Go Back  PPRuNe Forums > Aircrew Forums > Rotorheads
Reload this Page >

NTSB says EMS accident rate is too high

Wikiposts
Search
Rotorheads A haven for helicopter professionals to discuss the things that affect them

NTSB says EMS accident rate is too high

Thread Tools
 
Search this Thread
 
Old 7th Jan 2012, 15:48
  #221 (permalink)  
 
Join Date: Jun 2009
Location: In the desert southwest
Posts: 181
Likes: 0
Received 0 Likes on 0 Posts
Bell ad etc

I saw that Bell ad and immediately thought the same thing. I wonder who they are talking to? Not pilots or medical crew but hospitals with deep pockets who buy these thing with the promise from the manufacturer and the companies that possibly staff them that we can go anywhere and do anything.

As for all this talk about IFR EMS in the US. It is such a complicated situation that there will never be a set of short regs to cover the industry. For those of you who are not from here, look at a map of the US. The sheer size of the country dwafts most European countries. Understand that the US features some of the largest mountain ranges in the world, one of the largest desert regions in the world, oceans along two borders. The environmental changes in the US in a one to two hour flight can take you from a deep flat desert environment to a snow covered mountain. Why would you want to require IFR dual engine for operations in a desert area that sports clear weather 350+ days per year? I am not even talking about Alaska where you have not only artic environments but tropical rain forests!

I fly EMS in a single and twin at night with NVG's. (dual Garmins, moving map, Sat tracking, TAWS) Most of my flights with a patient on board last less than 25 minutes, many ten to fifteen. It is still a benefit to the patient because in rural areas it would take the ambulance 1-2 hours to get the patient to the same level of care.


If the weather is not conducive to taking the flight, we don't go. A wise man once told me that if you study the weather for a flight request more that five minutes, your answer is NO.

I still have not seen on this thread a conclusinve statement on what the failure rate is for any turbine engine mounted in a helicopter, whether it has two or one and further how many of these are the direct cause of an accident.

Cheers





=
grumpytroll is offline  
Old 7th Jan 2012, 15:49
  #222 (permalink)  
 
Join Date: May 2002
Location: Downeast
Age: 75
Posts: 18,286
Received 500 Likes on 208 Posts
JimL.....I best watch my step around you....something along the lines of "Don't tug on Superman's Cape!" springs to mind!

Jim has done a great job of forcing some rational considerations up the flag pole and into law
I think Anfi was trying in his own way not to be humerous and suceeded.

If only "rational considerations" found themselves codified in law!




Grumpy.....excellent advice he an you have given here.

A wise man once told me that if you study the weather for a flight request more that five minutes, your answer is NO.
I also say...."If the other guy asks you what you think of the weather....it is not a question but rather a statement!"
SASless is online now  
Old 8th Jan 2012, 01:53
  #223 (permalink)  
 
Join Date: Oct 2003
Location: Over here
Posts: 1,030
Likes: 0
Received 0 Likes on 0 Posts
The Bell ad is obviously not aimed at pilots or med crew. They don't buy helicopters, nor decide which to buy. It's aimed at hospital administrators, who make decisions, and not always based on rational factors. I agree it's a poor ad, but it's certainly legal, and marketing is always a dog-eat-dog business, with little if any concern for safety. Sell the product, and worry about any fallout later.
Gomer Pylot is offline  
Old 8th Jan 2012, 04:57
  #224 (permalink)  
 
Join Date: Sep 2003
Location: Redding CA, or on a fire somewhere
Posts: 1,959
Received 50 Likes on 15 Posts
Sasless, Grumpy et al.... In line with your posts.....

I give you the best helmet sticker ever, I may have to get this printed:

Gordy is offline  
Old 8th Jan 2012, 13:15
  #225 (permalink)  
 
Join Date: May 2002
Location: Downeast
Age: 75
Posts: 18,286
Received 500 Likes on 208 Posts
Gordy,

The one I was going to put on my helmet was...."Do You want to fly with a Pilot who ALWAYS says Yes?"
SASless is online now  
Old 8th Jan 2012, 13:31
  #226 (permalink)  
 
Join Date: Dec 2007
Location: uk
Posts: 419
Likes: 0
Received 0 Likes on 0 Posts
or..........there are old pilots, there are bold pilots, but few old and bold pilots. Now look at the open side to decide which type is flying you today.
Art of flight is offline  
Old 8th Jan 2012, 17:43
  #227 (permalink)  
 
