"Medical evacuation helicopter crashed"

[RCG]

AURORA, Ill. -- Four people have been killed after a medical evacuation helicopter crashed in the Chicago suburb of Aurora, Ill.

According to Aurora police, the helicopter was headed for Children's Memorial Hospital from Valley West Hospital in Sandwich.

Sgt. Robb Wallers said the helicopter belonged to Air Angels, an emergency medical transport service.

He said the victims included three crew members and a patient. He refused to provide further information on the victims, saying the next of kin had yet to be notified of the crash.

According to police, the helicopter crashed in a field near a residential area in east Aurora and was engulfed in flames. He said police and fire officials learned of the crash around midnight.

Investigators with the National Transportation Safety Board were at the scene of the crash.

[Hedge36]

Damn it.

Damn it.

Damn it.

:ugh:

[Aser]

oh my god, not again... :sad:

R.I.P.

[turboshaft]

Reported as a Bell 222.

"Not again" really does sum it up. It's been such a bad year that it's almost inevitable that lawmakers will intervene, just to be seen to 'stop the bleeding' (no irony or offense intended). With this and the economic meltdown, the industry is now facing the perfect storm.

[Furia]

One more :(

Seems something is really wrong with those Night VFR HEMS programs.

According to the latest news seems it may have cliped a guy wire from a radio station tower.

Single pilot night flight on HEMS operations is risky bussines.
The pilot workload on HEMS operations is very high and by night multiplies its factor.
A copilot may help to reduce the workload and maybe would help to spot hazards to the flight in time.

I have no magical solutions but something must be done or this is bound to be repeated. :uhoh:

[griffothefog]

I have said it before in a similar thread... stop night HEMS :ugh:

I really do not beleive it will make any significant difference if patient transfer or primary response is reverted to ground ambulances. You will never stop people from trying to kill themselves and at the end of the day as much as I support HEMS, it is becoming an embarrassment in the USA.:{:{

[CareerHeloDrvr]

Hold on a minute folks, let's not throw out the baby with the bathwater just yet. I am not going to crawl into the deceased pilots cockpit but the weather was pretty crappy yesterday in Aurora. I'm not sure what time the accident occurred or what his flight weather was, but we were down for weather all day yesterday 50 miles south of Aurora due to low ceilings and vis. I am speculating here, and I mean no disrespect to our fallen brethren, but possibly clipping a tower guywire at night sounds like he may have been pushed below his normal night cross country altitude by unexpected weather. In fact he may have been trying to land due to weather, but we don't know at this point. You would not expect to be so low as to hit a guy wire on an interfacility transfer.

We have to step back (especially at night) and assess the risks to the entire crew making sure we are not focusing too closely on the patient and all the surrounding information that should not be part of the go-nogo decision process. While there has been a decided uptick in stateside EMS accidents, this older pilot feels some of these are related to newer less experienced pilots filling the void. Overall, night HEMS ops are being conducted in massive numbers across this country and are being executed in a safe and professional manner. Like it or not, single pilot night HEMS operations are an accepted NORM here in the states and new tools like ANVIS 9 Pinnacle NVG's are making them even safer.

Condolences to the familes and friends of the deceased.

[helimutt]

WTF? You say they're getting safer? Doesn't sound like it if you only read pprune. There seems to be a lot of night hems ops go wrong! Reasons why? pushing the envelope?

[CareerHeloDrvr]

Greetings Helimutt, I am not saying that things are safer right now, they seem decidedly unsafe. I was saying NVG's can make night operations safer. Of course, that's provided you hire qualified, experienced pilots, etc..etc.

[TheMonk]

Crap. I live only 30 minutes from the last crash (Maryland State Police near Andrews AFB).

Crap crap crap.

Sad days indeed.

[Jackonicko]

"Like it or not, single pilot night HEMS operations are an accepted NORM here in the states ........"

Time to regulate them out of existence and to go for a new norm.

Twin engined, Category A, with two pilots AND NVG or FLIR.

Yes it will cost money.

Yes the two bit ops will go to the wall.

But better that than losing more friends and colleagues.

[tottigol]

Yes, it WOULD COST money and NO, it WON'T HAPPEN unless they kill a Senator or a General (see the changes in the LUH competition following a UH-60 crash in TX) in the process.
Just because of the first paragraph above, who really runs the industry and who the FAA is in bed with.

[CareerHeloDrvr]

I flew EMS for 10 years, on and off, and I have always thought every EMS pilot, in fact all commercial pilots, should have an IFR rating with some set number of hours of actual IMC experience. I think a lot of these crashes are IIMC related and speak to the inability or fear of these pilots to transition to instruments and commence IFR flight. IIMC and night Training with a well equipt aircraft could make the difference in some of these events. Its fiscally unrealistic to think the entire system will be revamped to the point these operations are dual pilot, full IFR aircraft, etc, etc.

[RJ Kanary]

Links to the latest we have here. :(



4 killed in helicopter crash in Chicago suburb - USATODAY.com (http://www.usatoday.com/news/nation/2008-10-16-illinois-helicoptercrash_N.htm)

Crash victim's family thanks Air Angels :: Beacon News :: Local News (http://www.suburbanchicagonews.com/beaconnews/news/1224794,aurora-helicopter-crash-au101608.article)

[deeper]

Careerhelodriver, are you serious, it is getting worse not better, this would have to be the worst year to date on record, ever. Don't you read the forums.

