NTSB says EMS accident rate is too high
Autopilots vs NVGs
EN48 made a very good point concerning the utilization of auto pilots in light single engine machines. That one device would take much of the anxiety out of IIMC events. An autopilot doesn’t care if the machine is in IMC conditions. All the pilot has to do is properly manage the autopilot throughout the flight. In the US, operators have opted for NVGs to mitigate night operational risks. NVGs may assist in not encountering IIMC but would do little once IIMC is encountered.
Single versus twin engine has little bearing on the discussion at this time. Statistically, because the actual number of in-flight engine shut downs for all turbine engine helicopters is so low it would be difficult to establish that the number of engines has any bearing on EMS accident rates.
Our regulatory system in the US should absorb much of the blame. Our system has turned its back on safety putting the operators concerns ahead of safety when regulating operators. The fact that a helicopter can operate at night with only 1 mile visibility (FAR135.205) and with no reference to minimum ceiling borders on insanity. Our air medical mishap rate however dismal it may seem, could be far worse if it were not for the professional decisions put forth by most PICs before each and every flight.
Single versus twin engine has little bearing on the discussion at this time. Statistically, because the actual number of in-flight engine shut downs for all turbine engine helicopters is so low it would be difficult to establish that the number of engines has any bearing on EMS accident rates.
Our regulatory system in the US should absorb much of the blame. Our system has turned its back on safety putting the operators concerns ahead of safety when regulating operators. The fact that a helicopter can operate at night with only 1 mile visibility (FAR135.205) and with no reference to minimum ceiling borders on insanity. Our air medical mishap rate however dismal it may seem, could be far worse if it were not for the professional decisions put forth by most PICs before each and every flight.
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The big issue with using twins is largely that (in Europe at least) you need a twin to have IFR capability. You can't go IFR (and shouldn't go IMC) in a single. End of story. And no-one here sees that changing. I had thought that applied in the US too, but maybe not? I'm sure someone will confirm. Apart from engine redundancy, an IFR twin will also have redundancy of many other systems such as instrumentation, hydraulics, generators and inverters, providing added safety when stuck up in the clag for some time.
As it happens, I'd be fairly comfortable in IMC in a well maintained and preferably newish single like a 350B2/3, with a good autopilot, but the law doesn't allow it in Europe. Having said that, I'd still take the psychological comfort (as would most pax) and some practical benefit of a second engine!
SASless; you say the pilot/operator should make the decisions not the government. Ideally yes, but history proves that pilots' judgement is too often not adequate. Legislation therefore reduces the scope for such decisions - and getting them wrong. They can also take pressure off a pilot by enabling him to simply say, for example, I'm not legally permitted to take the B206 on the flight tonight. It will need to be IFR twin or not at all. Don't get me wrong, the extent of legislation can be very frustrating, but it does have its benefits.
And finally - as I've asked before with no response - does anyone know of any safety statistics relating to European and US EMS ops? Clearly they need to be interpreted carefully and can be misleading, but would be useful.
As it happens, I'd be fairly comfortable in IMC in a well maintained and preferably newish single like a 350B2/3, with a good autopilot, but the law doesn't allow it in Europe. Having said that, I'd still take the psychological comfort (as would most pax) and some practical benefit of a second engine!
SASless; you say the pilot/operator should make the decisions not the government. Ideally yes, but history proves that pilots' judgement is too often not adequate. Legislation therefore reduces the scope for such decisions - and getting them wrong. They can also take pressure off a pilot by enabling him to simply say, for example, I'm not legally permitted to take the B206 on the flight tonight. It will need to be IFR twin or not at all. Don't get me wrong, the extent of legislation can be very frustrating, but it does have its benefits.
And finally - as I've asked before with no response - does anyone know of any safety statistics relating to European and US EMS ops? Clearly they need to be interpreted carefully and can be misleading, but would be useful.
So who in the area had a Stokes Litter or other Rescue Litter? Do the RAF or CoastGuard SAR aircraft carry such a device aboard the aircraft? I wonder if any thought was given to asking for their support in the mine shaft rescue?
I can understand a reluctance to moving a casualty by harness and rope lift....considering the circumstances as there was a great risk of spinal injuries. Immobilzation of the head, neck, and spine are very important where there is such a risk.
Part of every fire fighters basic training in this country requires rappelling, rope work, and rescue techinques. Every EMS wagon/aircraft carries and routinely uses immobilzation equipment. Fire Fighters are also dispatched to such calls and each unit carries trained EMT's amongst the fire wagon crew.
We have practiced Short Hauls of Emergency Personnel using helicopters for isolated area rescues in various fire units around the country.
How far away is RAF Kinloss and RAF Leuchars from the site of the mine shaft?
I can understand a reluctance to moving a casualty by harness and rope lift....considering the circumstances as there was a great risk of spinal injuries. Immobilzation of the head, neck, and spine are very important where there is such a risk.
