Mercy Flights
 

In a discussion over beers last night with other pilots we started exploring what flights one could conduct under a Mercy Flight category.

Given the situation that someone was going to die, and there was no other option, could one reasonably expect to be permitted to:

Fly a twin without endorsement
Fly without a weather forecast
Fly across an international border
Fly at night without rating
Fly over water without raft or survival gear

Obviously not all of the above at once and not a close family member (which would cloud risk assessment).

Thoughts ?

Interesting topic:

Personally, my thoughts would be the following for your standard VFR pilot... however it depends on you personally. I understand that a Mercy flight is one where you know that a rule or multiple rules are going to be broken during the flight.

No:

Fly a twin without endorsement
Fly at night without rating

Yes:

Fly without a weather forecast
Fly across an international border
Fly over water without raft or survival gear

The difference between a No and a Yes in my mind are around whether you took off knowing that you were not qualified for the flight that was about to take place and whether or not you would be accepting a large amount of risk in conducting such flight.

It's just a risk equation. If you were standing next to a Seneca, your friend has a heart attach and you were 1 hour by Seneca from the nearest medical aid and you were 4 hours by car, plus you have a few twin hours in your log book, a a few hours flying unofficialyl with your mate, no endorsement, but you know in your mind that you would be very safe, then that's up to you.... I can't see insurance paying out if it goes pear shaped though.

Same goes with the night flight. You haven't flown at night, are not confident and don't know if you'd make it safely - then don't do it! To the contrary, if you have a few night hours at night, but personally guarantee yourself that you will be 100% safe, then you'd think about it. Remember you kill yourself AND your mate if it all goes wrong and you might need to scrape your bank account for a new aircraft when insurance won't pay out.


I am aware of a REAL mercy flight that took place some years ago and it might be in his book. If I recall correctly Ben Buckley flew a young child into Essendon when the child had their leg severely severed in an accident. The weather was not suitable for VFR into Essendon but Ben insisted that he could get in there. The tower / radar advised him to not attempt to land because he would not be able to. I believe he did manage to successfully land and the child was rushed to hospital. Unfortunately the operation wasn't successful and the child lost their leg.

The closest I have personally had to a mercy flight was where I was phoned by the Police in an emergency situation where an aircraft was desperately needed as PolAir was unavailable. Due to where I was standing at the time and the fact that the aircraft was full of fuel and warmed up, I was able to be airborne within a minute. I knew nothing of the mission brief other than that a gunman was on the loose in a near-by town so I entered into the flight by not knowing which rules were going to be broken if any. A few small rules were broken during this flight and a succesful result followed, however I wouldn't like to be standing in front of CASA if things went bad!

Fly a twin without endorsement - NO
Fly without a weather forecast - NO
Fly across an international border - NO
Fly at night without rating - NO
Fly over water without raft or survival gear - NO

In all cases you are putting lives at risk to try and save one. Depending on the border, you could get shot down!

ALL flights must be done legally. That is why there are regulations to ensure this happens.

Not quite.... that's what a Mercy flight is all about, where you KNOW you are going to break a rule.



http://www.casa.gov.au/wcmswr/_asset...vfrg-whole.pdf

Page 395.

Although CASR 91.170 authorises the declaration of a mercy flight, the pilot and operator remain bound by Civil Aviation Act Section 20A, which prohibits careless or reckless operations.

How does one define 'reckless' quantitatively - remember - you/re in court after saving life now !

What would Smithy have done to save someone's life?

Not sure if it happened or not but was a question floatIng around The flying school when studying CPL law as to if a flight was legal or not. Story was a bloke had been attacked by a shark on the Chatham islands and was evacuated to the mainland in a metroliner. No qualified pilot was available to do the flight but a pilot who had done all the training and was about to be signed off was and did the flight even though did not have the stamp in his logbook. The question was would we do the flight?

It all depends upon the outcome of the flight.

If the patient is saved, the pilot is a Hero.

If the patient is not saved, the Lawyers get into the pilot, the pilot pleads his case eventually in The AAT and is found guilty.

One wonders had the Pelair flight into Northfolk Is been declared a mercy flight what would havee been the outcome seeing as all survived including the patient.

REG 206 has many strange and twisted interpretations.

Be careful of the repercussions.

'XXX' has it pretty much covered here:-)

'Biggles' obviously you mean well but are incorrect in some .of yr content as has been mentioned.
I've done around 3 or so Mercy Flts as there was no other option at the time that could be taken to complete the mission. The ONLY rules that where not complied with where duty hrs & the addition of another pilot which was needed on certain long duty timed flights, all other rules that involved safety directly such as A/C serviceability, fuel requirements, compliance with WX etc,crew ability/authority & Equip where never broken, anything else outside of those area's was willful disregard for life before you even launched the mission.

The main criteria was that the CP had to be informed & that all reasonable alternative possibilities where considered/exhausted BEFORE a Mecry Flt was undertaken & even then there was paper work for the Flt at the end of the mission.
It was taken lightly that's for sure!

There's a saying that we whom where involved at putting lives at risk to save others ........... "there's no point in killing 3 or 4 to save one, made sense to me, life preservation begins with ones self:ok:


Wmk2

G'Day Fission, long time no speak! :ok:

Knowingly exceeding Flight and Duty times would be the most obvious one.

What about having had one sip of a stubbie when the phone rings? :p

From now on, all ambulances will follow the speed limit and not run red lights! :ok:

Bit of a stretch there - the ambulance drivers are trained, have equipment (sirens, radios) to assist in getting attention and through traffic and are unlikely to have any issues with granite clouds. The argument here is how much risk do you take outside your permitted capabilities.