NVG's will not help anyone when you are in cloud or heavy rain at night, are you saying that if all the accidents this year in marginal weather would not have happened if NVG's were used, what a load of rubbish, four more good people dead, for what??? for what??? What a disaster your system is.:suspect::suspect::ugh::{

[Phil77]

:( :( :(

:ugh::ugh::ugh:

some facts:
- time of accident: 11:58 (3:58Z)
- guy wire was clipped at approximately 700ft agl (tower is 734ft agl)
- NTSB guy stated that the lights where not on when he got to the scene, however could have been taken out by the accident.

Weather:
Cold front moved through at roughly that time; metar's indicate that a FEW015 was the lowest all night.

10nm west of crash site:
KARR 160352Z AUTO 33009KT 10SM OVC033 10/07 A3014 RMK AO2 SLP207 T01000072

8nm north-west:
KDPA 160352Z 32007KT 10SM BKN016 OVC023 12/09 A3012 RMK AO2 SLP201 T01170089

25 nm east:
KMDW 160404Z 33011KT 10SM FEW015 OVC028 12/09 A3011 RMK AO2
KMDW 160351Z 33009KT 10SM FEW015 OVC030 12/09 A3011 RMK AO2 SLP194 T01170094

[RJ Kanary]

In an "irony of ironies" situation tomorrow, weather permitting a helicopter is going to be used to replace the severed guy wire in hopes of keeping the tower from collapsing.

RJ

[Revolutionary]

Careerdriver you bring up an interesting point about not focusing too much on the 'patient and all the information that should not be part of the go/no-go decision process', by which I presume you mean the patient condition. We just got a flight request for a patient pickup over 100 miles offshore. It's 2:45 AM and nearby weather stations are reporting a zero temperature/dewpoint spread so we've turned this one down but it occurred to me that maybe we should make the patient condition part of the go/no-go process.

Here's what I mean: This patient could have had anything from a broken ankle to a brain aneurysm for all I know. The decision to ask for a helicopter was made by some medical director somewhere who was either looking at the patient's medical chart or (cynical me) at his insurance card but surely wasn't looking at a weather chart or thinking about the risk involved in bringing a patient in from offshore in the dead of night in marginal weather. He made his medical decision and now it's up to me to make my pilot decision and neither one of us is fully informed.

Of course I can't make judgments on medical necessity any more than a doctor can judge the weather but a medically trained flight dispatcher could. Somebody in the chain of operational control could be in a position to weigh the two and see if a helicopter is really called for. Somebody should. Unfortunately though the health care industry in this country is not driven by medical necessity but by profit so the hospital only thinks about filling a bed and the EMS provider only thinks about billing for a transport; nobody does the cost-benefit analysis and up goes another helicopter, launching into the night to pick up a patient with a broken ankle. And therein lies -I think- the root of this problem.

In a strict sense most of these crashes are a result of CFIT at night in marginal weather (or some variation on that theme) but in a larger sense they are a statistical inevitability -the result of the over abundance of EMS helicopters in this country and their gross over utilization. No amount of additional equipment or training is going to remedy that. It's going to take changes in the way aircraft are allocated to different areas, the way they are utilized and how they are dispatched.

[CareerHeloDrvr]

Revolutionary: I absolutely agree with you. I have seen this system at its worst. Launching helicopters to get people out of clinics so doctors can go home....flying people all over the mountains of Montana who were flown only to save an ambulance from having to drive for three hours.... These decisions are being made by medical professionals and medical crew members and in many cases, the reason is almost always so they can bill for the flight. I was almost always, and rightfully so, never made aware of the patients condition until arrival on scene.

To answer those who haven't read closely my previous post: I did not say the accident rate for EMS is getting better, it is getting worse. We all see that! I pointed out some practical ideas to make them safer. The Air Angels flight tragically clipping a 700' AGL guy wire probably could have been avoided.

[Devil 49]

It's already been posted, but:

"Damn it.

Damn it.

Damn it."

And already posted, "Hold on a minute folks, let's not throw out the baby with the bathwater just yet." Night VFR can be very, very safe. Perhaps not as safe as day VFR, but a heck of a lot safer than we're doing at present. NVGs make an immense contribution to this, but more is needed to make EMS night flights anywhere near as safe as day flights. Twins and singles, VFR and IFR, hospital and community based, all seem to share the increased risk of night flight. If you look at the trend, the common issue is that for some reason the pilot failed at some critical task: managing the autopilot; maintaining altitude; in severe clear VFR and other WX conditions, the pilot failed at something that, as a rule, is accomplished in daytime. Physiology, ladies and gentlemen.

[DTibbals53]

There are many aspects to this. Poor decision making, poor weather flying, improper influences to "get the mission done", all while under operational control that is non-existant in most cases.

Why are dispatch calls getting to the base when the weather is below company minimums? When I challenged a communicator on why even call, I was told that "we just get the calls and forward them. It is the pilot's decision to accept or not." Pilots, with operational control listed in the A008 section of their OpsManual, overseeing the communcations centers with an active veto authority would be true operational control, not the brainless call forwarding service we currently suffer. If the company would not approve after the crash, why send the call out to the field offices? I was taught a long time ago that the best way to make a decision was to look at the possible conclusions of the accident investigation prior to the flight.

Also, young pilots are not sufficiently trained in the early years with no one on shift to mentor them in their development. 2 Pilot crews would bring this along, as well as provide that second set of eyes on pilot thoroughness. Too often, pilots shortcut preflight planning. Whether these omissions are because a flight request came in too early in the shift to complete the normal preparation, or whether the call awakens the crew at 0300 and the computer did not update the radar, HEMS weather or other information pertaining to the flight, the end result is an ill informed pilot. We tend to perform to standard when we are in the teaching/learning modes. Attention to detail would be increased, not to mention the increased crew coordination within the cockpit.