Part of every fire fighters basic training in this country requires rappelling, rope work, and rescue techinques. Every EMS wagon/aircraft carries and routinely uses immobilzation equipment. Fire Fighters are also dispatched to such calls and each unit carries trained EMT's amongst the fire wagon crew.
We have practiced Short Hauls of Emergency Personnel using helicopters for isolated area rescues in various fire units around the country.
How far away is RAF Kinloss and RAF Leuchars from the site of the mine shaft?
BFC....exact right thread...see Brassed Off's post and link.
The answer pertains to the discussion about lack of service...rules getting in the way of getting the job done...and lives being lost as a result.
A fully qualified medical team could have been delivered by an EMS helicopter directly to the scene if it had been available. Shy of that....there is the RAF SAR units that could have been tasked despite their lack of first class life support equipment in their cab.
There seems to be a misunderstanding about the capability our US Helicopter EMS operations can bring to a casualty amongst our UK friends. The modern EMS helicopter is not just a transport wagon but a fully equipped medical unit with two very skilled medical crewmen....usually one being a Flight Nurse and the other an experienced Paramedic with advanced training.
A situation described in the article linked by Brassed Off would have been an immediate call for an EMS helicopter in the USA....without any doubt what so ever....and one would have responded within minutes of being called. (With the usual assumptions about flyable weather).
The answer pertains to the discussion about lack of service...rules getting in the way of getting the job done...and lives being lost as a result.
A fully qualified medical team could have been delivered by an EMS helicopter directly to the scene if it had been available. Shy of that....there is the RAF SAR units that could have been tasked despite their lack of first class life support equipment in their cab.
There seems to be a misunderstanding about the capability our US Helicopter EMS operations can bring to a casualty amongst our UK friends. The modern EMS helicopter is not just a transport wagon but a fully equipped medical unit with two very skilled medical crewmen....usually one being a Flight Nurse and the other an experienced Paramedic with advanced training.
A situation described in the article linked by Brassed Off would have been an immediate call for an EMS helicopter in the USA....without any doubt what so ever....and one would have responded within minutes of being called. (With the usual assumptions about flyable weather).
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I'm saying what I did, no more, no less. Slightly difficult to decode your post, but I'm not saying what the cause was, I do suspect the most likely cause is LOC in IMC, I do not think for one minute this 206 was IFR, I do not think it's just UK that does not permit SE IFR - indeed I am waiting to hear if the US does permit it.
Right?
I'm saying what I did, no more, no less. Slightly difficult to decode your post, but I'm not saying what the cause was, I do suspect the most likely cause is LOC in IMC, I do not think for one minute this 206 was IFR, I do not think it's just UK that does not permit SE IFR - indeed I am waiting to hear if the US does permit it.
Right?
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Right, the US does permit SE and or SP IFR. Why not? It is about training. If it were about engines.....how many is really enough for IFR? Over the north Atlantic in the winter, 3 or 4 would be grand. I think your "No SE IFR" is just a knee jerk reaction. Obviously one cannot just throw more pilots and engines into the mix and call the problem rectified, can we? It is still mostly about training. Of course having more then one engine that will sustain flight while in the flight regime you are in one one engine dies is nice also. Maybe I just do not fully appreciate knee jerk reactions as much as I should, that's all.
BTW my post #81 was the result of a knee jerk reaction.
BTW my post #81 was the result of a knee jerk reaction.
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Single-engine IFR is not prohibited in the US, but it is very rare for commercial operations. BH206s are not approved for IFR because they have only one electrical power source. There have been a few approved, with stability augmentation and spare generators, but it's uncommon. I don't know of any approved for commercial operations, which are different from private or corporate use. The US Army does operate 206s IFR, but it is not subject to FAA oversight. Nor is any other government entity.
EMS helicopter operations are becoming rather highly regulated in the US, but this flight was not an EMS operation. It was a straight Part 135 charter. Criticizing the Mayo Clinic for operating an older aircraft is just silly, because they didn't own it, they just chartered a helicopter on short notice. They took what they could get at the time, and almost certainly had no idea how old the airframe was. And the airframe age makes no difference at all. That's a complete red herring.
Allowing or not allowing night flights in single-pilot, single-engine helicopters is a decision that has to be made through a cost/benefit analysis. How many lives are likely to be saved over the long run, and how many lost? In England, probably not many will be saved, because the distances are so short. The entire island would almost fit into the area in Texas that I routinely cover. Here, an ambulance would take hours to cover the distance to a trauma center over rural roads, while a helicopter can do it in well under an hour. However, there is no way to break even, much less make a profit, using twin-engine two-pilot helicopters. And profit is the overriding issue, make no mistake about that. The federal government will not be involved in providing EMS services. So the choices are to allow HEMS flights in smaller, cheaper-to-operate aircraft, or to go back to the early 20th century and run ambulances hundreds of miles to get trauma, cardiac, and stroke victims to a hospital that can provide the necessary care. Local hospitals are fine for minor illnesses and sprains, but they simply can't handle much else. That's not ideal IMO, but I'm not in charge of the system. In short, as I've said before, those on the eastern side of the pond are simply ignorant of the way things work here, and why, and their babblings will continue to be ignored here. We already fought two wars to be rid of English rule, and aren't about to give in to it now.
