NTSB says EMS accident rate is too high
"Just a pilot"
What Limits wrote
Quote:
It's a different culture, under different rules, with different philosophies, expectations, and goals. Right or wrong, profit is the driving force for all business in the US, and that will not change no matter how much fun the rest of the world wants to make of it. Short-term profit is the end-all and be-all of the US economy, and short-term profit is not possible if multi-engine, multi-crew aircraft flown only under IFR are required. So get over it, those will never be required, and will seldom be used.
With the greatest respect to our American brothers, there is the problem, right there.
What is the acceptable death rate of pilots, medical personnel and patients before something has to be done to change this?"
Acceptable death rate? Zero. This isn't combat, where one calculates an acceptable loss (unless you're an insurance company). You can't usefully (or profitably) have a fatal accident, so good management is always working to reduce the possibility of that cost.
That said, the scenarios that US HEMS operates in and the risk management thereof will affect accident rates. How does that relate to the Missouri accident?
------------------------------------------------------------------
ShyTorque wrote:
"This profit driven philosophy is quite possibly where the much of the press-on-itis comes from. As for a mantra that the USA always knows best and no-one else is entitled to comment on any of it because they don't understand.....really!
How would relatives of a deceased patient or crew member feel if they knew that lives of their loved ones might not have been lost if things had been different i.e. profit for the service provider wasn't such a major issue?
We had a similar issue in UK a couple of decades ago. The only logical remedy was for CAA legislation to be tightened up, and it was.
As the saying goes, if you think safety is expensive, try having an accident."
Sir, the scheduled airlines are all very much profit oriented, at least in the US, and their safety record is a respectable benchmark. It's not the "for profit aspect" that compromises safety, it's the methods used to maximize profitability.
The ultimate criterion might be "profits" but the methods are the same with bad management across the aviation spectrum, for profit and non-profit; government and private. Bad management encouraging bad practices isn't specific to any model.
-------------------------------------------------------------------
Jack Carson wrote:
"I can’t speak to European HEMES operations but I can address what I believe may be a contributing factor to the mishap rate here in the United States. The vast majority of US HEMS operations are would fall into a category identified as a traditional model. These are typically single engine machines strategically located to provide the operator with a solid business base for the machine. The AS-350 series make up a significant portion of this fleet. The AS-350 has limited payload range when kitted out for HEMS operations. It is typical to operate very near or at the aircraft’s maximum gross weight on every mission. A 250-300 lb patient in the US is the norm today in the US. At 33% fuel burn and using 11% (20 min.) with three 180 lb crewmen the fuel load would have to be limited to 45%. This leaves the pilot with only 1 hour mission fuel. Flexibility is not the norm."
I don't know where Mr Carson's numbers come from, I didn't wade through his table. I've flown EMS for 10 years, and I routinely operate at 2+10 in fuel. Yes, I'm often at or near MGTO or forward CG, but haven't had issues when I respect the RFM- and I do. Yes, when I have 200+ in each of the crew seats, I reduce base departure fuel load, and I may go as low as 1+55 in the summer, to allow a useable patient weight with NG limiting at Appalachian mountain heights.
45% departure fuel would have been an issue for the Missouri crash pilot, but I'm betting against fuel exhaustion in this event. I can't imagine why he'd leave base with almost 500 lbs to MGTO.
Quote:
It's a different culture, under different rules, with different philosophies, expectations, and goals. Right or wrong, profit is the driving force for all business in the US, and that will not change no matter how much fun the rest of the world wants to make of it. Short-term profit is the end-all and be-all of the US economy, and short-term profit is not possible if multi-engine, multi-crew aircraft flown only under IFR are required. So get over it, those will never be required, and will seldom be used.
With the greatest respect to our American brothers, there is the problem, right there.
What is the acceptable death rate of pilots, medical personnel and patients before something has to be done to change this?"
Acceptable death rate? Zero. This isn't combat, where one calculates an acceptable loss (unless you're an insurance company). You can't usefully (or profitably) have a fatal accident, so good management is always working to reduce the possibility of that cost.
That said, the scenarios that US HEMS operates in and the risk management thereof will affect accident rates. How does that relate to the Missouri accident?
------------------------------------------------------------------
ShyTorque wrote:
"This profit driven philosophy is quite possibly where the much of the press-on-itis comes from. As for a mantra that the USA always knows best and no-one else is entitled to comment on any of it because they don't understand.....really!
How would relatives of a deceased patient or crew member feel if they knew that lives of their loved ones might not have been lost if things had been different i.e. profit for the service provider wasn't such a major issue?
We had a similar issue in UK a couple of decades ago. The only logical remedy was for CAA legislation to be tightened up, and it was.
As the saying goes, if you think safety is expensive, try having an accident."
Sir, the scheduled airlines are all very much profit oriented, at least in the US, and their safety record is a respectable benchmark. It's not the "for profit aspect" that compromises safety, it's the methods used to maximize profitability.
The ultimate criterion might be "profits" but the methods are the same with bad management across the aviation spectrum, for profit and non-profit; government and private. Bad management encouraging bad practices isn't specific to any model.