Join Date: Jul 2010
Location: The American Steppe
Posts: 55
Likes: 0
Received 0 Likes on 0 Posts
I don't wear cute stickers on my helmet. There's my name, and there's a little memorial sticker (put on by the helmet's previous assignee) with an N-number, which anyone can ask about if they want. If they do, I'll tell them it was a helicopter assigned to a hospital where I used to be stationed. It's not there anymore, not since the pilot accepted a flight he shouldn't have and killed everyone on board.
Aerobot is offline  
Old 8th Jan 2012, 20:01
  #228 (permalink)  
 
Join Date: Feb 2004
Location: Home:California. Work: the lower 48
Posts: 67
Likes: 0
Received 0 Likes on 0 Posts
Have to agree with Aerobot. No stickers, just scratches and dings.
Used to work with a guy in Maui who had "IT'S ALL ABOUT ME", on his......
Need I say more?
AirWon is offline  
Old 8th Jan 2012, 20:30
  #229 (permalink)  
 
Join Date: Sep 2003
Location: Redding CA, or on a fire somewhere
Posts: 1,959
Received 50 Likes on 15 Posts
Here is mine when I first got it, before it got all scratched and dinged, sometimes you just gotta have some fun.....:

Gordy is offline  
Old 9th Jan 2012, 12:09
  #230 (permalink)  
 
Join Date: Feb 2005
Location: Australia
Posts: 1,957
Likes: 0
Received 0 Likes on 0 Posts
Just for interest I went back and read the summary of the report as printed by CNN. here it is.

In a 2006 report on the crashes, the NTSB found that 29 of those 55 accidents could have been prevented.
The NTSB identified four recurring safety issues:
• Less stringent requirements for EMS operations conducted without patients on board.
• A lack of aviation flight-risk evaluation programs for EMS operations.
• A lack of consistent, comprehensive flight-dispatch procedures for EMS operations.
• No requirements to use technologies such as terrain awareness and warning systems to enhance EMS flight safety.
Apart from that the CNN article is quite weighted with discussion on NVG's. There is nothing about engines, one or two, so talking about them is a waste of time.

There is probably nothing there that is incurable. It is still the nut behid the wheel and the big wheel behind the nuts when they promote their company's capability when they vie for these contracts.

Let the buyer beware they say, but how can the (buyers) the hospital administrations be aware of safety matters and legislation of aviation, when they see magic carpets portrayed as the ultimate cure for the 'golden hours' etc by slick salemen.

The simple rhetorical might be, what controls pilots? Well it's supposed to be chief pilots.

The chain of responsibilty (COP) legislation which is starting to bight in this country would lead you to the Ops manual and the two contollers of that. The CP and the Federal Administration.

That is what is supposed to control safety, why isn't it?

(COP) If I load a truck with cattle and note the driver is tired or don't note, either accidently or intentionally on my part, that he has driven over his rest periods, but don't stop him I can be held jointly accountable when he crashes and kills several people.

That COP legislation would lead one also to the directors, managers and owners of the aviation companies. Perhaps that may be the elixer that is needed to put in place adequate controls?
topendtorque is offline  
Old 9th Jan 2012, 12:59
  #231 (permalink)  
 
Join Date: May 2002
Location: Downeast
Age: 75
Posts: 18,286
Received 500 Likes on 208 Posts
Operational Control became an issue as a result of that NTSB report as I recall. Until that point...each base operated independently and provided monthly reports of operational statistics. No direct supervision of flight operations such as Dispatch oversight was done by the CP or DirOps from the Corporate Office. They issued Directives, SOP's, conducted Training and Checkrides, did the recruiting and other tasks but no daily close handed control or monitoring. If an accident occurred....they were notified by the customer generally.

The fact FAR Part 135 places the operational control burden on the CP/DirOps and the EMS Operators had been ignoring that for years did not bother the FAA for any number of reasons.

That is not the case now....as the FAA is requiring the Operators to comply fully with the 135 Requirements re Flight Tracking. I would suggest the issue also applies to Utility Helicopter Operators as well when their fleets are widely scattered and operating in remote areas far away from the Main Base/Main Office.