EMS helicopter operations are becoming rather highly regulated in the US, but this flight was not an EMS operation. It was a straight Part 135 charter. Criticizing the Mayo Clinic for operating an older aircraft is just silly, because they didn't own it, they just chartered a helicopter on short notice. They took what they could get at the time, and almost certainly had no idea how old the airframe was. And the airframe age makes no difference at all. That's a complete red herring.
Allowing or not allowing night flights in single-pilot, single-engine helicopters is a decision that has to be made through a cost/benefit analysis. How many lives are likely to be saved over the long run, and how many lost? In England, probably not many will be saved, because the distances are so short. The entire island would almost fit into the area in Texas that I routinely cover. Here, an ambulance would take hours to cover the distance to a trauma center over rural roads, while a helicopter can do it in well under an hour. However, there is no way to break even, much less make a profit, using twin-engine two-pilot helicopters. And profit is the overriding issue, make no mistake about that. The federal government will not be involved in providing EMS services. So the choices are to allow HEMS flights in smaller, cheaper-to-operate aircraft, or to go back to the early 20th century and run ambulances hundreds of miles to get trauma, cardiac, and stroke victims to a hospital that can provide the necessary care. Local hospitals are fine for minor illnesses and sprains, but they simply can't handle much else. That's not ideal IMO, but I'm not in charge of the system. In short, as I've said before, those on the eastern side of the pond are simply ignorant of the way things work here, and why, and their babblings will continue to be ignored here. We already fought two wars to be rid of English rule, and aren't about to give in to it now.
Jack Carson has hit the nail on the head. He describes exactly, what the US environment is like. Commerce comes first and safety follows a close 2nd, or maybe 3rd.....
The end.
The end.
TC.....Does not the Operator have the option of setting higher standards...does not the Pilot have the option of saying "NO!"? As an industry....do not the EMS providers through their many Professional Associations and Certification Councils have the ability to set safe minimums or minimum standards for all their members?
Why is the government supposed to be the decision maker as to "Best Practice" standards and upon what basis do they know what that Standard is supposed to be?
When I was in the seat both as a Pilot and later as a Manager....I set higher limits for myself and later for my Pilots. It was not always easy or well received by all....but the majority of folks I either worked for or supervised learned to live with me.
Case in point....a company pilot flew a Bell 206 to our home base after dark one night over some very dark ground....it being a forested area surrounding a fair bit of saltwater. I told him I preferred he not do that....and that I would gladly pay for his Room and Board if he would wait until daylight to make those kinds of trips. He took it as an insult to his abilities....when all it was intended to do was make it a bit safer for him in the future. As he was doing the trip under Part 91....the surface light reference requirement noted by Part 135 did not apply. (One of the odd things in the FAA rules...) thus he was legal and within the law. At that time there was not a Company SOP Manual....and as Part 135 did not apply....the decision to make the flight was his to make. In time he came to understand my reasons for my view on the matter. That and he found himself a Girlfriend in the remote location and thus had far more incentive to accept our coin for spending the night up there.
Point being...it does not remain with the Guvmint to tell us what to do right down to the very letter of the word....and in fact the less they interfere in our business is the better leaving us, those actually doing it to arrive at a safe standard. That is an American viewpoint....and flies in the face of the mindset in the UK and Europe. That is where we shall always differ from you folks over there....and hopefully despite the current Regime in office here....the current trend will only be a temporary one.
In our system....the Insurance Providers carry far more clout than do the FAA! If one cannot get the necessary insurance or cannot pay for it when offered....one is out of business! Commerce and Safety do go hand in hand when viewed from that perspective.
Why is the government supposed to be the decision maker as to "Best Practice" standards and upon what basis do they know what that Standard is supposed to be?
When I was in the seat both as a Pilot and later as a Manager....I set higher limits for myself and later for my Pilots. It was not always easy or well received by all....but the majority of folks I either worked for or supervised learned to live with me.
Case in point....a company pilot flew a Bell 206 to our home base after dark one night over some very dark ground....it being a forested area surrounding a fair bit of saltwater. I told him I preferred he not do that....and that I would gladly pay for his Room and Board if he would wait until daylight to make those kinds of trips. He took it as an insult to his abilities....when all it was intended to do was make it a bit safer for him in the future. As he was doing the trip under Part 91....the surface light reference requirement noted by Part 135 did not apply. (One of the odd things in the FAA rules...) thus he was legal and within the law. At that time there was not a Company SOP Manual....and as Part 135 did not apply....the decision to make the flight was his to make. In time he came to understand my reasons for my view on the matter. That and he found himself a Girlfriend in the remote location and thus had far more incentive to accept our coin for spending the night up there.