-------------------------------------------------------------------
Jack Carson wrote:
"I can’t speak to European HEMES operations but I can address what I believe may be a contributing factor to the mishap rate here in the United States. The vast majority of US HEMS operations are would fall into a category identified as a traditional model. These are typically single engine machines strategically located to provide the operator with a solid business base for the machine. The AS-350 series make up a significant portion of this fleet. The AS-350 has limited payload range when kitted out for HEMS operations. It is typical to operate very near or at the aircraft’s maximum gross weight on every mission. A 250-300 lb patient in the US is the norm today in the US. At 33% fuel burn and using 11% (20 min.) with three 180 lb crewmen the fuel load would have to be limited to 45%. This leaves the pilot with only 1 hour mission fuel. Flexibility is not the norm."
I don't know where Mr Carson's numbers come from, I didn't wade through his table. I've flown EMS for 10 years, and I routinely operate at 2+10 in fuel. Yes, I'm often at or near MGTO or forward CG, but haven't had issues when I respect the RFM- and I do. Yes, when I have 200+ in each of the crew seats, I reduce base departure fuel load, and I may go as low as 1+55 in the summer, to allow a useable patient weight with NG limiting at Appalachian mountain heights.
45% departure fuel would have been an issue for the Missouri crash pilot, but I'm betting against fuel exhaustion in this event. I can't imagine why he'd leave base with almost 500 lbs to MGTO.
Last edited by Devil 49; 29th Aug 2011 at 16:09.
Join Date: Aug 2011
Location: Arizona
Posts: 6
Likes: 0
Received 0 Likes
on
0 Posts
One obvious reason why the HEMS accident rate in the US is so high is because there are just so many flights.
The threshold for calling a helicopter to the scene of an accident is pretty low in many jurisdictions. First responders, concerned about lawsuits, treat every injury -minor or otherwise- as if it could be potentially life-threatening. Hospital doctors, too, are under pressure to err on the side of caution, ordering expensive treatment (to include helicopter transfers) that often goes beyond the actual needs of the patient. For-profit helicopter operators are only too happy to oblige.
Many studies have examined the effect of helicopter transfers on patient outcomes, and there clearly is a benefit. But it is a case of diminishing returns, with the benefit of transporting a patient with, say, a broken ankle approaching zero. Simply flying less will go a long way towards reducing the accident rate by reducing the exposure to risk. Unfortunately, it would require a wholesale overhaul, not just of the US EMS helicopter industry but of the entire healthcare system and the legal system to accomplish such a reduction on a nationwide scale.
The threshold for calling a helicopter to the scene of an accident is pretty low in many jurisdictions. First responders, concerned about lawsuits, treat every injury -minor or otherwise- as if it could be potentially life-threatening. Hospital doctors, too, are under pressure to err on the side of caution, ordering expensive treatment (to include helicopter transfers) that often goes beyond the actual needs of the patient. For-profit helicopter operators are only too happy to oblige.
Many studies have examined the effect of helicopter transfers on patient outcomes, and there clearly is a benefit. But it is a case of diminishing returns, with the benefit of transporting a patient with, say, a broken ankle approaching zero. Simply flying less will go a long way towards reducing the accident rate by reducing the exposure to risk. Unfortunately, it would require a wholesale overhaul, not just of the US EMS helicopter industry but of the entire healthcare system and the legal system to accomplish such a reduction on a nationwide scale.
Avoid imitations
Join Date: Nov 2000
Location: Wandering the FIR and cyberspace often at highly unsociable times
Posts: 14,573
Received 422 Likes
on
222 Posts
ShyTorque wrote:
"This profit driven philosophy is quite possibly where the much of the press-on-itis comes from. As for a mantra that the USA always knows best and no-one else is entitled to comment on any of it because they don't understand.....really!
How would relatives of a deceased patient or crew member feel if they knew that lives of their loved ones might not have been lost if things had been different i.e. profit for the service provider wasn't such a major issue?
We had a similar issue in UK a couple of decades ago. The only logical remedy was for CAA legislation to be tightened up, and it was.
As the saying goes, if you think safety is expensive, try having an accident."
Sir, the scheduled airlines are all very much profit oriented, at least in the US, and their safety record is a respectable benchmark. It's not the "for profit aspect" that compromises safety, it's the methods used to maximize profitability.
The ultimate criterion might be "profits" but the methods are the same with bad management across the aviation spectrum, for profit and non-profit; government and private. Bad management encouraging bad practices isn't specific to any model.
"This profit driven philosophy is quite possibly where the much of the press-on-itis comes from. As for a mantra that the USA always knows best and no-one else is entitled to comment on any of it because they don't understand.....really!
How would relatives of a deceased patient or crew member feel if they knew that lives of their loved ones might not have been lost if things had been different i.e. profit for the service provider wasn't such a major issue?
We had a similar issue in UK a couple of decades ago. The only logical remedy was for CAA legislation to be tightened up, and it was.
As the saying goes, if you think safety is expensive, try having an accident."
Sir, the scheduled airlines are all very much profit oriented, at least in the US, and their safety record is a respectable benchmark. It's not the "for profit aspect" that compromises safety, it's the methods used to maximize profitability.
