Twins are absolutely not the answer. First, take a look at the recent accidents, and you'll see multis at least proportionally represented. If that's not convincing, there are statistics that seem to demonstrate that light twins have a marginal if any safety advantage over singles (look for the OGP(?) published stuff on this, for instance). There's lots of qualifiers intentionally included in that sentence, and it contradicts intuition. My opinion as to why: The extra systems are extra management load in the best of times; When something goes wrong, systems management can become a distractor from your main job- flying the aircraft and NOT CRASHING into something (This one is very well documented, fixed and rotary wing); Finally, and the discussion itself strengthens my last point, what I call "twin engine invulnerability", is very wide spread. I've seen lots of guys fly twins into an unsurvivable engine failure situation because they have "two engines".
430EMSpilot-
I hope it isn't a 'class issue', HBM vs. CBM. I see a conflict of interest in that training are required to be management and not 'craft/trade/profession' oriented. The mindset shows in the application of redundant checklists. Identify and fix the root cause, not the symptom.
busdriver02-
We fly the same legs to the same places in the same weather and the same equipment, day and night. Yet, night is far more dangerous. My opinion-
Jet lag (circadian disruption) is a widely understood and accepted factor- By everybody but EMS?
There are also studies of mental efficiency with sleep loss, showing every hour after 3 hours being roughly equivalent to the standard alcoholic beverage. Again, doesn't apply to EMS?
Add that unaided human night vision can be as bad as 20/200 or 20/400...