Point being...it does not remain with the Guvmint to tell us what to do right down to the very letter of the word....and in fact the less they interfere in our business is the better leaving us, those actually doing it to arrive at a safe standard. That is an American viewpoint....and flies in the face of the mindset in the UK and Europe. That is where we shall always differ from you folks over there....and hopefully despite the current Regime in office here....the current trend will only be a temporary one.
In our system....the Insurance Providers carry far more clout than do the FAA! If one cannot get the necessary insurance or cannot pay for it when offered....one is out of business! Commerce and Safety do go hand in hand when viewed from that perspective.
there is the RAF SAR units that could have been tasked despite their lack of first class life support equipment in their cab.
Back to the thread and there seems to be a disconnect between what SAS and others are advocating - eg self-regulation being the answer because no-one wants the Govt (FAA) to determine what is and isn't safe whilst on the other hand, the evidence being that self regulation isn't preventing accidents from happening.
Is it the quality of those in the cockpits? Is it just that the operators won't apply quality control because they might lose profits and go out of business?
Sas, you said earlier that people died before the advent of ambulances, paramedics and helicopters - why not accept that is still the case and that EMS can't save every life in the US?
VFR night flight with 3nm and 1000' might be quite acceptable for many pilots to complete EMS jobs but add in variable weather and availability of accurate met info, mixed terrain and a non-stabilised, non-IFR, single pilot aircraft and surely anyone can see the holes in the swiss cheese lining up!
You can either continue to defend your right to bear arms (in this context fly without regulation) and accept that accidents will still occur in marginal weather - or mandate minimum operating standards and equipment rather than jumping through loopholes in the existing FAA regs in order to get the job done cheaper.
Sas, not sure what you mean by this and what extra kit you think an ambulance, air or otherwise, has on board that we don't.
I am quite sure the SeaKing you lot enjoy with all of its amazing kit....does not have Heart Pumps, Ventilators, LOX systems, and other standard fit that most US based EMS helicopters do. I also would be quite surprised your Crewmen are as highly qualified and certified medical specialists as are routinely assigned to US based EMS helicopter crews.
That is because you are Rescue folks and not Medical Intervention folks....as the tasks are very different.
What is the medical capability of the standard RAF SAR Rescue crew?
The rest of the discussion revolved around the lack of a Litter/stretcher where the woman who died in the Strathclyde mine shaft tragedy could be lifted safely to the surface.
My question about the RAF SAR units nearby....was whether you carry such a stretcher/litter onboard your aircraft as a standard fit as does our USCG and Air Force Rescue folks do.
Since you are involved here now Craab....can you answer those questions for us?
Do you lot have a winchable stretcher onboard your aircraft?
If requested by the Strathclyde Fire Brigade...would you have responded to the scene?
If requested....how long would it have taken for such a response?
Was the RAF contacted by the Strathclyde Fire Brigade about the feasibility of such a response?
Did the RAF Mountain Rescue Team(s) respond to that incident?
If they did...what were the results?
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Crab, we can advocate all we want, but here it's not a matter of what is best, more a matter of what is possible. It simply is not possible for the FAA to suddenly rule that single-engine, or single-pilot, aircraft can't fly VFR at night, or fly at all. It makes no difference at all whether that would be safer, or would save lives. It simply is not possible. Laws and politics are different in different countries, and just because Great Britain has such laws, that doesn't mean that any other country can or should have them. Political and constitutional realities have to be considered, regardless of whether they're right or make any sense. In the short run, regulations in the US will not change. Perhaps over decades, but not this year, or next. What we have to do is accept the regulations as they are, and provide for our own safety, by refusing flights that while legal, are too dangerous. Not everyone is capable of doing that, and not everyone has the same level of experience or proficiency. Thus what is safe enough for one may not be safe for another, and unfortunately not all have the same ability to judge the dangers correctly. It's the system we have, and we have to deal with it as it is.
Gomer Pylot - I can see your points entirely but if that is the feeling amongst all pilots in the US there is no reason to be wringing hands every time an EMS heli crashes in dodgy weather.
If you accept your system for what it is and believe that it cannot be changed for the better, the only thing you can do is mourn the poor sods who have died and will continue to die in accidents that could (more often than not) be avoided.
Sas, our standard rearcrew complement is a paramedic qualified winchman who is able to intubate and cannulate and give pain relief like morphine - and a winch op who will be ambulance technician qualified - so 2 medically qualified crew in each aircraft. Some of the junior winchmen may only be technician level until they have been in the job for a year or so but they are in the minority.
When you say 'heart pumps and ventilators and LOX systems' what are you actually talking about? Heart pumps and ventilators are the sort of thing only doctors can treat patients with and usually only in hospital - we carry these items when we transfer a patient from one hospital to another and they are quite big and heavy.
LOX - we carry more than sufficient O2 for casualties, along with entonox - is that what you mean or are you referring to something like the S-92 which has its own oxygen system in the aircraft?