The ultimate criterion might be "profits" but the methods are the same with bad management across the aviation spectrum, for profit and non-profit; government and private. Bad management encouraging bad practices isn't specific to any model.
Not trying to fly through the hills in bad weather at night. Completely different ball games.
The point I was making is that if the EMS service provider had no profit to make, or profit to lose, based on retrieval of the patient, it would put less presssure on the crew to press on in marginal conditions.
Join Date: Oct 2003
Location: Over here
Posts: 1,030
Likes: 0
Received 0 Likes
on
0 Posts
And if your Aunt Tess had balls, she would be your uncle. The current political climate in the US simply will now allow the government to do anything more than it's doing, probably less. Profit is the driving force of everything. I'm not saying it's right, I'm just saying it is. 
Avoid imitations
Join Date: Nov 2000
Location: Wandering the FIR and cyberspace often at highly unsociable times
Posts: 14,573
Received 422 Likes
on
222 Posts
Folks complain about over-regulation of aviation in UK (some of them have contributed to this thread). We can see the alternative in some of these accident reports. 52 lives lost since 2006 on supposedly life saving missions.
Join Date: Aug 2011
Location: Arizona
Posts: 6
Likes: 0
Received 0 Likes
on
0 Posts
There's no reason to be defeatist; the US HEMS market is far from homogeneous. Even within the US there are many local and state governments that have taken a different approach to providing HEMS services to their constituents. The Austin, Texas STAR flight program, or Miami-Dade County Fire Rescue are just two examples that come to mind. They tend to be well-funded and highly regulated, just like many of the European HEMS programs. Anecdotal evidence suggests they maintain a similar level of safety.
Such programs provide a template for any other local or state government to follow, irrespective of FAA regulations; the state of the healthcare industry or the intrinsically capitalist nature of the country.
Such programs provide a template for any other local or state government to follow, irrespective of FAA regulations; the state of the healthcare industry or the intrinsically capitalist nature of the country.
Join Date: Sep 2007
Location: USA
Posts: 336
Likes: 0
Received 0 Likes
on
0 Posts
irstly,let me add to the condolences offered here to the three souls in the aircraft and also to the person waiting for the heart transplant.The pilot was experienced and he certainly did not wake up that morning thinking that this would be a good day to die.There,but for the grace of God, go I.
Second, I too fly a VFR single (AS350B2) for an EMS outfit.We have only recently been provided with NVGs and before that,at my location, there were times when,if granny turned the porch light off at night, I was,for all intents and purposes, IFR.So,I too am on both sides of the Night VFR issue.
Twins versus singles is a non starter at this point as we don't know if the engine had anything to do with this.But, twins do have the ability to haul a lot more weight ,i.e. a second pilot,more bells and whistles etc.However, I do recall an S76 "fully loaded" for IFR with two pilots on board ,departing an airport,no less, running into a hill a few minutes after take off because they forgot to climb.
Ultimately, it boils down to Training and Technology going hand in hand.And, to be an EMS pilot and be able to say NO every now and then also requires a certain Temperament. It is up to the operators to offer the first two and to help select the appropriate guy for the job.And, it is getting harder everyday as the pool of experienced ,qualified pilots dries up.
Hope you all have a safe and a happy 2012.
Alt3.
Second, I too fly a VFR single (AS350B2) for an EMS outfit.We have only recently been provided with NVGs and before that,at my location, there were times when,if granny turned the porch light off at night, I was,for all intents and purposes, IFR.So,I too am on both sides of the Night VFR issue.
Twins versus singles is a non starter at this point as we don't know if the engine had anything to do with this.But, twins do have the ability to haul a lot more weight ,i.e. a second pilot,more bells and whistles etc.However, I do recall an S76 "fully loaded" for IFR with two pilots on board ,departing an airport,no less, running into a hill a few minutes after take off because they forgot to climb.
Ultimately, it boils down to Training and Technology going hand in hand.And, to be an EMS pilot and be able to say NO every now and then also requires a certain Temperament. It is up to the operators to offer the first two and to help select the appropriate guy for the job.And, it is getting harder everyday as the pool of experienced ,qualified pilots dries up.
Hope you all have a safe and a happy 2012.
Alt3.
Join Date: Apr 2007
Location: Center of the Universe
Posts: 645
Likes: 0
Received 0 Likes
on
0 Posts
do we always have the choice when we work...?
BTW, my understanding so far is that this flight, while somewhat urgent, was not a matter of immediate life or death. It appears as though the transplant recipient had a substantial time window and continued waiting for a new organ to become available after the flight. As others have pointed out, not an EMS flight responding to a trauma event.
"Just a pilot"
Yo, "Thomas Coupling"
"Who, exactly is supervising this aspect of FAA operations, to CONTINUE to allow crash after crash in the US EMS world. When will you guys learn, enough is enough. I thought EMS had been flushed through and a safer regime adopted. Obviously not."
The accident flight was not an EMS flight. This was a charter to harvest a donated organ.
