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HEMS - Regulations and saving life

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HEMS - Regulations and saving life

Old 7th Oct 2005, 23:08
  #341 (permalink)  
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Now what might Schedule 4 and 5 have to say about this situation? If a bit of medicine is good....a big dose would be better would it not?
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Old 8th Oct 2005, 06:44
  #342 (permalink)  
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JimL, Tees et al - I did understand how the rules work which is why I made the point about no NVFR in the UK in reply to 800's comments.
I don't want to memorise the whole ANO, I have more than enough flying orders to try and remember in the military but I would like to know if you can fly an R22 at night IFR if it isn't cleared for IFR operations. I hope not since they manage to claim enough victims during the day.
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Old 8th Oct 2005, 07:56
  #343 (permalink)  
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The simple answer (without providing all of the justification and rules) is yes - if it is a private flight.

Helicopters are certificated for flight in IMC not IFR - some helicopter Flight Manuals do have a night endorsement but not all (which does not mean that it is prohibited); it is the operational rules that drive the requirements for crewing and equipment.

For commercial air transport (and with respect to JARs) it is the performance rule in Subpart I - Performance Class 3, which provides the proscription.

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Old 8th Oct 2005, 08:13
  #344 (permalink)  
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Its not entirely true to say that civvy aircraft dont operate VFR at night... the SAR aircraft in Ireland and the UK routinely do.
Give me NVG and a good quality moving map and you have now increased the safety of any night op enormously.

I recently discussed this with a buddy of mine who flies NVG on EMS in CA (Sierra Nevada mountains)...I think they use Anvis 9. He said seeing is believing. They flip them down on the way out to the aircraft and flip them up on the way back in. The FAA have actually certified them as a corrective lens as you have to adjust them for your own eyes at the beginning of the shift. He said they quite literally turn day into night.

The moving map technology thats out there now is amazing and again would decrease the workload enormously in difficult circumstances. Anyone interested check out the Garmin 396 and see they way you can get current progs and sat images superimposed on the screen...brilliant stuff. And theres probably better ones than that available....
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Old 8th Oct 2005, 08:57
  #345 (permalink)  
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How's our friends near Gatwick going to accept NVG's for night flight in the UK? The FAA fought it for a while, the Aussie CAA fight it still...the NZ CAA folks embraced it.

Will it be treated like GPS....just another Spam DOD thing and thus similar to shaking hands with a Leper or will lightning strike and the techology be embraced to enhance safety. Maybe the HEMES outfits in the UK could then start flying at night and saving more lives rather than only working daylight hours only?
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Old 8th Oct 2005, 09:30
  #346 (permalink)  
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Right now there is discussion about Primary missions at night in Czech. Pretty much everyone has agreed that they will not take place unless NVGs are used.

The machines we fly use the "Moving Terrain" moving map,


- which we are looking at up-grading by adding the weather overlay system. This adds a transparent overlay of the weather radar picture which is updated via Sat-phone every 10 minutes. This will be a big help inflight. The moving map is also backed up by 2 Garmin 430s.
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Old 8th Oct 2005, 10:41
  #347 (permalink)  
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Do not get too carried away with the benefits of NVG, yes they are very good however, they do have their limitations and in certain conditions will bite you if you are not careful.

There is an extra training burden, and I would recommend two pilots (or qualified LHS) as Speed and Rod is difficult to assess.

Finally, they are virtually unusable over built up areas and most pilots I know (including myself) hinge them up when over a city or large town.

Having said that NVG is by far better than non NVG, but they do not turn Night into day.
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Old 8th Oct 2005, 11:38
  #348 (permalink)  
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JimL - thanks a for clear, concise reply - I am enlightened.

Decks , I don't know about Ireland but I suspect that the UK civvy SAR (of which Portland is day only) fly in accordance with all the sub paras and sub, sub, paras mentioned by others and are in fact flying IFR below 3000' in sight of the surface. UK mil SAR does fly VFR at night either reversionary (no NVG) or with NVG. I believe the Bristows SAR guys have been given clearance by the CAA to fly with goggles but I heard that 3rd or 4th hand.

Sasless - I hope the UK HEMS do get to fly at night but that the same mistakes you have highlighted on other threads about US EMS safety are not repeated; maybe they will go down the twin pilot/twin engine/IFR/NVG route rather than cutting costs and safety.
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Old 8th Oct 2005, 11:53
  #349 (permalink)  
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Role1a, what generation NVGs are you using?
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Old 8th Oct 2005, 12:59
  #350 (permalink)  
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I certainly agree with you about not going the cheap but deadly route. I plainly am firmly on the two pilot...two engine...full IFR kit...and current and...operative word there...and proficient crew....or do it in weather conditions that allow for safe handling by means of the MK I eyeball....preferably enhanced with NVG's.
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Old 8th Oct 2005, 14:00
  #351 (permalink)  
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Big Mike, I emphatically agree with your analysis and recommendation- NVGs.
I wish I had two engines, two pilots, full IFR capability. Ain't gonna happen in the present compensation environment, and that's a fact.
NVGs have proven their value.
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Old 9th Oct 2005, 03:56
  #352 (permalink)  
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Single engine vs. multiengine, I'll go with the latter anytime. Statistically though, the majority of EMS accidents (in the USA at least) stems from a lack of cockpit crew training and safety culture.
SAS, while I am with you for the full IFR suite and two ponies under the hood (I fly where you have flown before), I think that two pilots in the cockpit are not an affordable reality, at least in the USA and unless some Program Director feels like forking out the extra "dinero". Adequate (read rigorous) training in both flight and CRM specialties shall have to be entertained by the operators here.
The FAA has just released an Advisory Circular to establish minimum guidelines for Air Medical Resource Management training.
It shall be interesting to see how the cockpit crew proper is going to have to interact with the "cabin crew" for the greater good.