How many US HEMS crews carry a doctor on routine recoveries from traffic accidents or the like? I can imagine, as happens here, if you do an inter-hospital transfer, that any appropriate medical staff (consultants, specialist nurses, transplant specialists etc) are taken along.
As for the Strathclyde incident - yes of course we carry a winchable stretcher - its our job! We have the Stokes litter with a vac-mat and as an alternative we carry a Neil Robertson stretcher. The Stokes can be winched vertically. There is also a Kendrick Extraction Device for stabilising spinal/neck injuries.
Don't get too hung up on that incident - a US HEMS aircraft would have been no use either since the problem was the Fire Service management and the ridiculous Health and Safety culture that prevents lifesavers doing their job.
Our standard response time in the wee small hours of the morning is 45 minutes to take off (normally less) plus the time taken to get to the casualty.
I cannot answer the rest of your questions because I was not involved in the incident - if the police had requested SAR or MR then they would have been tasked unless there was a very good reason not to. Some of the emergency response protocols in UK are not that 'joined-up' especially across different agencies and boundaries and it is a constant source of frustration that we are often last on the list to be called instead of the first. The RAF SARF and the ARCCK seek constantly to educate ambulance and police control rooms so they understand out capabilities.
If you accept your system for what it is and believe that it cannot be changed for the better, the only thing you can do is mourn the poor sods who have died and will continue to die in accidents that could (more often than not) be avoided.
Sas, our standard rearcrew complement is a paramedic qualified winchman who is able to intubate and cannulate and give pain relief like morphine - and a winch op who will be ambulance technician qualified - so 2 medically qualified crew in each aircraft. Some of the junior winchmen may only be technician level until they have been in the job for a year or so but they are in the minority.
When you say 'heart pumps and ventilators and LOX systems' what are you actually talking about? Heart pumps and ventilators are the sort of thing only doctors can treat patients with and usually only in hospital - we carry these items when we transfer a patient from one hospital to another and they are quite big and heavy.
LOX - we carry more than sufficient O2 for casualties, along with entonox - is that what you mean or are you referring to something like the S-92 which has its own oxygen system in the aircraft?
How many US HEMS crews carry a doctor on routine recoveries from traffic accidents or the like? I can imagine, as happens here, if you do an inter-hospital transfer, that any appropriate medical staff (consultants, specialist nurses, transplant specialists etc) are taken along.
As for the Strathclyde incident - yes of course we carry a winchable stretcher - its our job! We have the Stokes litter with a vac-mat and as an alternative we carry a Neil Robertson stretcher. The Stokes can be winched vertically. There is also a Kendrick Extraction Device for stabilising spinal/neck injuries.
Don't get too hung up on that incident - a US HEMS aircraft would have been no use either since the problem was the Fire Service management and the ridiculous Health and Safety culture that prevents lifesavers doing their job.
Our standard response time in the wee small hours of the morning is 45 minutes to take off (normally less) plus the time taken to get to the casualty.
I cannot answer the rest of your questions because I was not involved in the incident - if the police had requested SAR or MR then they would have been tasked unless there was a very good reason not to. Some of the emergency response protocols in UK are not that 'joined-up' especially across different agencies and boundaries and it is a constant source of frustration that we are often last on the list to be called instead of the first. The RAF SARF and the ARCCK seek constantly to educate ambulance and police control rooms so they understand out capabilities.
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Further to Crab's reply, athough I have no involvement in SAR/HEMS, I am a local and can address some of SASless questions about the mine shaft death (based on the facts that came out in the Fatal Accident Inquiry rather than the media reporting):
The two fire engines that arrived about 15 minutes after the 999 call was made both carried sufficient "Safe Working at Height" kit to effect a rescue. The road ambulance (carrying two paramedics) that arrived at the same time also carried a Kendrick Extraction Device, which could have been used.
Less than half an hour later, the Fire Service Heavy Rescue Vehicle arrived, carrying in particular a thermal basket stretcher and a MIBS stretcher (also suitable). The Mountain Rescue Team that attended had their own McInness stretcher and rope access equipment.
That's not counting the specialist Scottish Cave Rescue Organisation if only they had been contacted sooner. Heck even the local Coastguard Rescue Service could probably adapt their cliff rescue equipment to do the job. Failing that they could even get the next over MRT and the neighbouring Lothian and Borders Fire Service Line Rescue Team. No doubt the Mines Rescue Organisation would also have been able to advice on a suitable rescue (particularly by allaying concerns about the stability of the shaft).
Crab covered what the RAF carried.
All firefighters in attendance had been trained in the use of the SWAH kit, which was routinely carried on their fire engines. Both the fire service and the ambulance had immobilsation equipment (frequently used for car crashes, which both services are highly trained in dealing with). All firefighters also had basic trauma care training, including the one who went down the shaft before the senior fire officers arrived. On top of this one of the ambulance paramedics volunteered to enter the shaft (before being prevented by a senior fire officer).