With two pilot cockpits comes twin engine capability, in most cases. I do not care what statistics are thrown on the wall when it comes to single vs. twin engine safety history. There are no existing databases, accurately sampled, that reflect the occurance of engine malfunctions on twin engine helicopters which resulted in a safe landing. If a twin becomes degraded by an engine failure, it now still flying when the single would be in an irretrievable autorotation. We know about those at night.

Night flights should have an Autopilot capability mandated from the feds. Several have commented on the workload on the single pilot, at night, in degrading conditions. Even in ideal VMC night conditions, workload his very high, stressors increasing throughout the flight, and the mere addition of an AP would assist greatly. With all the increased radio communication demands imposed after the AZ mid-air earlier this year, it is like playing switchboard opperator in a 1930's Keysone Cops movie. Give a man (or gal) a hand and provide a system that would at least hold altitude and heading. Even if two pilots are in the aircraft, it is a margin without which an airliner would not leave the gate.

Night flights also should have NVG mandated. I currently fly with the ANVIS 9 and it was the best safety advancement my company has ever made. Now, if we could only get the FAA to figure out that they do not need to regulate safety out of existance. Watching the FAA trying to figure out how they can regulate these things is like watching a monkey screw a football. It would be funny if not so sad.:sad:

Damn it, indeed! Common sense has taken a back seat to an entrenched FAA sorely out of touch with the demands imposed on insufficient aircraft; aircraft which were never designed for the task of EMS. Common sense abandoned for the saving of a dollar. Common sense ignored by operators who have the political connections to prevent positive change.

Damn it indeed.:mad:

[WhirlwindIII]

Interesting posts - thanks for the ideas.

To me this thread seems to be leaning towards recommending the medical side look at some way of factoring in a mode-of-transport risk decision track betwixt ambulances and helicopters rather than making such decisions based solely on the perceived medical necessity of transport time savings. Hope that makes sense!

I certainly agree there is a general death of common sense at play in this HEMS industry when it comes to overall risk assessment and decision making by a lot of folks involved, at all levels;and I think folks on the line like us are the only ones capable of pointing out the real problems and possible solutions.

[Old Skool]

I think very well summed up by DTibbals53.
I quite my last program because they equipped the ground crews with NVG (who knows why) but wouldn't even talk/listen about NVG for the aircraft.

It is a shame that the FARs are written in blood, how much more is needed?

[tottigol]

I was once taken aside by the CEO of the hospital based program where I flew, he in short words accused me "that instead of looking for reasons not to complete a flight I should look FOR REASONS TO COMPLETE A FLIGHT" and threatened to have me removed.

For as long as we allow that type of thinking in this industry and as long as we allow that degree of oversight by a customer, there will be death to pay.
We need to leave the medical equation OUT of our business, PERIOD.

[Gas Producer]

Tottigol,

Well said. Nothing to add.

GP

[BigMike]

Some good comments from some of the EMS pilots on this site.

I will give you my experience while flying EMS (Central Europe) at night.
We flew NVFR only, in a IFR equipped (less an autopilot), Bell 427. All pilots were given regular training, in a covered cockpit, on instruments and ILS captures.
There would always be 2 pilots (unless the 206LT was being used due to maintenance) with the Lead pilot for the shift making the go/no-go decision, with obvious input from the second pilot.
We had a 15 minute window to check weather along the route and to make sure that company minimums could be kept throughout the flight. The condition of the patient was not generally told to us, and even if so, was not relevant to the mission going ahead. The pilot’s decision was FINAL. He was backed 110% by the company management on this. Any medical personal pressuring a pilot would be removed from flight operations permanently.
We also only did inter-hospital transfers, or landings in to known areas at night. This is due to change with the introduction of NVG’s I believe. The weather minimums will remain the same however.
I don’t think NVFR is a big problem, but you have to pick your battles. If the weather is looking marginal just don’t go, it’s not worth it. You can’t save everyone.

This is a post from a while back where we said no, and another crew said yes, and died. It is well worth reading the entire thread. It all sounds depressingly similar.

http://www.pprune.org/rotorheads/204462-three-dead-another-night-bad-weather-flight-over-dark-terrain-2.html

[jinglejim]

We are wondering how much pressure is placed on HEMS pilots in the States. " Damn too many accidents to date for it not to be a consideration.
Do medical personnel give the pilot the patients condition prior to departure,? which would undoubtedly impact on a pilots decision making process.
Do the pilots get pressure from management? though I'm sure the pressure would be subtle enough not to place the management accountable for anything....
Due to pilot shortages world wide are operators finding it difficult to fill the positions with experienced pilots?? Even experienced pilots find it hard to say "NO" to a job.

I feel if the cockpit instrumentation required for NVFR was the same for IFR then I would n't have the same hesitation to fly NVFR. Personally I think it sucks and would never fly again with an operator that only has aircraft nvfr capable.

But when your young and need the hours you do and fly anything right????

[Old Skool]

Pressure, some subtle, some not so subtle.
Response times are recorded for every call, and yes sometimes questions are asked if it seems a slow response, no questions from the other pilots, questions come from the hospital.
Flight volume is also recorded and compared to previous months, this should in no way ever enter the mind of the pilot but there it is. If we can take the flight we will, if we can't we won't should be the answer.
Patient info is passed over the radio along with your heading and distance, why on earth does the pilot need to know anything about the patient, nasty harmfull diseases aside.
I got a light hearted comment tonight about my reading from the checklist and doing a quick 360 walkaround.
Luckily i think i can be very callous and i sleep soundly on the decisions i make, i hope this clear conscience continues.
This is just a business afterall? just don't let the med crew hear you say that!

