NTSB says EMS accident rate is too high

[Vertolot]

Have been following with interest the discussion around the EMS in the US in this thread, my opinion is the following:

- It´s very very tragic will all this resent EMS accidents and everything possible should be done to stop this negative trend (i.e. immediate and long term actions)
- the goal in any (EMS) flight operation have to be that, one single fatal accident is unacceptable

After having being involved in the HEMS in Europe I somehow have come up to the following:

- In Europe the HEMS flight operations is very “regulation/authority driven”
- In the US the EMS flight operations seems to be very “market driven”

I have many times been thinking that a system that should be somewhere between the US and European system could be a perfect solution (also when considering the long terms effects). On one hand one accident is too much but on the other hand someone has to pay for every flight in one form or another (free competition or government founded).

I think that the solution for safer EMS operations in the US consists of many factors that are involving some rather tuff and hard changes, ranging from customers to management to pilots to equipment (if the solution would have been very simple it should have been made a long time ago already J). Without knowing to much accurate details about the US EMS operations I have noticed the following:

• Flying VFR at night unaided in areas with very little or no visual references, should have in my opinion minimas like, Cloud base 2500-3000 feet and visibility of at least 10 km (yes, I know that with these minimas you will have to cancel a lot of missions during night time). The minimas could be slightly lower if you operate over cities and highly populated areas with a lot of illuminated ground references or if you have NVG.
• Before going on a night mission you should have the time to spend some 5 minutes extra on getting accurate weather information and talking to a meteorologist. Getting some accurate weather information over the region you are operating in.i.e. how fronts are moving and when they are expected to move in etc. A very good briefing and understanding of the weather in a big enough area is important. You might get a new mission during the flight with a higher priority or at the accident site you might get the destination hospital and to be able to make a go/no-go decision you must have good accurate weather information.
• If I had understood right, the systems in the US works so that the first EMS helicopter on accident site will get the job. With this time pressure 1 minute could be the difference of getting the job or not. In general in HEMS it will very seldom makes a difference in helping a patient if you come 5 minutes earlier or later (it can sometimes, but very seldom). Very often there is already ground units on the accidents sites before a helicopter reach it. In this terms there should be the required time to get accurate weather etc. information before making go/no-go decision. If you are competing with other EMS helicopters to be first on the accident site it looks like you have no time to make a good go/no-go decision based on accurate facts.
• Have Standard operating procedures (SOP) for the operations. They should not be written with the intention of satisfying any inspector from the Authorities. They should be written for the pilots and should be as simple and clear as possible. They should be practised in simulator at least twice a year representing scenarios in the operational area.

As I said earlier, these are only my opinions!


Cheers,

Vertolot