This was not an isolated area. It was ten minutes by road from a suitable hospital. The shaft was on a small hillock about 130 metres from a housing estate. The ground was too soft for the heavy fire engines but Land Rovers were able to drive right up with ease.
The RAF, RN and MCA routinely work with the other emergency and rescues (mostly Mountain Rescue).
The distances (as the crow flies) involved were 145 miles from Kinloss and 80 miles from Leuchars. Leuchars only has a RAF Moutain Rescue Team while Kinloss has both a MRT and RAF SAR helicopter flight. Neither are particularly relevant, however.
The two RAF MRTs would not have attended as Strathclyde Police maintained their own Mountain Rescue Team who in any event were the team best able to get to the scene quickly (there were also two other civilian MRT teams nearbyish).
Kinloss SAR would also unlikely to be involved as the SAR flight at RAF Boulmer was closer (110 miles) and even closer was the Royal Navy SAR flight (more or less the same capability as the RAF Sea Kings) at Prestwick Airport, a mere 10 miles away.
The Scottish Ambulance Service also maintains (government funded unlike the charity-run air ambulances in the rest of the UK) its own Air Wing of 2 EC135s and 2 fixed wing Beechcrafts. These are mainly used to transfer patients from the islands and remote areas of Scotland although they also do emergency response. Like other air ambulances in the UK this is primarily a day-VMC capability - although they sometimes operate to pre-arranged landing sites at night I believe. They are not equipped with winches. The nearest helicopter was at Glasgow Heliport (20 miles).
At the particular incident in question, the Police Sergeant at the scene contacted the Police HQ to ask whether the use of the RAF/RN SAR helicopters was appropriate. He was advised that it wasn't. No specific reason was given at the FAI but the sheriff "assumed that there were environmental obstacles and dangers to the helicopter and crew inherent in the descent of a winchman into a deep hole in the ground."
Not to mention that the weather conditions were recorded as foggy and extremely dark with dense and high vegetation in the vicinity of the hole.
At about the same time, the ambulance control room also made a call to Aeronautical Rescue Control Centre at RAF Kinloss to ask for assistance with search or flood lighting from a helicopter. This was also declined - possibly due to the weather conditions (fog) or perhaps the helicopters were already involved in other calls). Strathclyde Police could probably put their own helicopter up if the need was that great. In any event the fire service Heavy Rescue Vehicle carried flood lights, which were erected at the scene and provided sufficient lumination.
The rules that got in the way of "getting the job done" were not national regulations - indeed national legislation specifically allowed the fire service the flexibility to carry out the rescue operation. It was Strathclyde Fire and Rescue Service's own policies, rigidly but wrongly implemented by two senior fire officers who were both unfamiliar with the equipment and the training of the firefighters involved that prevented the firefighters from carrying out a rescue. Part of the problem was financial - the Fire Service did not want the SWAH equipment to be used for rescues because then they would have to pay the firefighters more for specialist skills.
They refused to allow the equipment to be used on the paramedic and the patient because they were not part of the Fire Service. They also ignored the expertise of external organisations who could at least provided advice on the rescue - because they didn't have the expertise to determine that those organisations would have been relevant!
I can't really see how this case can be used to criticise UK legislation or even "Health and Safety" (which is more often than mistakenly applied and a cover for the other issues). It was down to the judgement of two people who bearing in mind their subsequent appearances at the Fatal Accident Inquiry should not have been in those positions. If anything it sounds more similar to the situation in the States where it is incumbent upon individuals to self-regulate.
Why would you need an EMS helicopter to transport medics (at considerablely greater risk) when they could easily have got a taxi, let alone used official transport, from the hospital to the site in 10 minutes!
The patient didn't die because of a lack of "first class life support" - the senior fire officers simply did not have regard to the passage of time upon the patient's odds of surviving. Considering the equipment carried by the road ambulance and the proximity of the hospital, it's somewhat surprising they even bothered to use the air ambulance (the delay in the rescue was long enough for the sun to rise) for the very brief journey to the hospital.
That doesn't sound much different to any UK Air Ambulance - which routinely carry two highly experienced paramedics if not a doctor. I don't think flight nurses are common in UK Air Ambulances - transfers and retrievals are usually done by specialist (cardiac, neonatal, etc) air-minded teams from the receiving hospital who bring their own equipment and don't really care whether it's a SAS air ambulance, RAF/RN Sea King or fixed wing (which can include anyting from one of the ambulance service's beechcraft up to a RAF Hercules depending on the conditions) that carries them.
You can have all the medical capability in the world; but it's no use if you crash on the way to/from the scene because your procedures, training and airframe are unsuitable for the conditions. That's why I'll take a RAF/RN Sea King or Coastguard S-92 every day of week if I'm stuck at night in the winter on Ben Nevis with a broken leg and hypothermia rather than the SAS Air Ambulance valiantly trying to reach me packed with doctors and fancy equipment. Let them stick to their day job and the almost-scheduled nature of the inter-hospital transfers they do at night for which they're resourced and trained to carry out. That is Crab's point I believe.