Far as I know, nobody in the FAA is "allowing crash after crash in the US EMS world" or any other facet of US aviation. Mostly, I find relying on equipment- lots of engines, gauges, second pilots and autopilots, cooperative passengers and ATC to be very bad risk management. They all present issues and that stuff won't make the PIC smarter or errors made any less difficult. If the very real prospect of a killing oneself by accepting too much hazard isn't sufficient discouragement, all the regulations, risk assessment matrices in the world won't keep you out of a smoking hole.
Not saying I don't wish for power redundancy, etc. I do, often, and I can make it work. But I've also been way down in the bottom of that bucket scrabbling hard to get out, I have no illusions about invulnerability.
There seem to me to be many factors in common with a long list of accidents in this flight. The fact that this was a single, older pilot and a 206 isn't high on my list of potential issues.
The accident flight was not an EMS flight. This was a charter to harvest a donated organ.
Far as I know, nobody in the FAA is "allowing crash after crash in the US EMS world" or any other facet of US aviation. Mostly, I find relying on equipment- lots of engines, gauges, second pilots and autopilots, cooperative passengers and ATC to be very bad risk management. They all present issues and that stuff won't make the PIC smarter or errors made any less difficult. If the very real prospect of a killing oneself by accepting too much hazard isn't sufficient discouragement, all the regulations, risk assessment matrices in the world won't keep you out of a smoking hole.
Not saying I don't wish for power redundancy, etc. I do, often, and I can make it work. But I've also been way down in the bottom of that bucket scrabbling hard to get out, I have no illusions about invulnerability.
There seem to me to be many factors in common with a long list of accidents in this flight. The fact that this was a single, older pilot and a 206 isn't high on my list of potential issues.
Join Date: Nov 2003
Location: United States
Age: 62
Posts: 71
Likes: 0
Received 0 Likes
on
0 Posts
RIP and condolences to all those involved in another tragic accident.
I have to agree with Devil49. I too fly HEMS in the rural areas of the SE USA. The easy days/nights are the ones where the weather is either really good, or really bad. Those in between and especially at night, where reporting stations etc aren't always available make some decisions very difficult indeed, even when always erring on the absolute side of caution. I doubt there are many here who have not had to abort a flight for weather at some point in their career despite our best intentions to never have to make that decision 'up there'. There is no sense of invulnerability here.
Having flown under FAA and European regs, it seems that the FAA and operators alike are doing all they can to mitigate the risks of our business. Some more than others perhaps, but at the end of the day no matter what guidelines or tools are put at our disposal the old adage goes you can take a horse to water but..... so in the interim I hope that we can all take any lessons to be learned from this event and remind ourselves that we operate in a challenging job with little room for error.
I have to agree with Devil49. I too fly HEMS in the rural areas of the SE USA. The easy days/nights are the ones where the weather is either really good, or really bad. Those in between and especially at night, where reporting stations etc aren't always available make some decisions very difficult indeed, even when always erring on the absolute side of caution. I doubt there are many here who have not had to abort a flight for weather at some point in their career despite our best intentions to never have to make that decision 'up there'. There is no sense of invulnerability here.
Having flown under FAA and European regs, it seems that the FAA and operators alike are doing all they can to mitigate the risks of our business. Some more than others perhaps, but at the end of the day no matter what guidelines or tools are put at our disposal the old adage goes you can take a horse to water but..... so in the interim I hope that we can all take any lessons to be learned from this event and remind ourselves that we operate in a challenging job with little room for error.
Avoid imitations
Join Date: Nov 2000
Location: Wandering the FIR and cyberspace often at highly unsociable times
Posts: 14,573
Received 422 Likes
on
222 Posts
It's very sad to repeatedly read about these tragic accidents which often appear to follow a common theme.
Just to set the record straight for some:
In UK, single engined helicopters are no longer allowed to operate in IMC, period.
In UK, there is no such thing as "Night VFR" for civilian operations. Flight under VFR is not allowed by night / night flying must be carried out under IFR. However, IFR are deemed to be met below 3,000 feet if sufficient external visual cues on the surface are available for the attitude of the aircraft to be assessed and maintained.
The difficulty comes from recognising when sufficient external cues no longer exist. Pilots must be totally prepared (in all respects) for a safe and timely transition to instruments.
VFR is safe enough, IFR is safe enough (neither without some level of risk), but transitioning from one to the other needs some serious thinking about to be safe.
Public Transport (PT) by night in UK is no longer allowed in single engined (and therefore non-fully IFR equipped) helicopters. We suffered some very high profile public transport accidents some years ago and singles were subsequently outlawed.
This tragic accident was obviously not a police operation but seeing as this type of operation has been mentioned, it should be remembered that in UK, police operations are deemed to be Public Transport and must operate under the terms of a Police Air Operations Certificate. The Chief Constable of the unit is deemed to be the PAOC holder. UK Police helicopters must be twin engined, (day or night) and for night ops or IFR must have a stabilisation system fitted. They are actually most often operated under "Visual Contact Flight" (VCF) rules by day or night, which give defined, but slightly less strict, weather criteria than for other other public transport operations, including minimum separation from cloud.
UK police pilots are required to carry out mandatory regular instrument training with a safety pilot on board (whether holding a full IR or not), so that in the event of inadvertant entry to IMC they should be fully competent to recover to a diversion airfield for an instrument approach or at the very least for a letdown to VCF over a safe area.