My completely unqualified and inexperienced position would be legalities should not enter into it, only safety. If, with all factors considered, you can safely complete the mission then that is all there is to it. That assumes you confidently know your limits, the limits of the aircraft and the conditions facing you - completely separate from charging in cowboy mode to be a hero - can you do it *safely*.

It would be a sorry state if your answer to a coroner one day had to be "I was worried about the AAT".

One such situation that the operation I'm involved in will declare a mercy flight for, is when the use of car headlights are required for landing.

We are trained to be able to do them, however they're technically not legal.

baswell, I understand where you're coming from, however an ambulance will break rules with careful risk management. The risk management in aeromedical intervenes when the risk taken outweighs the gain made. So yes for high priority tasks, we will accept a higher risk. We just need to ensure the mitigation factors are there as well.

Unless it's life and death, there are little tasks that I as the PIC of my aircraft would accept, that places myself, my aircraft and my crew in a high risk situation. If we didn't keep a sensible approach to it, then aeromedical in this country would start heading the way of aeromedical in the US, where life and limb is placed on the line simply to save someone with a broken arm, simply because the other operation up the road may get the job instead.

morno

Please use my quote in context. It was a sarcastic response to a claim that implied that mercy flights should not even exist as one should never risk your own life to save another.

That's an absurdly ignorant view.

If morno's clearly reasonable scenario of headlight landings was not enough, what about limited lighting (6 runway lights total)? What about doing 15 hours duty with a 5 hour rest at the hospital in between? What about arriving at the destination and after 3 approaches and a lowering minima, conducting an ILS without it having being renewed (despite having 100s of PIC hand flown ILS under you belt)? All because getting to a capital city hospital is the only way that person will survive? They're all mercy flights, they're all, for the most part, normal ops.

Perhaps these should be limited to Aeromed and kept out of the hands of the general flyers (PPL CPL ATPL or other). But by having already had it without incident for the last xx years would leave CASA liable if someone dies as a result of removing it.

FWIW:

In Qld, ambulance officers operating under the Qld Ambulance Service act (and police, and fire services) do NOT have carte blanche to break the road (or any other) law. The Strict Liability of an offence does not necessarily apply but the driver of an ambulance may be held to account for their actions.

Also, there is very little evidence that 'rushing' anywhere is of any actual benefit in reducing morbidity or mortality in severe illness or trauma. A study in USA demonstrated an average time difference of <42 seconds between a 'lights and sirens' run to a hospital vs a normal drive. It DID however show a much higher chance of injury to both ambulance personnel and other road users from the dangers inherent in emergency driving.

As far as Mercy Flights go, the criteria are pretty clear. There must be serious and immediate threat and no better alternative, plus regulations are going to be broken. In Oz these days with the high standard of ground ambulance services plus RFDS and emergency helicopters providing medical cover across most of the country a genuine mercy flight would be very unlikely.

I believe RFDS does occasionally declare a mercy flight for landings on unsurveyed public roads.

Brown snake bite. Two hours max to cardiac arrest. Three hours to get RFDS to the site. You take off with arrangements to meet RFDS half way.

It's VFR but night. You're not current not having flown in the preceeding few weeks with a circuit or pax.

Hanging offence?

Frank - with respect - I get your intent but your example is Horsesh!t.

Plenty of people have died from snakebite. However - where appropriate and timely first aid has been applied NO fatalities from venomous snakebites have been recorded in Australia.

Lie the patient down, bind the site and the limb (no, don't wash it, cut it, suck it, pour beer on it, burn it or anything else, don't try and catch the bloody snake either), splint it to stop movement, keep the patient calm and wait for assistance. 3 hours? No prob. Won't even be showing any symptoms by the time the team arrives. In fact if they remain asymptomatic they won't even get antivenom until at hospital when the site has been swabbed to identify the snake and the blood work shows toxicity.

Having said that - with a legitimate threat to life & limb and a deliberate busting of a rule, where the risk of doing the proposed thing is less than the risk to the patient without the proposed thing being done, a mercy flight would be appropriate.

What would Nancy have done?:ok:

Over my time I have conducted a number of what, in the civil sphere, would be termed a mercy flights. The military equivelent at the time used different terminology. Examples include exceeding crew duty, ignoring a noise abatement area, and non-standard recording of maintenance action (the work was carried out and normally the aircraft would be shut down to do the paperwork).

The key thing was risk assessment and management and in each case there was more than one person involved in the decision making process in order to ensure that no-one was getting carried away. When I first got checked out as a helo captain the checker took a great deal of time to emphasise the importance of remaining part of the solution rather than part of the problem. It is very easy to get a rush of blood to the head but the laws of physics still apply, your capability doesn't suddenly get better, and cutting corners doesn't always save a meaningful amount of time.

As for the examples at the begining each could be done, but:

Fly a twin without endorsement. Maybe, if you have relavent experience but are not rated on that type this might be safe but for an inexperienced pilot with no twin time the risk is high.

Fly without a weather forecast. Depends on what information you do have. But the chances of not being able to get suitable weather info pretty quickly from ATC after getting airborne in this day and age are pretty slim.

Fly across an international border. Yes, but depends on which country you are heading into, there are parts of the world where you might be putting yourself at serious risk.

Fly at night without rating. If you don't know anything about flying at night or instrument flying this is, of course, best left alone. But a more reasonable example might be a military pilot who does not hold a CIR or NVFR rating but is current on the aircraft, he aircraft is suitable equiped and he/she has a valid military instrument rating.
Fly over water without raft or survival gear.

The risk management process for a mercy flight is the key. Why is it not within the existing rules? Just like a checklist rules can't cater for every situation and there will be times where a rule can be broken safely. I can't stress enough though, resist the urge to rush in. There are many, many dead pilots, pax, and casualties from well intentioned MEDEVACS that did not work out.