So a HEMS helicopter would have been sent for what was initially described to the emergency services as a "fall from an embankment" on the outskirts of a major town on a dark night with fog (admittedly covered by "the usual assumptions about flyable weather") where both the fire service and a road ambulance can be in attendance within 15 minutes of the call being received and, from initial impressions of those at the scene, likely effect a rescue within two hours (bearing in mind the conditions at the bottom shaft meant it took 30 minutes to get the patient into the stretcher), which even a winch equipped helicopter is unlikely to improve upon?
So who in the area had a Stokes Litter or other Rescue Litter? Do the RAF or CoastGuard SAR aircraft carry such a device aboard the aircraft? I wonder if any thought was given to asking for their support in the mine shaft rescue?
Less than half an hour later, the Fire Service Heavy Rescue Vehicle arrived, carrying in particular a thermal basket stretcher and a MIBS stretcher (also suitable). The Mountain Rescue Team that attended had their own McInness stretcher and rope access equipment.
That's not counting the specialist Scottish Cave Rescue Organisation if only they had been contacted sooner. Heck even the local Coastguard Rescue Service could probably adapt their cliff rescue equipment to do the job. Failing that they could even get the next over MRT and the neighbouring Lothian and Borders Fire Service Line Rescue Team. No doubt the Mines Rescue Organisation would also have been able to advice on a suitable rescue (particularly by allaying concerns about the stability of the shaft).
Crab covered what the RAF carried.
Part of every fire fighters basic training in this country requires rappelling, rope work, and rescue techinques. Every EMS wagon/aircraft carries and routinely uses immobilzation equipment. Fire Fighters are also dispatched to such calls and each unit carries trained EMT's amongst the fire wagon crew.
We have practiced Short Hauls of Emergency Personnel using helicopters for isolated area rescues in various fire units around the country.
How far away is RAF Kinloss and RAF Leuchars from the site of the mine shaft?
If requested by the Strathclyde Fire Brigade...would you have responded to the scene?
If requested....how long would it have taken for such a response?
Was the RAF contacted by the Strathclyde Fire Brigade about the feasibility of such a response?
Did the RAF Mountain Rescue Team(s) respond to that incident?
How far away is RAF Kinloss and RAF Leuchars from the site of the mine shaft?
If requested by the Strathclyde Fire Brigade...would you have responded to the scene?
If requested....how long would it have taken for such a response?
Was the RAF contacted by the Strathclyde Fire Brigade about the feasibility of such a response?
Did the RAF Mountain Rescue Team(s) respond to that incident?
The RAF, RN and MCA routinely work with the other emergency and rescues (mostly Mountain Rescue).
The distances (as the crow flies) involved were 145 miles from Kinloss and 80 miles from Leuchars. Leuchars only has a RAF Moutain Rescue Team while Kinloss has both a MRT and RAF SAR helicopter flight. Neither are particularly relevant, however.
The two RAF MRTs would not have attended as Strathclyde Police maintained their own Mountain Rescue Team who in any event were the team best able to get to the scene quickly (there were also two other civilian MRT teams nearbyish).
Kinloss SAR would also unlikely to be involved as the SAR flight at RAF Boulmer was closer (110 miles) and even closer was the Royal Navy SAR flight (more or less the same capability as the RAF Sea Kings) at Prestwick Airport, a mere 10 miles away.
The Scottish Ambulance Service also maintains (government funded unlike the charity-run air ambulances in the rest of the UK) its own Air Wing of 2 EC135s and 2 fixed wing Beechcrafts. These are mainly used to transfer patients from the islands and remote areas of Scotland although they also do emergency response. Like other air ambulances in the UK this is primarily a day-VMC capability - although they sometimes operate to pre-arranged landing sites at night I believe. They are not equipped with winches. The nearest helicopter was at Glasgow Heliport (20 miles).
At the particular incident in question, the Police Sergeant at the scene contacted the Police HQ to ask whether the use of the RAF/RN SAR helicopters was appropriate. He was advised that it wasn't. No specific reason was given at the FAI but the sheriff "assumed that there were environmental obstacles and dangers to the helicopter and crew inherent in the descent of a winchman into a deep hole in the ground."
Not to mention that the weather conditions were recorded as foggy and extremely dark with dense and high vegetation in the vicinity of the hole.
At about the same time, the ambulance control room also made a call to Aeronautical Rescue Control Centre at RAF Kinloss to ask for assistance with search or flood lighting from a helicopter. This was also declined - possibly due to the weather conditions (fog) or perhaps the helicopters were already involved in other calls). Strathclyde Police could probably put their own helicopter up if the need was that great. In any event the fire service Heavy Rescue Vehicle carried flood lights, which were erected at the scene and provided sufficient lumination.
The answer pertains to the discussion about lack of service...rules getting in the way of getting the job done...and lives being lost as a result.
