This might be of interest to you - check how many of these recommendations have been carried out!
Background
Between 1987 and 1997, there were on average four air medical helicopter accidents per year for the industry. By 1997, the accident rate for helicopter AMS operations had been reduced to 1.97 accidents per 100,000 flight hours from a high of 17.08 in 1987. In 1998, however, the number of accidents rose to a nine year high of seven, but more alarming was the rise in fatalities to fourteen, the highest number since the peak year of 1986. In 1999, the number of accidents rose even further to ten, the highest also since the peak year of 1986. Fatalities were down to ten but still higher than the average of six.
To address the issue of safety, the Association of Air Medical Service, in consult with HAI, the National EMS Pilots Association (NEMSPA), the National Flight Paramedics Association (NFPA), the Air & Surface Transport Nurses Association (ASTNA), the major air medical service operators and aircraft manufacturers, convened the Air Medical Safety Summit in Dallas, TX, on April 7, 2000, to discuss safety within the air medical service industry.
In a process very similar to that used by the FAAs Safer Skies Joint Safety Analysis Teams (JSATs) in their recent study of weather and controlled flight into terrain (CFIT) accidents, the Safety Summit attempted to identify what prevalent factors existed in AMS operations that tended to degrade safety. With insufficient time at this particular meeting to conduct an in-depth cause analysis, the identification of accident causes was based primarily on opinions and speculation. However, several broad areas were identified, including: a lack of training (recurrent, CRM, weather, decision making, etc.); an administrative culture that too often does not place safety first; inadequate technologies; and other human factors (fatigue, cockpit overload, sense of mission urgency, inadequate piloting skills, etc.)
Although the Summit arrived at a variety of perceived causes of air medical accidents, no comprehensive analysis of accidents had been conducted. Therefore, the Air Medical Service Accident Analysis Team was formed to conduct an in-depth analysis of air medical helicopter accidents to identify the chain of events that has led to accidents and to identify intervention strategies that would be both effective and feasible in preventing such accidents in the future.
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Recommendations - It is the recommendation of the Air Medical Accident Analysis Team that the Air Medical Safety Advisory Council (AMSAC) review these findings and focus efforts within the air medical service industry on the development of implementation strategies for those interventions that are highly effective and highly feasible. AMSAC should also consider interventions that are highly effective but moderately feasible, as well as interventions that are highly feasible but moderately effective. When time and resources permit, AMSAC should also consider interventions that are moderately effective and moderately feasible, as some of these interventions may require only modest implementation but may have some impact upon the enhancement of safety. However, those interventions that are identified as low in effectiveness, low in feasibility, or both, should not be pursued.
LIST of RECOMMENDED INTERVENTION STRATEGIES:
Interventions that ranked High Effectiveness and High Feasibility:
Enhance the training for night flying operations
Enhance the training for mountain flying operations
Equip aircraft with Terrain Avoidance Warning Systems (TAWS)
Equip aircraft with Radar Altimeters
Provide aircraft with mission essential equipment
Improve the content of weather briefings
Interventions that ranked High Effectiveness and Moderate Feasibility:
Conduct/enhance annual IFR proficiency checks
Conduct/enhance training to improve the understanding of weather briefings
Enhance overall training: recurrent, professional knowledge, etc.
Conduct/enhance training in Aeronautical Decision Making (ADM)
Establish an integrated and structured Pilot Training Program
Conduct/enhance mission oriented training
Conduct/enhance Crew Resource Management (CRM) training
Equip aircraft with Moving Map Displays to provide weather, obstacle and terrain data
Equip aircraft with avionics to provide a vertical awareness display or warning
Standardize cockpits of similar make/model used in similar operations
FAA to enhance/improve contents of annual IFR proficiency checks
Establish a national criteria for the marking of wires and towers
Interventions that ranked Moderate Effectiveness and High Feasibility:
Enhance the awareness of accident causes
Improve physiological training
Improve training with avionics equipment: usage, capabilities, etc.
Improve weather radar
Encourage greater utilization, interaction with and assistance from Air Traffic Management
Improve/enhance training of ATC personnel in rotorcraft operations and capabilities
FAA to enhance training elements of Biennial Flight Reviews and Pilot Training Standards
Interventions that ranked Moderate Effectiveness and Moderate Feasibility:
Operators to enhance training for Biennial Flight Reviews and Pilot Training Standards
Develop helicopter-specific, mission-specific computer based Emergency Procedures Simulators
Develop satellite-based Communications, Navigation and Surveillance (C/N/S) technology
Increase the rate of commissioning of new AWOS/ASOS facilities
Improve aeronautical charts (symbology, data, etc.)
LIST of INTERVENTIONS NOT RECOMMENDED FOR IMPLEMENTATION:
Intervention Strategies Scoring Low Effectiveness:
TRN-11: Improve Pilot Handbooks
EQ-3: Data-Link Technology
EQ-18: Readily available passenger/crew briefing cards
EQ-22: Fuel Flow indicators
ATC-3: Simplify contacting FSS
REG-7: Require annual calibration of fuel quantity gauges
REG-9: Publish a Mountain Flying Advisory Circular
REG-10: Publish a Flat Light/Whiteout Advisory Circular
REG-11: Require flight plans
NAS-2: Provide more UNICOM frequencies
Interventions Scoring Low Feasibility:
EQ-1: Avionics to provide horizontal awareness of terrain
EQ-4: Synthetic Vision
EQ-6: ADS-B technology
EQ-8: Heads-Up Display
EQ-9: Night Vision Devices
EQ-11: Automated Voice Callouts
EQ-12: Over-Bank Warnings
EQ-13: Excess terrain closure warning
EQ-21: Equip aircraft with state-of-the-art technology
EQ-24: Avionics to enhance detection of wires and towers
REG-2: Prohibit night flying by non-IFR rated pilots
REG-6: Require human factors/ergonomics in cockpit designs
MISC-2: Change corporate/management mindset
MISC-3: Improve safety culture
MISC-5: Improve safety programs
Interventions Scoring Low Effectiveness and Low Feasibility:
TRN-12: Increase Dual-Pilot time prior to solo PIC
TRN-13: Increase time requirements for mission certification
EQ-7: Obstacle Database
EQ-17: Enhanced ice detection equipment
ATC-5: Raise Minimums for night instrument approaches
ATC-6: Require ATC monitoring of instrument approaches
REG-1: Prohibit night VFR
REG-5: Update FAR Part 135 requirements
REG-8: Require crashworthy fuel tanks for certification