Autopilots vs NVGs
EN48 made a very good point concerning the utilization of auto pilots in light single engine machines. That one device would take much of the anxiety out of IIMC events. An autopilot doesn’t care if the machine is in IMC conditions. All the pilot has to do is properly manage the autopilot throughout the flight. In the US, operators have opted for NVGs to mitigate night operational risks. NVGs may assist in not encountering IIMC but would do little once IIMC is encountered.
Single versus twin engine has little bearing on the discussion at this time. Statistically, because the actual number of in-flight engine shut downs for all turbine engine helicopters is so low it would be difficult to establish that the number of engines has any bearing on EMS accident rates.
Our regulatory system in the US should absorb much of the blame. Our system has turned its back on safety putting the operators concerns ahead of safety when regulating operators. The fact that a helicopter can operate at night with only 1 mile visibility (FAR135.205) and with no reference to minimum ceiling borders on insanity. Our air medical mishap rate however dismal it may seem, could be far worse if it were not for the professional decisions put forth by most PICs before each and every flight.