[Shawn Coyle]

A question that might be related to the comments about the tower being unlit.
How many of you have ever reported a tower's lights as being off? Who do you report it to? Was any action taken? Did you record the fact that the tower was reported as unlit??

[alouette3]

Skool:
A few days ago, our Medical Base Manager made a comment that the job was getting more difficult because " the company is turning this into an aviation business". Therein lies a very important clue. I have said here before that, mentally, the crews are still in the back of the ambulance. Saving lives, going hell for leather, lights and sirens, to get there before " the hospital/volunteer squads/doctors(!) kill the patient". That is an inherent difference between the two groups.
As to the pressures,I believe, a lot of the pressure is self imposed. It could be something as mundane as --my paycheck will go away if my base gets shut down, or, as lofty as ---I am a part of the life saving equation. There is also an increase in the pressure (self imposed again) once the patient is on board.It is easier to abort on the first leg than on the second.These are the realities of the job and no amount of regualtion or deregualtion (i.e. take the medical equation out) or bells and whistles can fix them.
Just my 2 c worth---actually now I can only afford 1 c............!!
Alt3

[tottigol]

Shawn, there are local numbers to be called for unlit towers, however it's not the FAA jurisdiction but it belongs to the FCC.

[Gas Producer]

But when your young and need the hours you do and fly anything right????

When you're young and need the hours you should NOT get a job as an EMS pilot!

GP

[Devil 49]

Mr Coyle,
I have an 1200' tower just right of the approach course and 8.11 nm from the the nearest airport with scheduled service that's been NOTAMed as intermittently illuminated for 6 years. That's right, SIX years.
Sometimes it has 1 light (the top), sometimes more, and lately new lights, generally working. But 6 years. Yes, I reported it to the FCC after talking to the FAA. I even talked to the company contracted to monitor it. Still, 6 years is a long time. You can tell how urgent the situation is for the tower's owners.

At my program, no pressure to accept dispatch, and no medical information shared prior to dispatch. I'm paid to say no, it's the hardest part of my job. The medics I fly with share the same attitude, in that saying no is tough. They'd rather not go than abort a run, with or without a patient. The time wasted in that process is completely NOT what we're about. When in doubt, chicken out- and go back to bed.

[Zerodegreespitch]

When in doubt, chicken out- and go back to bed.

:D

Well said Devil

[WhirlwindIII]

Revolutionary rightly says:

"Unfortunately though the health care industry in this country is not driven by medical necessity but by profit so the hospital only thinks about filling a bed and the EMS provider only thinks about billing for a transport; nobody does the cost-benefit analysis and up goes another helicopter, launching into the night to pick up a patient with a broken ankle. And therein lies -I think- the root of this problem." :D :)

Excellent!


:*

There are just too many ways for HEMS launch criteria to be circumvented, or abused, by medical amateurs purporting to be professionals. If a medical ground crew want to get off shift at scheduled time, and can't due to an impending transport, guess what, that patient can suddenly, by a slight change in medical condition verbage, qualify for transport by helicopter (as if no one knows this already) - this straight from the horses mouth! Not amusing.

Perhaps our medical system here in the US should all be not-for-profit!? No doubt the medical side of the equation IS first in driving the bandwagon, and they need to wise up. All this abuse could stop with them. I wonder if they ever thought they could be, as Revolutionary says " ... the root of this problem." .

:bored:

[barit1]

Associated Press list (http://www.chicagotribune.com/news/chi-ap-il-helicoptercrash-g,0,2611318.story)of recent HEMS accidents; I don't believe the list is complete, because no 2007 accidents are listed.

According to FCC data, the tower hit last week in Aurora (WBIG-AM) was in a three-tower array (http://www.fccinfo.com/CMDProEngine.php?sCurrentService=AM&tabSearchType=Appl&sAppIDNumber=311656&sHours=N). I have often seen such arrays with one or more towers completely dark. The "lights out" issue isn't just a concern among pilots; Radio World magazine has also highlighted the issue, notiing the unresponsivenes of both FCC and FAA. When one or more lights are out, and can't be quickly fixed (due to wx or whatever), a competent owner will try to alert FAA to issue a NOTAM. But they often run into bureaucracy; "That office is in Minot...". :*

However, the pilot was close to his home base in Bolingbrook, and familiar with the towers as a landmark.

[tottigol]

AAMS Works with FAA, Congress Toward Safety Enhancements (http://www.rotorhub.com/Rotorhub/Default.aspx?Action=745115149&ID=7e413481-edb8-41fe-8e50-ed93cfdd48ad)

For as long as we allow the customer side of the business to run the show the priorities shall be reversed.:*

[TheVelvetGlove]

A couple of things:

1. Where I fly there are may, many antennas. Some are nearly 2000 AGL. Most of the other antennas are over 900 AGL. Sometimes the lights are OOS on those structures, and sometimes there is not a NOTAM to reflect that. The FSS will not allow a pilot to file a NOTAM on an unlit structure unless he is the owner of that structure (makes sense, right?). So anything that I see out there will not be disseminated to other pilots outside my own company.