Having operated under military, police and purely civilian / PT rules, single pilot, in both single engined, twin engined, non stabilised and unstabilised helicopters I would personally always take the "full IFR" option (where possible) for a job like the one in question. Irrespective of local rules or which type of AOC I was required to operate under.
This accident, for the purpose of saving one life, resulted in the tragic loss of three lives. Many others in the not-too-distant past have done the same.
In UK the flight in question just would not have been allowed. Period.
Seems to me that the only reason that the USA rules still allow this type of public transport job is resistance from the industry, to keep down the cost and keep up profit margins. If we can make the changes in little old and broke UK, why can't the USA?
Just to set the record straight for some:
In UK, single engined helicopters are no longer allowed to operate in IMC, period.
In UK, there is no such thing as "Night VFR" for civilian operations. Flight under VFR is not allowed by night / night flying must be carried out under IFR. However, IFR are deemed to be met below 3,000 feet if sufficient external visual cues on the surface are available for the attitude of the aircraft to be assessed and maintained.
The difficulty comes from recognising when sufficient external cues no longer exist. Pilots must be totally prepared (in all respects) for a safe and timely transition to instruments.
VFR is safe enough, IFR is safe enough (neither without some level of risk), but transitioning from one to the other needs some serious thinking about to be safe.
Public Transport (PT) by night in UK is no longer allowed in single engined (and therefore non-fully IFR equipped) helicopters. We suffered some very high profile public transport accidents some years ago and singles were subsequently outlawed.
This tragic accident was obviously not a police operation but seeing as this type of operation has been mentioned, it should be remembered that in UK, police operations are deemed to be Public Transport and must operate under the terms of a Police Air Operations Certificate. The Chief Constable of the unit is deemed to be the PAOC holder. UK Police helicopters must be twin engined, (day or night) and for night ops or IFR must have a stabilisation system fitted. They are actually most often operated under "Visual Contact Flight" (VCF) rules by day or night, which give defined, but slightly less strict, weather criteria than for other other public transport operations, including minimum separation from cloud.
UK police pilots are required to carry out mandatory regular instrument training with a safety pilot on board (whether holding a full IR or not), so that in the event of inadvertant entry to IMC they should be fully competent to recover to a diversion airfield for an instrument approach or at the very least for a letdown to VCF over a safe area.
Having operated under military, police and purely civilian / PT rules, single pilot, in both single engined, twin engined, non stabilised and unstabilised helicopters I would personally always take the "full IFR" option (where possible) for a job like the one in question. Irrespective of local rules or which type of AOC I was required to operate under.
This accident, for the purpose of saving one life, resulted in the tragic loss of three lives. Many others in the not-too-distant past have done the same.
In UK the flight in question just would not have been allowed. Period.
Seems to me that the only reason that the USA rules still allow this type of public transport job is resistance from the industry, to keep down the cost and keep up profit margins. If we can make the changes in little old and broke UK, why can't the USA?
UK police pilots are required to carry out mandatory regular instrument training with a safety pilot on board (whether holding a full IR or not), so that in the event of inadvertant entry to IMC they should be fully competent to recover to a diversion airfield for an instrument approach or at the very least for a letdown to VCF over a safe area.
I guess another way of phrasing the question would be why would the same CAA insist on an IF rating if there is no "intent" for a VFR operation to convert to an IFR operation.
As to your final paragraph....here in the USA...as mentioned dozens of times in the past by mulitiple posters....we operate on the "You Can unless prohibited"....as compared to the UK "You Cannot unless specifically authorized" mindset under the Air Regulations.
The CAA and FAA rules sometimes defy commonsense and logic it seems!
Join Date: Nov 2005
Location: UK
Posts: 281
Likes: 0
Received 0 Likes
on
0 Posts
The debate against single/twin engine and single/multi crew will go on for ever until the laws are changed and enforced. Unfortunately, we as pilots often don't have the choice to decide. Sure we can say no to certain flights, but as in this case for example (which might have happened), when someone knocks on your door late at night and asks you to go fetch a heart urgently before it and/or the recipient dies, what are you going to say??? I can only do it in the twin... But lets say the twin is down, not fueled, or parked in the back of the hangar and it will take an hour to get it airborne...and the perfectly good old 206 is parked in front, fueled and ready to go... 9 out of 10... if not 10 out of 10 of us, who all have done these flights before in a singles and on our own (with out the added rush of loss of life pressure) would say lets go.....
As a professional pilot I for one would do my utmost not to allow those sort of consideratons to influence my judgement, and I would further venture that its exactly this sort of "lets go" attitude that is a major factor in the accident rate for US EMS related flights being so high. Unfortunately I can see from other replies that this sort of mindset seems to be ingrained in a majority of US pilots and until a change in the rules is forced upon a reluctant helicopter EMS sector, nothing will change and accidents such as this will continue to happen at an alarming rate.
BC
Avoid imitations
Join Date: Nov 2000
Location: Wandering the FIR and cyberspace often at highly unsociable times
Posts: 14,573
Received 422 Likes
on
222 Posts
SASless, they weren't my rules, I only had to stick to them.
