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Old 25th Jan 2006, 14:21
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Flying Lawyer
Join Date: Jul 2000
Location: London
Posts: 2,917
Exclamation HEMS safety: Statements issued by FAA and NTSB

Issued by the FAA yesterday.

January 24, 2006

EMS Helicopter Safety
Helicopter Emergency Medical Service (HEMS) operations are unique due to the emergency nature of the mission. In August 2004, the FAA initiated a new government and industry partnership to improve the safety culture at EMS operators and recommend short- and long-term strategies for reducing accidents. While the FAA has not ruled out proposing new or changing existing rules, the agency has prompted significant short-term safety gains that do not require rulemaking. The FAA’s immediate focus has been on:
  • Encourage risk management training to flight crews so that they can make more analytical decisions about whether to launch on a mission.
  • Better training for night operations and responding to inadvertent flight into deteriorating weather conditions.
  • Promote technology such as night vision goggles, terrain awareness and warning systems and radar altimeters.
  • Provide airline-type FAA oversight for operators. Identify regional FAA HEMS operations and maintenance inspectors to help certificate new operators and review the operations of existing companies.
There are approx. 650 emergency medical service helicopters operating today, most of which operate under Part 135 rules. HEMS operators may ferry or reposition helicopters (without passengers/patients) under Part 91.

The number of accidents nearly doubled between the mid-1990s and the HEMS industry’s rapid growth period from 2000 to 2004. There were 9 accidents in 1998, compared with 15 in 2004. There were a total of 83 accidents from 1998 through mid-2004. The main causes were controlled flight into terrain (CFIT), inadvertent operation into instrument meteorological conditions and pilot spatial disorientation/lack of situational awareness in night operations. Safety improvements are needed.

FAA Oversight
The FAA inspects HEMS operators, but is prompting changes beyond inspection and surveillance. Rather, the FAA is moving to a risk-based system that includes the initiatives outlined below which focus on the leading causes of the HEMS accidents.

FAA Actions
  • In August 2004, the FAA established a task force to review and guide government/industry efforts to reduce HEMS accidents. The FAA most recently met with HEMS operators on October 18, 2005.
  • On January 14, 2005, the FAA hosted a meeting with EMS industry representatives to discuss safety issues and gain feedback. Representatives from the Association of Air Medical Services, Helicopter Association International, the National EMS Pilots Association and several operators attended.
  • On January 28, 2005, the FAA published a notice that provides guidance for safety inspectors to help operators review pilot and mechanic decision-making skills, procedural adherence, and crew resource management practices. It includes both FAA and industry intervention strategies (Notice 8000.293 Helicopter Emergency Medical Service Operations).
  • On August 1, 2005, the FAA issued guidance to inspectors to promote improved risk assessment and risk management tools and training to all flight crews, including medical staff (Notice 8000.301 Operational Risk Assessment Programs for Helicopter Emergency Medical Services).
  • On September 22, 2005, the FAA issued guidance to HEMS operators to establish minimum guidelines for Air Medical Resource Management (AMIRM) training. The training focuses on pilots, maintenance technicians, flight nurses, flight paramedics, flight physicians, medical directors, specialty team members (such as neonatal teams), communications specialists (dispatchers), program managers, maintenance staff, operational managers, support staff, and any other air medical team members identified by specific needs (AC No. 00-64 Air Medical Resource Management).
  • On September 27, 2005, the FAA issued a notice to inspectors to provide guidance for special emphasis inspection programs (Notice 8000.307 Special Emphasis Inspection Program for Helicopter Emergency Services). During summer 2005, FAA safety inspectors met with EMS operators to review their Operations Specifications (OpSpecs) for EMS VFR weather minima. Changes to those minima, including the level of lighting for night operations, are in the final stages of development.
  • On January 24, 2006 the FAA issued a handbook bulletin to inspectors describing acceptable models for CFIT Avoidance and Loss of Control (LOC) Avoidance Programs. The bulletin contains information for inspectors to provide to HEMS operators for developing LOC/CFIT accident avoidance programs and clarifies existing guidance (HBAT 06-02 Helicopter Emergency Medical services (HEMS) Loss of Control (LOC) and Controlled Flight Into Terrain (CFIT) Accident Avoidance Programs).
  • On January 24, 2006 the FAA issued revised guidance to inspectors regarding HEMS OpSpecs, amending the Visual Flight Rule (VFR) weather requirements for HEMS operations (HBAT 06-01 Helicopter Emergency Services; OpSpec A021/A002 Revisions).
  • Members of the aero medical and rotorcraft industries continue to work with the FAA through the Part 135/125 Aviation Rulemaking Committee to recommend changes to Part 135 (general aviation) segment of the industry.
  • The helicopter industry recently formed the International Helicopter Safety Team (IHST) to gather data and draft strategies to reduce helicopter accidents globally by 80 percent by 2015. The effort is modeled on the Commercial Aviation Safety Team (CAST) which has achieved a significant reduction in the commercial fatal accident rate in the United States. Members include the FAA, European Aviation Safety Agency (EASA), Transport Canada, the International Civil Aviation Organization (ICAO), and industry representatives.
  • The FAA’s Flight Standards Service formed a task group this month to focus on the large HEMS operators that support a variety of medical organizations throughout the United States.
On March 21-23, the FAA in cooperation with the University Corporation for Atmospheric Research (UCAR) will host a government/industry HEMS Weather Summit in Boulder, Colorado. The purpose of the summit is to identify the HEMS-specific issues related to weather products and services. Attendees will explore possible regulatory improvements, weather product enhancements, and operational fixes specific to HEMS operations. Invitees include the National Weather Service, National Center for Atmospheric Research, Helicopter Association International, American Helicopter Society International, Association of Air Medical Services, National EMS Pilots Association, National Association of Air Medical Communications Specialists, manufacturers, and many HEMS operators.