2. Many of us do not have terrain/obstacle warning systems installed in our aircraft.

3. Many of us fly unstabilized aircraft, which makes makes looking down at a chart in your lap while 900 AGL at night in 4 miles viz not a very good idea.

4. Goggles have saved my life on one occasion, when I otherwise would have had intimate contact with a 1470 ft antenna with lights OOS in a dark region that I was diverted through. I was at 1400 AGL at the time, under a cloud ceiling that prevented cruising any higher.

5. Those of us who conduct mostly scene flights, are regularly flying in unfamiliar areas- we are not flying regular routes.

My point is that we still don't know all the factors surrounding this accident. We do know that the pilot was in the process of diverting to a different hospital, and that might have been why he hit the wire. Here in the US, 700 AGL is generally not considered to be "too low" to fly at night. My company expects a minimum of 1000 AGL, weather permitting. But we can fly as low as 600 AGL in or local area (25nm radius of the base). While transitioning through towered airspace, we must generally not climb higher than 800 AGL.

This job that we do is not the same job in every region- some are doing mostly hospital transfers, some are flying familiar routes, some are dropping into suburban neighborhoods at night while dealing with a busy Class B surface area(s). Agreements that we have brokered with ATC may require that we transit at lower altitudes in order to avoid heavy terminal traffic. Sometimes we get turned around enroute due to hospital saturation. Single pilot VFR at night in an unstabilized aircraft does not make in-flight flight planning very much fun.

I do know that an autopilot or a second pilot would make my job easier and safer, but I just don't see that happening unless insurance companies are willing to start paying $18,000 USD per patient transport.

[DTibbals53]

Perhaps our medical system here in the US should all be not-for-profit!?


Not trying to pick on you here, but there is no such thing as a not for profit. It is merely a tax category. There have been 3 "not for profit" services in my area that no longer exist. Why? They did not make enough money to justify their existence. When a not for profit makes money beyond expenses and expansions, the board divies up extra as bonuses, new foundation automobiles (Benz for the Docs!) and on a rare occasion a bonus for the employees. Not for profit is not for real

[Bravo73]

1. Where I fly there are may, many antennas. Some are nearly 2000 AGL. Most of the other antennas are over 900 AGL. Sometimes the lights are OOS on those structures, and sometimes there is not a NOTAM to reflect that. The FSS will not allow a pilot to file a NOTAM on an unlit structure unless he is the owner of that structure (makes sense, right?). So anything that I see out there will not be disseminated to other pilots outside my own company.

Does the FAA have an equivalent to the Mandatory Occurrence Reporting (MOR) (http://www.caa.co.uk/default.aspx?catid=1425&pagetype=90&pageid=8178) system? In the UK, unlit antennae could be reported via this channel.

[WhirlwindIII]

DTibbals53

"Not for profit is not for real ..."

Good way to put it!

WIII

[Gomer Pylot]

Other countries can legislate as they like, but that won't affect the USA. The FAA is required by law to consider the economic impact of every new regulation, or change to existing regulation. Under the current regime, there is absolutely no interest in doing anything that might affect the profits of any corporation. Whining, wailing, and gnashing of teeth have no effect. As for NVGs, most of them are going to Iraq, and there is an acute shortage of them for civilian use. Several companies want to start using them, but simply can't buy enough to cover their needs.

Medical information may come with the flight request, but it's usually sparse, mostly just whether it's a trauma or medical patient. I don't want to know much about the patient's condition, but the med crew in the back does. They want to plan their actions, and know what to take with them from the helicopter. I usually try to get some patient information for them, but it never affects my decision about flying. Like someone said above, this is no place for young and inexperienced pilots. There are a few around, though, and they will either learn to be cautious or die. Most of us are old and nearing retirement, and not prone to risking our lives. Some of us always will, though, and legislation won't change that. I would love to be flying a modern twin with a 2-pilot crew, nicely IFR equipped, but I've come to realize that's just pie in the sky. Never happen, GI, no matter how much the other side of the pond complains.

[Swamp76]

A question that might be related to the comments about the tower being unlit.
How many of you have ever reported a tower's lights as being off? Who do you report it to? Was any action taken? Did you record the fact that the tower was reported as unlit??


Same experience. Many towers unlit, NOTAMed for years, reports ineffective. After one report about a tower I missed (at night) by about 5 feet within the control zone (1 mile from the airport) I was told that only the highest tower in the area needed to be lit. I can't remember how far away it was but I had seen and, I thought, taken a flight path well clear of it for my (helicopter) into wind approach not aligned with a runway.

[SASless]

Devil 49,

Perhaps a question to the owner of the tower as to which insurance company carries his liability insurance might rev him up a bit about improving the situation. Perhaps suggesting he is maintaining a public nuisance and thus increasing his risk of legal troubles would get him to thinking. Contact with his insurance carrier might also provoke a positive response.

Hit'em in the pocket book Bubba!

[helmet fire]

Swampy and others,
Why dont you guys use a calculated Lowest safe altitude that guarantees you clearance from the nearest highest obstacle regardless of lighting serviceability?

[DTibbals53]

We often land away from familiar areas, and away from certified Heliports, Airports, etc.. The problem with the Chicago aircraft was, as best I know, was experienced upon departure from one of the scene flight points of origin. I am sure that once he was established in cruise, if he had been so lucky, he would have used your suggestion.

Not trying to call you out, but merely trying to explain to some who may not understand the environment in which US EMS operates.