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Old 9th Oct 2005, 08:51
  #353 (permalink)  
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Your outfit has had far more fatal accidents with a single crewed aircraft than it has a two crew aircraft. If my memory serves me correctly....your outfit has had exactly one fatal accident in a two crewed aircraft but has had many single pilot fatal accidents. I would suggest SPIFR is fine up to the point something goes wrong...at which point a very busy pilot gets really busy. As long as George is driving and the single pilot is acting as a conductor then all is fine....it is when the conductor becomes the driver, communicator, approach plate finder, navigator, and trying to cope with the problem(s) is when that second pilot pays off in spades.

Granted, your company operates very few two pilot crewed helicopters and the majority of the aircraft are single pilot crewed but I would suggest a well coordinated crew with a well trained and experienced second pilot would be much safer than flying SPIFR. That being said....things happen in a two pilot crewed aircraft as well....as the two 76 accidents show us....one with PHI EMS and the ERA GOM crash.

The question we need to answer is how many lives do we sacrifice for economy of operation.

Just what is a human life worth in the EMS business or in the Gulf of Mexico offshore oil business?
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Old 9th Oct 2005, 11:56
  #354 (permalink)  
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Biff says

Can't see it happening in the UK for a long time if ever, if only on a cost vs need basis.

Just as a starter, look at what you would need to replace a current day-only HEMS operation typically operating with a pilot and two paramedics :

Suitably-equipped new generation IFR twin with all the bells and whistle, plus Nightsun, NGV etc. $$$$$$

A doubling of crew costs (flight, medical and ground) to cover the extra hours - plus extra pilotage costs as you'll be running two on the night shift.

Training costs - lots more initial and re-currency costs.

24 hour engineering cover

Hospital Landing sites to be upgraded for night landings - if possible. If not, then you run the risk of having to overfly a suitable receiving hospital in order to reach a heli-friendly LS - not in the patient's best interests.

I'm sure there are lots of other financial considerations, but even the above would be a massive outlay - and let's not forget that UK HEMS units are all charities, hardly swimming in spare cash.

As for the need - is it really that great? Once the evening rush hour is over with it's spate of RTC's, surely there are more than enough road crews to cover the majority of calls? It would be interesting to see some ambulance call-out stats to look at the number of incidents that would have been suited to carriage by HEMS and how the patients actually fared.

I can see an argument for cover during "normal" working hours in the winter months when it's getting dark by 4 o'clock and the HEMS units have had to stand down, but 24hrs?

And finally there is the age-old HEMS conundrum of balancing aviation risk with medical risk. Landing on a well-lit (closed) motorway is one thing, but rural night landings in unsurveyed / unprepared sites in winter with no illumination save what you bring with you slung under the heli? I have no idea of how difficult this might be, but as a layman the thought of risking a multi-million dollar machine plus 4 crewmembers against maybe saving one RTC victim doesn't really stack up. Pilots run into wires on bright sunny days in the middle of a summer's afternoon when they really should be able to see them.

You can probably gather that I'm not really in favour of night HEMS...but that's just one man's opinion

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Old 9th Oct 2005, 12:22
  #355 (permalink)  
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Don't Sussex (UK) Police run a combined Paramedic / Police role, single pilot, day and night? Unless the paramedic role isn't used in darkness. Any Sussex drivers can assist?
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Old 9th Oct 2005, 13:36
  #356 (permalink)  
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Yes they do, but it's only because they have the Police role eqpt (Flir N/Sun) already on the aircraft.
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Old 9th Oct 2005, 14:40
  #357 (permalink)  
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Unfortunately people find themselves getting hurt not just during “normal” working hours, but 24 hours a day.

Like everything, it comes down to money. How much does the community want to pay?
If you want to have a 24 hour service, including Primary missions at night, and to conduct these as safely as possible, then you will have to pay for it. Ask the community. What do they think? After all they are the ones ultimately paying the bills.

My point about NVG’s is that while they are not quite the second coming, they will let EMS pilots flying NVFR, remain NVFR.
Over-fly hospital sights because of no suitable approach lights? Why? You could fly there during the day VFR, so what stops you flying there NVFR with Goggles?

Why is it some people seem to be so scared of new technology? The New Zealand CAA is to be congratulated on a sensible, informed approach to the introduction of NVG’s to civilian aviation. Maybe we can learn something from the Kiwi’s other than how to play Rugby.
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Old 9th Oct 2005, 21:28
  #358 (permalink)  
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For night ops the best is : Twin Engine IFR certified aircraft with two qualified properly trained instrument rated pilots (not just meat in the co-jo seat).

From a personal stand point; I would sooner be a passenger in a single-engine turbine IFR certified helicopter with 2 qualified pilots than be in a twin engine IFR certified helicopter with one pilot. I think the plank wing statistical data would probably support my stance.
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Old 10th Oct 2005, 10:01
  #359 (permalink)  

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I think the plank wing statistical data would probably support my stance.
Using fixed wing statistical data for supporting a stance on a rotary based discussion,

How does that work?

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Old 10th Oct 2005, 11:43
  #360 (permalink)  
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Crab: If Bristow's SAR are operating under CAP360, national regs, then I'd be interested to learn that they have certification for full NVIS?
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