Night Vision Goggles
The FAA has a solid record of facilitating safety improvements as well as new technologies for EMS helicopters, including certification of Night Vision Goggles (NVGs). Since 1994, the FAA has worked 28 projects or design approvals called Supplemental Type Certificates (STCs) for installation of NVGs on helicopters. This number includes EMS, law enforcement and other types of helicopter operations. Of the 28 projects, the FAA has approved approximately 15 NVGs for EMS helicopters. The FAA initiated and wrote (in coordination with RTCA) the minimum standards for NVGs/cockpit lighting. Technical Standard Order (TSO) C164 was published on September 30, 2004 referencing RTCA document DO 275 Minimum Operational Performance Standards (MOPS), published October 12, 2001. The FAA has hosted workshops to help applicants work with the FAA to obtain NVG certification. One set of NVGs costs approximately $7,000 and an operator must carry multiple sets per flight. Certification is just one step. The operator must also have an FAA-approved training program for using NVGs.

Flight Data Recorders
Flight Data Recorders (FDRs) are not required for HEMS operations. FDRs offer value in any accident investigation by providing information on aircraft system status, flight path and attitude. The weight and cost of FDR systems are factors. Research and development is required to determine the appropriate standards for FDR data and survivability in the helicopter environment, which typically involves substantially lower speeds and altitudes than airplanes. Funds are currently best invested in preventive training.

Terrain Awareness Warning Systems
The FAA supports the voluntary implementation of Terrain Awareness Warning Systems (TAWS) and did consider the possibility of including rotorcraft in the TAWS rulemaking process. Through this process, however, the FAA concluded that there are a number of issues unique to VFR helicopter operations that must be resolved before the FAA considers mandating the use of TAWS in this area, such as modification of the standards used for these systems. For example, helicopters typically operate at lower altitudes so TAWS could potentially generate false alerts and “nuisance” warnings that could negatively impact the crew’s response to a valid alert. TAWS application to HEMS would require study of TAWS interoperability within the lower altitude HEMS environment, and possibly a modification of TAWS system standards.


Any thoughts by those in the industry?


Last edited by Flying Lawyer; 25th Jan 2006 at 14:59.
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