Risk 'v' Gain

[Scattercat]

I would like some feedback on the issue of how much information should EMS pilots / crew be told about patient's conditions / task. On one hand there is the train of thought that pilots should simply be tasked (asked) to fly from A to B. "Yes I can or no I can't (Poor WX etc). On the other hand, does that allow the pilot to make an accurate "Risk v Gain" assessment? Ultimately there will always be a line of risk that no task should cause to be crossed but how many times have you pushed through the "dark & stormy" to retrieve a case of "terminal dandruff"? Do we rely on the tasking agencies to make that decision? Your thoughts!

[Jerka]

Most professional rotorcraft pilots will concerntrate or specialise in a certain type of operation.....Be that EMS, Offshore, Police, Long Lining etc.
The depths of capacity will deepen once that pilot has reached a certain level of role specific knowledge and experience. However there are the hard rules that govern us all...and these have been written with safety as the essence.

There are many aspects that govern each and ever flight.....Weather, PUS, Fuel, FDTL etc......and of course client pressure.

The health of any passenger [Patient] is just one of the aspects that must be considered...just one of many.

There are certain rules that can be challenged, and if justified, then acted against, the guidelines for this action is outlined in Jeppesen Air Traffic Control, AU-1101 [Mercy Flights]. Part of this "Mercy Fight" declaration is that the PIC must be convinced that the non compliance with any rule can be substainiated in a Court of Law. Therefore he must "Test" the sincerity of the medical request, and be positive that it is legitamate, and his/her decision is defendable.
The only decision regarding the actual flight belongs with you...and you alone.

[heedm]

The decision whether to go or not should be based on the weather, regulations, and your limitations. It may be that the tasking agency isn't well versed in anything helicopter. I consider that I may be the helicopter authority while talking to the tasking agency, and as such should assist them in the risk analysis.

The patient's condition should be known by the pilot, not necessarily to substantiate delaying or refusing a mission, but to be best suited to plan the mission.

If the patient has heart attack symptoms, time on scene is paramount. If the patient is severely burnt, a longer trip to a burn center may be required, so extra fuel and a slower speed will be accepted.


In any case, there should be no question what the authority of the tasking agency is and what rights you as the pilot have to refuse missions.

[ 15 January 2002: Message edited by: heedm ]</p>

[RW-1]

I like to think that when I get to that type of flying, I won't mind knowing the patient's condition for the reasons mentioned beforehand, for flight planning, where taken, etc.

As sorry I might feel for the patient however, the safety of my aircraft, myself and my crew will be the only issue in determining whether the flight will be undertaken, wich all other factors made (weather, etc.)

Some would feel that the patient is cargo, and at some level that is true, a pickup and delivery. But unless one is detached in making flight go-nogo decisions, you could find yourself in a bad situation with the best intentions.

[ 15 January 2002: Message edited by: RW-1 ]</p>

[Devil 49]

Patient info is a two edged sword, folks. Once you've declined a flight that in your judgement you can't be reasonably certain of completing-will patient criticallity improve your capabilities?

I'll take any flight any time, anywhere that meets my company's guidelines. The guys I work with have the same attitude-we're eagerly waiting for that next flight. If we turn it down, it's for cause.

[sling load]

Ive seen this sort of thing so many times, and in nearly every case the urgency and the condition of the patient is second in your mind when you are on final into a black hole in driving rain.

My attitude from experience, get the paramedic to ask " can we go to point B?"

If the answer is no, go back to sleep.

If the answer is yes, then ask "has the patient got head injuries?"

If the answer is yes, this will affect your return flight plan due to LSALT, and pressure changes forced on the patient.

Thats it.

Ive busted my arse too many times for secondary bull**** transfers that could have been FAR safer by road, thinking I was doing the right thing, then realising how much you push your capabilities and machine.

Poor weather and an urgent job is always the precurser to bad decisions and missing little things that have huge ramifications at the other end.

[Skycop]

For reasons already stated we used to have a system for grading casualties. We would know if it was life-threatening or not and be able to weigh up the odds.

Contact the Hong Kong Government Flying Service for details, they have such a system in place.