They refused to allow the equipment to be used on the paramedic and the patient because they were not part of the Fire Service. They also ignored the expertise of external organisations who could at least provided advice on the rescue - because they didn't have the expertise to determine that those organisations would have been relevant!
I can't really see how this case can be used to criticise UK legislation or even "Health and Safety" (which is more often than mistakenly applied and a cover for the other issues). It was down to the judgement of two people who bearing in mind their subsequent appearances at the Fatal Accident Inquiry should not have been in those positions. If anything it sounds more similar to the situation in the States where it is incumbent upon individuals to self-regulate.
A fully qualified medical team could have been delivered by an EMS helicopter directly to the scene if it had been available. Shy of that....there is the RAF SAR units that could have been tasked despite their lack of first class life support equipment in their cab.
The patient didn't die because of a lack of "first class life support" - the senior fire officers simply did not have regard to the passage of time upon the patient's odds of surviving. Considering the equipment carried by the road ambulance and the proximity of the hospital, it's somewhat surprising they even bothered to use the air ambulance (the delay in the rescue was long enough for the sun to rise) for the very brief journey to the hospital.
There seems to be a misunderstanding about the capability our US Helicopter EMS operations can bring to a casualty amongst our UK friends. The modern EMS helicopter is not just a transport wagon but a fully equipped medical unit with two very skilled medical crewmen....usually one being a Flight Nurse and the other an experienced Paramedic with advanced training.
You can have all the medical capability in the world; but it's no use if you crash on the way to/from the scene because your procedures, training and airframe are unsuitable for the conditions. That's why I'll take a RAF/RN Sea King or Coastguard S-92 every day of week if I'm stuck at night in the winter on Ben Nevis with a broken leg and hypothermia rather than the SAS Air Ambulance valiantly trying to reach me packed with doctors and fancy equipment. Let them stick to their day job and the almost-scheduled nature of the inter-hospital transfers they do at night for which they're resourced and trained to carry out. That is Crab's point I believe.
A situation described in the article linked by Brassed Off would have been an immediate call for an EMS helicopter in the USA....without any doubt what so ever....and one would have responded within minutes of being called. (With the usual assumptions about flyable weather).
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Some recent US HEMS accidents after IIMC
:
Hospital Wing, Brownville, TN
Mountain Lifeflight, Doyle, CA
OmniFlight, Georgetown, SC
Maryland State Police, District Heights, MD
PHI, Huntsville, TX
AMC, LaCrosse, WI
Metro Aviation, South Padre Island, TX
Evergreen, Whittier, AK
Meanwhile another VFR HEMS 206 gets caught out:
Medical Helicopter Makes Unexpected Landing - WKBN - 27 First News - Local News - Youngstown, Warren, Columbiana, Ohio - Sharon, Pennsylvania
Still they put it into a carport.
Me thinks that asking questions on Scottish mine rescues is just diverting attention from an ugly truth.
:Hospital Wing, Brownville, TN
Mountain Lifeflight, Doyle, CA
OmniFlight, Georgetown, SC
Maryland State Police, District Heights, MD
PHI, Huntsville, TX
AMC, LaCrosse, WI
Metro Aviation, South Padre Island, TX
Evergreen, Whittier, AK
Meanwhile another VFR HEMS 206 gets caught out:
Medical Helicopter Makes Unexpected Landing - WKBN - 27 First News - Local News - Youngstown, Warren, Columbiana, Ohio - Sharon, Pennsylvania
Still they put it into a carport.
Me thinks that asking questions on Scottish mine rescues is just diverting attention from an ugly truth.
Were the two individuals indicted for Involuntary Manslaughter?
The question that is begged is why someone with a grain of common sense and a huge pair of testicles did not insist the two stand down, cease and desist, and effect a timely rescue of the victim.
Have effective measurses been taken to ensure such a tragedy shall not happen again for similar reasons?
Are these two folks still in the employ of the government agency that they represented?
Were they sued in civil court over their misfeasance/malfeasance?
It sure sounds like a very sad story....and a needless death.
A couple of fire ladders...some rope rigging....bit of rope...a stretcher...prep of patient by the medical folks on site....a few strong backs and up she rises. It sound like all the gear, expertise, and people were there but no one could put it together to save the poor Woman.
The question that is begged is why someone with a grain of common sense and a huge pair of testicles did not insist the two stand down, cease and desist, and effect a timely rescue of the victim.
Have effective measurses been taken to ensure such a tragedy shall not happen again for similar reasons?
Are these two folks still in the employ of the government agency that they represented?
Were they sued in civil court over their misfeasance/malfeasance?
It sure sounds like a very sad story....and a needless death.
A couple of fire ladders...some rope rigging....bit of rope...a stretcher...prep of patient by the medical folks on site....a few strong backs and up she rises. It sound like all the gear, expertise, and people were there but no one could put it together to save the poor Woman.
Last edited by Senior Pilot; 31st Dec 2011 at 13:58. Reason: Fix YouTube link: again....