:)

[eagle 86]

Here in Oz I can recall at least three accidents resulting in around ten fatalities in which the common thread was:
a lack of "risk vs gain" philosophy,
wrong helicopter,
wrong crew qualifications, and
bad weather or lack of visual cues.
HEMS is not war - as a PIC you just have to learn to say NO - there is always another way.
Australian HEMS has learnt the lessons - the cowboy operators have largely been weeded out - the HEMS now have proper equipment - twin SPIFR - NVG - CRM training - support from non aviation management should a mission be declined ie your job is not at risk.
I'm afraid from the outside looking in it APPEARS that US HEMS has a press on at all costs attitude.
Mind you an assessment of accidents per hours flown may provide interesting reading for comparison purposes.
GAGS
E86

[Shawn Coyle]

So, if there are a lot of towers that are unlit - and one of the basics of VFR is to see and avoid obstacles, how can anyone still say night flying can be anything except IFR???
What we need is precise low altitude routes, realistic fuel reserves and quick clearances - radar coverage would be nice, but the piston engine FW world got around without it for a long time.
Or something else that provides us with some better safety.

[tottigol]

Shawn, we came full circle then.

What we need is a capillary low level IFR structure.

More AWOS III, more GPS approach procedures and the aircraft equipment and crew training qualifications necessary to meet those standards.

We came back to cost vs. profit.

We came back to the FAA not being in a position of strength to enforce those standards.
I think that most (if not all) pilots involved with this industry long enough already know what we need, but those pilots (ironically in Operational Control) have no authority over whether spending the money is worth it.
The technology is already here and ready to be applied, it's the mindset that's lacking.

[Shawn Coyle]

I agree. We need something that is better than what we currently have!

[Gomer Pylot]

For most EMS, IFR as it is currently configured is worthless. You simply can't do an IFR approach to an unprepared scene. Nor can you fly an approach to the hospital. I often fly to scenes 5 miles or less from my depaarture point. IFR simply won't work, even if I had an IFR capable aircraft. That isn't the answer. An autopilot, and proper TAWS and TCAS might help, but I have the TAWS, mostly, in the GPS. I don't have a good answer to preventing all the EMS accidents, I do know that IFR is not the answer. It can work for some transfers, but I do mostly scene work, and IFR simply isn't possible.

[JimL]

Gomer,

I totally agree with your analysis; those who call for IFR as the answer have little understanding of HEMS (which, essentially, is a VFR activity) and have never been involved with the provision of let-down procedures (for which formal obstacle clearance - in accordance with precise criteria - has to be provided).

In "Human Error Associated with Air Medical Transport Accidents in the United States", Albert Boquet discusses all of the issues and concludes that there are no definitive answers. However, two passages from the Discussion Paragraph stand out:So where does this leave the HEMS? While it is easy to sit back and in retrospect “arm chair quarterback” an industry that has become a mainstay of emergency medicine, the answers will not be as simple as they seem. Number one on the list to be addressed are operations in degraded conditions. The obvious recommendation here are IMC equipped aircraft and pilots who are truly instrument certified. While this may seem counter-intuitive for an industry that operates under VFR rules, the number and severity of accidents that occur in weather and in night conditions coupled with the number of weather-related violations indicates that the time has come to consider IFR currency and similarly equipped aircraft.

Another solution that has been batted about are dual crew and dual engine aircraft. However, this presents problems for smaller operations, due to the increased expense of these aircraft and higher costs associated with additional crew-members. Night vision goggles (NVGs) have also been suggested due to the number of accidents that occur at night. However, this is not supported by the data. Specifically, there were no more accidents at night compared to daytime operations. And while the severity of accidents occurring at night are greater in terms of fatalities, most of the night-time accidents occurred in IMC, where NVGs would have been of no use Furthermore, NVGs do not increase visibility of wires and fence lines which pose problems at landing and take-off sites.
I'm not sure that the last paragraph above resonates with the industry view: for solutions in the large: It should be understood that any operation has a certain amount of risk associated with it, and HEMS operations are no different. But there are two ways to go about reducing this risk. One is to make the operation safer, in other words, to reduce the probability of an accident. The second is to reduce the exposure to the environment within which the accidents take place. While most of the efforts are focused on the first solution (with little success), the second solution is often ignored. However, it may be time to ask, how many of the operations flown are true emergencies? Should HEMS operations be used to transfer stable patients, and if so, under what conditions should these be considered? How are go/no go decisions made, and by who? At what point should a transport be turned down?
Jim

[Shawn Coyle]

I'm not advocating IFR as it is currently practiced, but something that fits what we do - Canada's National Research Council has already flown a system that will give you an IFR approach to any point you nominate - and that was over two years ago.
We have pretty good knowledge now of the terrain and cultural features like towers, and in the US, have very precise navigation thanks to WAAS GPS. Why aren't we putting all that together to make things really work for us?
Combined with NVG for when you get close to the landing zone and have no choice but to be VFR, we could make a significant difference in our safety record.
But it's going to take a large change in mentality from the '5 hours training is all you're going to get and you'd better be able to hack it on that' that currently prevades.

[Gomer Pylot]

I agree that pilots should be IFR qualified, and AFAIK most, if not all, companies require an IFR rating for EMS pilots. Having the aircraft IFR qualified would also be advantageous, both for inadvertent IMC and for safer cruise in VMC. I know that Sikorsky, and perhaps others, have demonstrated IFR approaches to a hover, to confined landing areas. With the proper equipment it might be possible to do roll-your-own instrument approaches to scenes, provided you can be assured of getting accurate coordinates. However, the present regulatory environment won't permit that. Bureaucracy always moves slowly, and permission to do Part 135 IFR approaches and departures from ad hoc locations isn't going to happen any time soon, nor are most companies willing to pay for the capability. I hope it happens sometime, but in the short term, a decade or so, it ain't gonna happen.

