How to improve the HEMS safety record in the USA
I think you will see several solutions coming but eventually the industry will become more regulated.
NVGs are not the total solution but the industry is banking on that fixing the problem. NVGs have limits and the pilot needs to keep in mind...googles will still get someone in trouble. Would not be surprised within a year that goggles will be mandated. Serves to address a couple of issues: FAA can show that they did something and smaller programs that cant afford the cost will be absorbed or go away.
Terrain/obstacle avoidance programs for the GPS becoming widly used on EMS aircraft. The programs are there, but the $$$ are in the NVG market as the fix so this will be slower to come into force.
The pilot market is streched at this time no immediate solution for that . Totally hypothetical is that the business plans of the major EMS providers throttle back and get realistic with pilot supply and growth. Slim chance.
Another reason to regulate the industry, the surge in articles that are being done on unncessary flights. Granted for every one the papers say should not go there is a story that its good the flight was there. Insurance costs tied into health care costs will make its way into the front running as a reason to put some regulation in place verus common sense on the hopsita. Hospitals generate the cash flow from the follow up services once we get the patient there. EMS programs are the whipping post for this one.
Twin engines may seem the solution to the public and a marketing tool for the companies that fly them but if you crashing in night/weather, the second engine gets you to the crash that much faster.
The fleet needs to be looked at for a different reason, (personal opinon only, my time is in UH-1 and 60s now the AStar) for what we do. Power management is a must but if you flying with 1/2 fuel so you can take a patient and your range is limited, maybe you have the wrong aircraft.