19:57
You there SASless?

homonculus
23rd May 2013, 00:47
SARWannabe

I would be interested to see your evidence for London HEMS reducing the trauma death rate by 50%. The definitive Sheffield study stated it might save a couple of lives a year. In fact as there is no double blinded control study we just dont know.

I do remember a lamp post being taken out outside Charing Cross hospital

and the original 365 rolling backwards into some bushes

and several more....

jimf671
23rd May 2013, 06:31
Returning to the original illustration, I had been wondering where I had seen the balancing act before. In fact a similar balancing act is portrayed by another Norwegian air ambulance aircraft in a presentation given by their Oyvind Juell.

Considering the type of roads and size of the fjord features, this type of action is not at all surprising. In Scotland, roads like the A82 and A830 have similar situations for a couple of km but the scale of Norwegian features is much greater. I have been impressed by the Norwegians approach to training for some of their riskier techniques and their typical joined-up thinking aout co-operation between air and land ambulance assets and SAR assets.

==========================================

The measured Norwegian approach contrasts sharply with some of what is happening in England. I think that getting the kit and the qualified to a serious casualty quickly in a west European city does not require a helicopter. It is mainly showing off. The few cases that benefit from air transport may not be worth the additional risks and costs of those operations that do not.

500guy
23rd May 2013, 23:25
I dont have EMS experience but I'm speaking for utility company who does about 100 of skid transfers a day to tower tops at 100'-200' agl.

Its all about trianing. If this company prepares pilots to do such toe-ins it is hardly any more dangerous than a normal landing.

We may crash a lot more helicopters in the US, but we fly a lot more too. Im not sure the accident rates in the UK are any better.

jayteeto
24th May 2013, 21:42
You are correct, you do a LOT more flying, however your accident rate per flying hour is higher. Someone who likes stats has shown that in the past. We have a VERY low accident rate in the UK.

helmet fire
1st Jun 2013, 13:16
As is normal, we will all see this landing against the context of our own experiences and systems without, in my view, appreciating the differences at hand. Normal human behaviour - and you can see that in the normal banter you lot have across the Atlantic trying to compare two totally different systems and cultures.

A universal here is not always a universal there.

From my perspective, SASless is right to question this landing based on his system and culture - it just would not be considered good airmanship with the constraints in that system. However, some of the constraints that I do not believe necessarily apply to the system in question, but that are certainly shaping that reaction are:

Why accept such risks when you don't know what is wrong with the patient?
Well.... first you have to think this is a high risk manoeuvre, which many pilots who do this routinely do not think it is anything particularly outside normal operations. I do not think this is particularly risky and I am sure TC may recall our detailed discussion around a swift water rescue off a car roof several years ago - I accept that crews who don't train for this and don't do it regularly may find it looks risky, I hold a different view. But that is not "right" or "wrong" it is just views shaped by different experiences.
Second: you are assuming that a ground response will be there quickly to tell you the condition of the patient. Many EMS organisations (even in the USA) are first on scene responders and get there before any ground response - so this question is one over appropriate over triage, not that we should not do the landing until we find out what is wrong.

You are only bringing a medical response that could have otherwise have arrived and accessed the patient by road.
Well.... that is always the view of Anglo American based pilots who nearly always convey ambulance officers by helicopter. But in Norway, like many other non Anglo American parts of the world, they carry a trauma specialist/senior registrar doctor and they do bring a level of care that is sometimes (not always) the aim of the "golden hour" that is quoted above so many different ways.


I know we will all hold the same views we held prior to reading this whole thread. But please reflect on this: each scenario has many many cultural and systemic influences that may make a particular manoeuvre or practice safe in one place yet silly and dangerous in another.

My personal example is on two of our EMS operations in Australia. in one we get airborne extremely quickly, within 4 minutes. In the other we take 30 plus. The 4 minute response is perfectly safe in the way it is set up SYTEMICALLY and limited to only certain jobs, but it would be completely unsafe in the other system which requires 30 mins to be safe due to the unpredictable and marginal nature of the scenarios. They are both as efficient and as safe as each other for WHAT THEY DO WITHIN THEIR CONSTRAINTS. But one system cannot look to the other and say "unsafe" or "too slow".