You often criticise our stricter UK rules and anyone who dares to mention them here, but the proof is in the pudding - we don't suffer the same losses. From experience, the risk of these kind of flights (i.e. are they VFR or are they IFR) is deemed to outweigh the benefit by the regulatory body.
The answer to your first question is about the same as the last but one line of my previous post. The rules here were changed after a fatal night-time accident to a UK police helicopter. Problem was, when it occurred, the majority of police ASUs were relatively very new entities. Many of the aircraft coming into use were not fully compliant with IFR flight. The one I flew had to have it's stabilisation system removed to save sufficient weight to fit the police equipment and had to be flown completely floppy sticked (i.e. twin engined, previously IFR equipped but now NOT so).
You can perhaps understand the problems it would have caused if Chief Constables were suddenly told the helicopters they had just paid for had to be scrapped...... Back then the large majority of police pilots were ex-mil. Giving those pilots some IF training was a half-way compromise.
A police aircraft is an observation platform. If the aircraft goes IMC the job is, by definition, thrown away. The limited IR training mandated was to give pilots some recency; many of them had previously held a military IR.
Last thing I heard was that once the "old" aircraft were replaced by more capable ones (i.e. fully IFR equipped) the further intention was for all UK police pilots to become IR holders. As I've been out of that industry for over a decade I'm not qualified to give a more up to date progress report on that front. Again, it's down to money.
You often criticise our stricter UK rules and anyone who dares to mention them here, but the proof is in the pudding - we don't suffer the same losses. From experience, the risk of these kind of flights (i.e. are they VFR or are they IFR) is deemed to outweigh the benefit by the regulatory body.
The answer to your first question is about the same as the last but one line of my previous post. The rules here were changed after a fatal night-time accident to a UK police helicopter. Problem was, when it occurred, the majority of police ASUs were relatively very new entities. Many of the aircraft coming into use were not fully compliant with IFR flight. The one I flew had to have it's stabilisation system removed to save sufficient weight to fit the police equipment and had to be flown completely floppy sticked (i.e. twin engined, previously IFR equipped but now NOT so).
You can perhaps understand the problems it would have caused if Chief Constables were suddenly told the helicopters they had just paid for had to be scrapped...... Back then the large majority of police pilots were ex-mil. Giving those pilots some IF training was a half-way compromise.
A police aircraft is an observation platform. If the aircraft goes IMC the job is, by definition, thrown away. The limited IR training mandated was to give pilots some recency; many of them had previously held a military IR.
Last thing I heard was that once the "old" aircraft were replaced by more capable ones (i.e. fully IFR equipped) the further intention was for all UK police pilots to become IR holders. As I've been out of that industry for over a decade I'm not qualified to give a more up to date progress report on that front. Again, it's down to money.
You often criticise our stricter UK rules and anyone who dares to mention them here, but the proof is in the pudding - we don't suffer the same losses. From experience, the risk of these kind of flights (i.e. are they VFR or are they IFR) is deemed to outweigh the benefit by the regulatory body.
I am quite willing to bet one of the reasons you don't suffer the same losses is you don't do the same tasking. For sure your loss rate will be better if one does not leave the ground but then if you don't fly....injured and ill folks pay the price for that kind of mindset.
Do it in an unsafe manner and the EMS crews and some patients will pay the that price as well.
The UK Helicopter industry ashore is quite limited compared to the sheer size of the US helicopter industry.
There are between 400-500 EMS helicopters in the USA providing a 24/7 service to the country. Compare that to the the UK please and tell us it is an Apples to Apples comparison.
That we lose too many people and aircraft.....for way too many of the same reasons year after year is a true statement and if you recall I am critical of the US EMS industry for its seemingly cavalier attitude towards that.
The past two years has seen a marked improvement in the loss rate as the industry and the government has been forced to reconcile the old way of doing business with the adverse PR they have had to face up to due to the number of fatalities the industry has experienced in the past.
One metric that is not measured is the numbers of lives lost due to the lack of a 24/7 EMS service in the UK and Europe due to the strict rules of flight. That might be a telling number?
The sad truth is trying to provide the 24/7 service but doing so in a safe effiecient manner is always going to be a balancing act.
The CAA/FAA rules should assist in improving safety but do so without preventing the provision of the service for unnecessary bureaucratical reasons.
Just what is different between VFR weather (1000/3 miles) in the UK and the USA....same aircraft, same standard of pilots, same weather....yet we can fly and you cannot. Does it not seem just a wee bit odd to you?
The UK legal environment for Helicopter EMS operations is different than that here in the USA and one set of rules does not fit both situations.
People died before the advent of ground ambulances, EMT's, Paramedics, and Helicopter EMS with its Paramedics and Flight Nurses and the current EMS crews should accept they will not be able to "save" every life in jepordady. Way too many forget they are in the medical transport business and not the life saving business.
Avoid imitations
Join Date: Nov 2000
Location: Wandering the FIR and cyberspace often at highly unsociable times
Posts: 14,573
Received 422 Likes
on
222 Posts
I criticize the unrealistic UK Rules and those who hit us with a "Father knows best" attitude about them.