[WhirlwindIII]

Shawn

Agree.

My 2-cents, again.

I think the biggest and most beneficial hurdle is just getting operators to transition to a requirement that an IFR flying standard, and currency in such, be met by all HEMS pilots, irrespective of the helicopter they fly.

Currently, at many if not all HEMS operations, those pilot's flying VFR-only machines get a six month check to assess ability to recover from inadvertent IMC. That does not exactly breed confidence, or willingness, in one's ability to exercise prudent professional beahior by intentionally climbing in to IMC to avoid the dangers of scud running when that environment becomes an inadvertent fact.

As we know most operators do allow pilots extra flying time between checks to get hood time. That could be put to further use in meeting such a standard.

My thought is a 135.297 instrument check, with provisos for flying a non-IFR certificated machine, could at least be a company level training and checking solution for VFR HEMS operations, and obviously legal one for those flying IFR.

To me this is a natural place to start and should be somewhat easy and cost-effective to implement as most required elements appear to be in place.

The idea would certainly have follow-on benefits when the industry finally realizes that IFR has to be part of the solution to the accident rate.

Thanks.

WIII

[Shawn Coyle]

An IFR mentality would help a lot - a more deliberate approach to all the flights might make a difference.

[alouette3]

WWIII:
I agree with everything you say about the training. However, even if the training/practise is on a monthly basis ( in the perfect world) I would still hesitate to intentionally climb into IMC in an unstable platform such as an AS350 or a Bell single.The only option, then, is to avoid getting into a situation where scud running is possible.That brings us back to the whole pilot decision making thing.

Alt3.

[WhirlwindIII]

A 3

Yes, I agree, thinking round the loop via ADM is the right process; and taught by training organizations regularly because it is worthwhile. It should keep a pilot from entering a flying environment in which IMC skills will be required - but it is not fool proof, thereby the need for real confidence via training and currency in IFR flying to hone one's ability to handle IMC, altered plains of reference, no horizon, etc. type flying when those realities of our world appear.

I don't know any HEMS pilot who does not have an instrument rating. Why not develop this line of defense against loss of control associated with IIMC, CFIT, altered planes of reference etc. by requiring appropriate IFR training and currency for the make/model helicopter being flown? Right now the IFR flying requirements for pilots flying on VFR-only operations are insufficient to meet the threat - I have no trepidation in making that statement.

I too would hesitate to enter IMC in any unstabilized helicopter. That reluctance should serve us all well, but, unstabilized SPIFR can be accomplished if the pilot is properly trained and current. I know that sounds a bit on-the-limb but having intentionally operated unstabilized helicopters IFR under the Bermudan Registry, and a couple unintentionally on the US Registry, I assure you it can be done; albeit nowadays acceptable only as a last line of defense, which is what we are discussing.

This certainly is an idea that can be implemented now, and built upon should VFR HEMS operations morph in to IFR ones.

Thanks.

WIII

[alouette3]

WWIII:
Everything about the training you suggested is right on. It would also be a simple fix to give the singles a litlle stick trim/mag brake to make them reasonably stable. At least then, the confidence to keep it right side up if the unthinkable happens, and ,as a last resort, will improve.
In my previous life, I flew Alouettes with a rudimnetary SAS.It permitted us to operate out at sea at night from deck. Kept us upright and was a great confidence builder and training for advanced aircraft in the future.

Alt3.

[WhirlwindIII]

A 3

Offshore night, especially on a moonless/overcast night with weather, is serious business. You obviously know the territory and the value of the training standard I propose.

Every bit of equipment helps up to the point where its employment serves to confuse the situation. I tell folks to use what they need first (KISS principle), then add on a few bits and pieces as supporting information - any confusion which arises is probably conservative grounds for a second opinion, an overshoot/missed approach, etc.

Most pilots received their instrument flying certification in unstabilized helicopters so a lot of them do know what is expected in this area.
Training and maintaining one's IMC currency to a high standard, then using those skills for real, in a pinch, is certainly not an unrealistic expectation for HEMS pilots. As things go it would probably add some confidence to the equation, and a measure of pride and respect to our profession as well.

I'll get off me box now!

Thanks.

WIII

[Shawn Coyle]

Training in an unstabilized helicopter with foggles is not the same as being in cloud in an unstabilized helicopter. World of difference when you really, really can't see outside.
And while a force trim system helps with flying in clouds, it does not make the helicopter more stable. And the force trim system really only helps if you use it all the time - not just when you go into clouds.
Same as any stabilization system - has to be used all the time, not just when the weather is bad.

[Gomer Pylot]

Regular IFR training is a good idea, but it's not really practical. A safety pilot is required when flying with vision limiting devices, and most common EMS helicopters are configured without a copilot's seat. In order to do IFR training, a mechanic has to remove the stretcher and install a seat and all the controls, then replace all that when the training is complete. It requires putting the aircraft out of service for almost an entire day just to do an hour of training. It's either that, or having a spare aircraft devoted just to that training, floating around the company. Then you have to find a spare pilot to fly along, which is really the easy part. Convincing the bean counters to allow this regularly is hopeless.