Same, I think, in this case. By all means ask questions about why this technique was used and considered safe, but lets not use that questioning to assume they were at fault because we dont do business that way. If we approach it that way, I believe a far better discussion would result.

For the record, good job guys, I would have no problem doing the same given your system and your capabilities. I would not have done this in the USA, nor in parts of the UK where the helicopter brings a lower level of care AFTER the ground response and where crews are not trained in the procedure.

SASless
1st Jun 2013, 19:03
In the USA...the majority of the EMS Crews and Aircraft are very well trained, equipped, and certified for very advanced life support protocols. The level of care they can provide as compared to a single Doctor is probably quite comparable. In more than a few cases....the American EMS crew can handle more patients than can a single Doctor....although the patient carrying capacity of the aircraft is the normal limiting factor rather than the Med Crew being able to attend to the patients.

Flying Bell 412's...it was not uncommon to use a Ground Response Med Crew to supplement the Helicopter Med Crew which in most operations conisists of a Flight Nurse and Flight Paramedic. The Level of Care required by the Patient(s) is the more common limiting factor.

We could carry four litter patients but could not treat more than one very critical patient unless the third Med Crew Member was taken on board to handle the less critical patients. Our Helicopter Crews could attend to two critical patients in most cases.

Unless I miss what the European method is....I would assume it all revolves around maintaining an airway, controlling/stopping bleeding, treating for Shock, and immobilizing limbs, spines,necks, and heads.....and transporting the casualty to the Trauma Center in a timely and safe fashion.

The level of care that can be given on scene or inside a helicopter, no matter where it happens in the World, is less than that possible in a proper ground based Trauma Center....thus I see the on-scene effort being all about getting the Patient to the best care possible as soon as possible.....contingent to doing it as safely as possible.

helmet fire
2nd Jun 2013, 01:13
Understood.

The typical non Anglo American model that carries the doctor on a three man crew has the highest level of paramedic as the third crew-member. Adding a doctor is rarely at the expense of taking out the paramedic who is certainly the pre hospital expert and scene expert, though some programs have tried this.

The rushing of patients to the trauma centre is certainly justifiable in some circumstances, however, the focus of the doctor/paramedic team is to rush the care to the patient, unlike paramedic based teams (incl ambulance) whose focus is on rushing to the patient AND THEN rushing the patient to high level care.

getting the Patient to the best care possible as soon as possible
So to turn your expression around a tad, some models are specialist designed to get the highest level of care to the patient as soon as possible.

What I am saying is that persons who are more used to one model may sometimes project limitations or sound practices of their model onto situations that are systemically different and therefore not always as applicable as it may appear to be. And yet, those same practices or limitations are appropriate and safe for that particular system.

The easiest example I have of this is night over water winching. Many organisations do it safely and have done using specialist training systems, equipment, go/no go protocols, etc. From outside, it appears sheer madness to do night over water winching. NVG use in EMS is another typical example. My point is that each system will be capable of different processes and techniques SAFELY within that system that do not translate so well into other environments or systems.

strangesteve
5th Jun 2013, 22:51
Sorry to side step all the sniping and change the subject a bit but what are the white aerials on the sides on the nose and the one above the side door behind the winch please.
Thanks
Steve

Heli-News
12th Aug 2013, 18:23
More Norwegian skill on display

lPB6BUqFuq4

skadi
13th Aug 2013, 05:44
More Norwegian skill on display

:ok:

Balancing on the crash barrier with wheels would have been a real show act :E

skadi

Nubian
13th Aug 2013, 12:01
Oh no!!:eek:
They are using the helicopter like a helicopter AGAIN....!:yuk: What a lucky escape:D Now the CAA must put a stop to this madness..:mad:

Where is this going to end???:E

farmpilot
13th Aug 2013, 14:18
Does everyone crash in the same place there????

SASless
13th Aug 2013, 14:42
You reckon there might have been a change in SOP's lately?

RVDT
13th Aug 2013, 15:52
Does everyone crash in the same place there????

Apparently. And inside the helipad fencing as well! :O