There's many a time when there is no IFR option that I could have launched in poor weather and easily have got to my destination under our military regulations. But despite flying a more capable aircraft, these days I fly under stricter civvie rules. Frustrating at times, to be honest.
Way too many forget they are in the medical transport business and not the life saving business.
But I can't completely follow your underlying rationale. Do you want safer night EMS ops in USA, or not? It appears that you do, but appear to strongly oppose any suggestion that the stricter rules already applying elsewhere just might help make it safer. When legislation levels the playing field, the only difference once the dust settles is that the price of the job goes up. So how much are the lives of an EMS crew worth? You appear to be saying there is a difference from one side of the Atlantic to the other.
It appears that you do, but appear to strongly oppose any suggestion that the stricter rules already applying elsewhere just might help make it safer.
If the rules were changed...would there be more EMS operations that would set up shop and thus provide a needed service to the community? You reckon the Operators would find a way to do it safely despite a change in your rules?
Have you ever done a realistic comparison of the US aviation infrastructure provided by the government to that provided by the UK government?
Can you land at an airport when the Control Tower is closed? Can you land at an airport that does not have on-site manned Fire Services? There are dozens of examples of where your system is so restrictive it kills the industry but will you accept it being so?
Lord God Shy....what happens if you have the sheer gall to walk on the Dispersal without a Hi-Vis Jacket?
Your rules don't make it safer....they make it impossible!
That is my underlying message Shy......the rule should make it safer...not bloody impossible!
Again...you fail to make the connection that the UK rules prevent real Helicopter EMS operations based upon the "rule" rather than 'performance".
It is the Pilot/Operator that should be the deciding authority upon when the service is provided...not the Government. The government should provide the opportunity for the private sector to offer its services.
If one legislates the standards to the point the service cannot be done at all....then where is the sense in that?
Your inability to accept the CAA's rules as being excessive is the usual Achille's Heel Brits have when defending the rules you have to work under.
The CAA has earned a nickname of "Crats Against Aviation" for valid reasons...some fairly applied and some not.
Join Date: Aug 2011
Location: Ventura Ca U.S.A.
Posts: 222
Likes: 0
Received 0 Likes
on
0 Posts
Helicopters even with A full box of IFR gear, Helipilots and such make a rotten platform, The IFR ststem was designed for Fixed wings flying to equiped locations via airways , The helicopter environment is too close to mother earth & what hospital will put out for a pad with all the trimmings?
New rules never fix anything, A better infrastructure will. Till then learn to say later.
New rules never fix anything, A better infrastructure will. Till then learn to say later.
Avoid imitations
Join Date: Nov 2000
Location: Wandering the FIR and cyberspace often at highly unsociable times
Posts: 14,573
Received 422 Likes
on
222 Posts
SASless,
So what is your "text book" solution to the issue in question, ie. how would you make "VFR" Night Ops safer?
Yes, I can. I can also legally land off airfield by night, too. I try to avoid it like the plague.
I've done it many times in the past (UK Military/ Civilian Casevac & SAR, Far East / UK police/ Private). I'm fully aware of the risks involved and those risks are not to be underestimated.
Towards the end of my military service non-NVG ops became known as "reversionary night flying". Twenty years ago, a decision was made such that every night flight was made on NVG. Ad-hoc landing sites were not normally allowed unless a second aircraft could illuminate the site with black light. The military decided over two decades ago to desist from doing multi-crew what your EMS folk are still struggling to do single pilot and without NVG.
I'm fairly sure that the UK rules don't forbid night landings for EMS / Air Ambulance flights. Instead the individual authorities providing the service have risk assessed it and for now have decided not to do it. I was in conversation with the chief pilot of an air ambulance unit about three weeks ago and this was a subject he brought up. He said that it will be done in the not too distant future.
Hi-viz jackets? I don't see what that has to do with the issue at all, but some UK airfields (licensed or otherwise) don't mandate Hi-viz. Some actively discourage them. It's not a CAA requirement, but a local Health and Safety one. I don't like wearing mine just because some graduate did a course on it, but I will wear it if I think it's safer to do so, such as on our unlit dispersal at night (shock horror, yes, totally unlit, in the dark).
My inability....? I don't defend the rules (CAA always known as "Campaign Against Aviation", btw, not 'Crats).
I do however comply with their rules A) because I want to keep my licence and B) because I hope to reach my retirement in one piece without being put in a situation where I feel under commercial pressure to push the limits, risking my aircraft and crew / pax to get a job done. Let alone in an outdated aircraft. Did you operate differently? Does EMS USA operate differently to that? What's wrong with a planned IFR transit, in a properly equipped aircraft, followed by a letdown to VMC below?
SASless, Why not refrain from attacking the messenger and look outside the box?
So what is your "text book" solution to the issue in question, ie. how would you make "VFR" Night Ops safer?
Can you land at an airport when the Control Tower is closed? Can you land at an airport that does not have on-site manned Fire Services? There are dozens of examples of where your system is so restrictive it kills the industry but will you accept it being so?
I've done it many times in the past (UK Military/ Civilian Casevac & SAR, Far East / UK police/ Private). I'm fully aware of the risks involved and those risks are not to be underestimated.