[alouette3]

Shawn:
I agree that the force trim or other stabilizing equipment should be used all the time.
While the force trim does not make the helicopter more stable, it certainly prevents inadvertent inputs into the roll and pitch plane.The techniques we practised were: fly through the transparency while leaving the cyclic trimmed for a datum pitch attitude.Never trim or use the stick release in a turn. In case of doubt, release pressures and allow the aircraft to return to the datum set. It was not as sophisticated as the auto pilot systems I used later and certainly required a lot more maintenance, but it got the job done.And the penalty on the payload was negligible, even though that was not a governing factor.
Alt3.

[WhirlwindIII]

Gomer

I agree with your observation reference those helicopter types that require the mechanic time to configure them for IMC/IFR training. There is always a solution. Bean counters will have little to say about it if the company, or FAA, mandates something. As to expense - nothing is more expensive than an accident - something we all agree upon.


Shawn

I agree that flying with Foggles is different than being in cloud. Each has its visual plus and minus - I'd rather be in cloud than using Foggles just because everything on the flight deck is in sight without turning ones direct view through Foggles (when utilizing them in VMC training) away from the basic T of attitude control instruments.


Thanks.

WIII

[havoc]

Cumulative Toll of Helicopter Ambulance Crashes Tops $100 Million - Aviation Safety & Security Digest (http://www.aviation-safety-security.com/current-newsletter/articles/cumulative-toll-of-helicopter-ambulance-crashes-tops-100-mi.html)

[WhirlwindIII]

Havoc

The true dollar cost of an accident is almost always ten times the direct cost - i.e. 10x the cost of the obvious bits such as replacing the helicopter, scene reaction and evacuation/cleanup, insurance personnel time, insurance cost, increased cost of insurability, all the personnel time of all the folks involved, lost revenue opportunity, lawyers, new standards and training required, lawsuits, etc. etc. etc. If negligence is awareded the penalty in US courts is usually 4x the calculated one.

"If one thinks safety and training are expensive - just try the cost of an accident!"

A bit from the article you provide says if very well:

" " The economic losses from these crashes are around $100 million, assuming a statistical value of $3 million for each life lost, some $500,000 for each injury, and about $5 million for replacing each helicopter. If anything, the costs are on the low side and could be substantially higher.
The costs are certainly greater than any safety improvements, and the toll over the last 12 months is the worst in the history of such operations" "

Thanks for the link!

WIII

[havoc]

As I read the article I was wondering what the risk matrix before the flight had shown. The company I fly for (IMHO) has a poor one. I know you cant cover all the "what ifs" but the only NTSB recommendations are that you have a method of assessing risk.

Any insight from HEMS in Europe and OZ as to what you use?

NTSB releases Trooper 2 tapes:

wjz.com - Video Library (http://wjz.com/video/[email protected])

[helmet fire]

Moved post to here for wider discussion:

HEMS Brainstorming (http://www.pprune.org/rotorheads/349858-brainstorming-us-hems.html)

[WhirlwindIII]

helmet fire

Excellent!

Thanks for such a well thought out response! Especially the realistic time line for implementation.

I would add some sort of regulatory requirements for certification of medical crewmembers. Too much medical influence (WAY too much) in HEMS aviation operations.

Thanks again!

WIII

[Devil 49]

"helmet fire" said-

"1. Night flying requires reference to instruments. If you want to fly at night get an IFR rating. Even just the simplified en route IFR rating. 3 hours instruments required each 3 months to stay current. Renewals required each year."

Geeminy cricket- I've been doing it wrong for 40 years- keepng my eyes out, aborting if I don't like what I see, and keeping the panel setup for IIMC... I get the impression many people don't understand night VFR. The rules are simple:
1. You have to see to go.
2. You have to see where you're going, adequately.
3. Have a place to land in sight, or a fail-safe plan to get to one.

It's just like day VFR, without the sunlight.

[RJ Kanary]

Additional information, plus three links.

Radio tower stabilized -- chicagotribune.com (http://www.chicagotribune.com/news/local/chi-chopper-crash-folo-18oct18,0,6579181.story)

cbs2chicago.com - Slideshows (http://cbs2chicago.com/slideshows/deadly.aurora.helicopter.20.841718.html)

Fixing the radio tower :: Suburban Chicago News :: Photo Gallery (http://www.suburbanchicagonews.com/beaconnews/photos/1228333,gallery_au17_towerfix.photogallery)

RJ


{Courtesy of Wireless Estimator. }
Train station video confirms that tower's lighting system was operating prior to fatal crash
October 23, 2008 - Last week's fatal Air Angels helicopter crash in Aurora, IL was not caused by the absence of obstruction lighting on the guyed tower that the chopper struck, according to a preliminary report being issued by the National Transportation Safety Board.
NTSB investigator John Brannen said yesterday that strobe lights on the tower owned by WBIG-AM were operating prior to the helicopter's rotor clipping a guy wire and killing four people when it crashed.
That determination came from video shot by a parking lot surveillance camera two miles away at the Route 59 train station, which was turned over to authorities earlier this week.
"At the approximate time the collision occurred, the lights stop blinking," Brannen said, suggesting that the lights were knocked out by damage from the crash. When fire and police personnel responding to the crash just before midnight on Oct. 15 saw no lights on the tower, some wondered whether lack of lighting had contributed to the crash.
The video did not show the tower or the helicopter, but provided coverage of the flashes of the lighting system.
The 750-foot tower had two levels of white obstruction lights.
WBIG President Rick Jakle says he never doubted the lights were on, though he was relieved to hear the tape supported his belief.
"Those lights are extremely reliable," he said. "They don't go out unless there is a thunderstorm or lightning. We're happy to hear the corroborating evidence, but the fact is, we knew they were on."