Towards the end of my military service non-NVG ops became known as "reversionary night flying". Twenty years ago, a decision was made such that every night flight was made on NVG. Ad-hoc landing sites were not normally allowed unless a second aircraft could illuminate the site with black light. The military decided over two decades ago to desist from doing multi-crew what your EMS folk are still struggling to do single pilot and without NVG.
I'm fairly sure that the UK rules don't forbid night landings for EMS / Air Ambulance flights. Instead the individual authorities providing the service have risk assessed it and for now have decided not to do it. I was in conversation with the chief pilot of an air ambulance unit about three weeks ago and this was a subject he brought up. He said that it will be done in the not too distant future.
Hi-viz jackets? I don't see what that has to do with the issue at all, but some UK airfields (licensed or otherwise) don't mandate Hi-viz. Some actively discourage them. It's not a CAA requirement, but a local Health and Safety one. I don't like wearing mine just because some graduate did a course on it, but I will wear it if I think it's safer to do so, such as on our unlit dispersal at night (shock horror, yes, totally unlit, in the dark).
Your inability to accept the CAA's rules as being excessive is the usual Achille's Heel Brits have when defending the rules you have to work under. The CAA has earned a nickname of "Crats Against Aviation" for valid reasons...some fairly applied and some not.
I do however comply with their rules A) because I want to keep my licence and B) because I hope to reach my retirement in one piece without being put in a situation where I feel under commercial pressure to push the limits, risking my aircraft and crew / pax to get a job done. Let alone in an outdated aircraft. Did you operate differently? Does EMS USA operate differently to that? What's wrong with a planned IFR transit, in a properly equipped aircraft, followed by a letdown to VMC below?
SASless, Why not refrain from attacking the messenger and look outside the box?
As this thread swings from mandatory twin pilot IFR to landing on scene at night it is important to remember that EMS is totally different in the UK from the US.
In the US many helicopter systems are bolted on to hospitals because they are needed to provide adequate population numbers for specialist services. Many systems operate secondary transfers, often involving patients with low levels of pathology, again so regional centres can exist outside big cities. Neonates need to be transferred far more frequently over longer distances and trauma is far more common and severe.
In the UK we dont have community hospitals and since 1997 more and more hospitals have provided all but the most specialist services so that the trauma concept of 1990 has been abandoned and the much lower number of trama victims are taken to the local hospital. Neonatal transfers are less common, involve shorter distances, and paediatricians normally manage most transfers with specialist ground vehicles. Inter ITU transfers by helicopter have been shown to save lives, but the specialised equipment is quite different from a HEMS helicopter and to put it bluntly the NHS wont pay.
So in the UK there is little evidence of lives saved; the London hospital's HEMS was very carefully audited but the only 'life saving' was severe head injuries and the cost was many times that of even heart transplantation. As a result we are likely to continue to see EMS helicopters used by ambulance services as opposed to hospitals, for rural areas and to help ambulance managers meet time targets. That is not to say they do not have major benefits including pain reduction and freeing ground units but life saving doesnt stack up financially or logistically.
As such running daylight only systems seems to be sensible, together with a proper chinese wall such that despatchers and pilots do not know the medical indications of the mission. The idea of landing on scene at night terrifies me and the potential benefits are questionable. However, having flown in the back of these ships both sides of the atlantic I despair at the holier than thou attitude towards the US with its totally different needs and driving forces. I am sure most US operators wouldnt turn away full IFR ships and would like the opportunities to reject more flights, but hospital operators asnd indeed patient needs demand otherwise - for the present at least.
In the US many helicopter systems are bolted on to hospitals because they are needed to provide adequate population numbers for specialist services. Many systems operate secondary transfers, often involving patients with low levels of pathology, again so regional centres can exist outside big cities. Neonates need to be transferred far more frequently over longer distances and trauma is far more common and severe.
In the UK we dont have community hospitals and since 1997 more and more hospitals have provided all but the most specialist services so that the trauma concept of 1990 has been abandoned and the much lower number of trama victims are taken to the local hospital. Neonatal transfers are less common, involve shorter distances, and paediatricians normally manage most transfers with specialist ground vehicles. Inter ITU transfers by helicopter have been shown to save lives, but the specialised equipment is quite different from a HEMS helicopter and to put it bluntly the NHS wont pay.
So in the UK there is little evidence of lives saved; the London hospital's HEMS was very carefully audited but the only 'life saving' was severe head injuries and the cost was many times that of even heart transplantation. As a result we are likely to continue to see EMS helicopters used by ambulance services as opposed to hospitals, for rural areas and to help ambulance managers meet time targets. That is not to say they do not have major benefits including pain reduction and freeing ground units but life saving doesnt stack up financially or logistically.
As such running daylight only systems seems to be sensible, together with a proper chinese wall such that despatchers and pilots do not know the medical indications of the mission. The idea of landing on scene at night terrifies me and the potential benefits are questionable. However, having flown in the back of these ships both sides of the atlantic I despair at the holier than thou attitude towards the US with its totally different needs and driving forces. I am sure most US operators wouldnt turn away full IFR ships and would like the opportunities to reject more flights, but hospital operators asnd indeed patient needs demand otherwise - for the present at least.