Applying the FAR's to helicopter operations can sometimes be very difficult even when the Operators are dedicated to doing the very best they can and a very bad situation if they are not so dedicated.

For a great bad example....think back to the Maryland State Police Bell 206 crash that went unnoticed for quite a long time despite being within minutes of takeoff and within just a mile or so of the point of departure.
SASless is online now  
Old 9th Jan 2012, 13:00
  #232 (permalink)  
 
Join Date: Jul 2010
Location: The American Steppe
Posts: 55
Likes: 0
Received 0 Likes on 0 Posts
topendtorque, are you talking about making responsibility commensurate with authority? That's just crazy talk, man!

Oh, wait. I see you're in Australia. Here in the US we're not big into blame sticking to upper management.

Seriously, as long as the CP's can point to the place in the Big Happy Fun Book where it says that the PIC has the authority to terminate any flight, the responsibility will stick to the PIC and won't go uphill. They can make things a bit safer by raising the weather minima, but most won't as long as their competitors don't. The FAA can raise everyone's minima, as in the case of AO21 but they've already done it once and probably won't again for a while at least.

No, I still think it falls to the pilots - you have to be willing to quit when you feel that your safety margin has gotten intolerably thin, and you have to have a company that will back you up on that decsion - or you have to find another company. But if the alternate companies won't, the pilots' only alternative is a union.

Ultimately, it falls to us at the sharp end to be the final authorities on the safety of flight. The government can't do it, the CP can't do it. It comes down to the "C" word in the acronym PIC. Command is not just wiggling the sticks.

Well, I think the coffee's written enough for one day. Fly safe.
Aerobot is offline  
Old 9th Jan 2012, 15:36
  #233 (permalink)  
 
Join Date: Jan 2005
Location: Out there somewhere
Posts: 353
Likes: 0
Received 0 Likes on 0 Posts
A smart pilot and crew!

Officials: Helicopter makes emergency landing - Live5News.com | Charleston, SC | News, Weather, Sports

COLLETON COUNTY, SC (WCSC) -
A medical helicopter made an emergency landing Saturday night in Walterboro after a patient on board began fighting with the crew.
According to Colleton County Fire and Rescue officials, a man sustained multiple traumatic injuries around 6:45 Saturday after he jumped from a moving vehicle on Interstate 95 South near mile marker 60.

Emergency personnel found the man semi-conscious lying on the shoulder of the highway. The man was immobilized, given IVs and rapidly transported to Colleton Medical Center. Once at the hospital, he was then transferred to a medical helicopter. The crew lifted off for the trauma center at MUSC.

About five minutes into the flight, fire and rescue officials say the patient became combative, broke the immobilization straps on the backboard and began fighting with the crew. The pilot turned around and made an emergency landing at the Lowcountry Regional Airport east of Walterboro.

Several Colleton County sheriff's deputies, and fire and rescue crew members rushed to the airport to assist the crew. The helicopter was able to safely land and emergency crews restrained the patient.

The man was then transported by ambulance to MUSC. En route to MUSC, the patient's condition deteriorated. He was later admitted to the intensive care unit at MUSC, according to Colleton County fire and rescue officials.

His condition is unknown at this time. The incident is still under investigation.
IntheTin is offline  
Old 9th Jan 2012, 17:07
  #234 (permalink)  
 
Join Date: May 2002
Location: Downeast
Age: 75
Posts: 18,286
Received 500 Likes on 208 Posts
Must have been a helicopter pilot.....when he realized he was in a single engined VFR only EMS Helicopter at Night....he insisted upon being allowed to leave and freaked out when refused permission.

Granted...the first step would have been a doozy!
SASless is online now  
Old 9th Jan 2012, 18:39
  #235 (permalink)  
 
Join Date: May 2003
Location: Europe
Posts: 898
Received 14 Likes on 8 Posts
We have discussed at length the issue of encountering a reduction of visual cues in the en-route phases (associated with lighting levels, weather or just a sparsely populated area with low levels of cultural lighting). Although mentioned several times, we have not spent a great deal of time on Operational Control.

Contrary to the implication of Aerobot's post, operational control is not just about aborting a flight in the en-route phase - which quite correctly lies completely within the ambit of the pilot. It has more to do with section C. of Appendix 1 Order 8400.10, Volume 3, Chapter 6 Section 5 which includes: the delivery and maintenance of a serviceable helicopter; locating the aircraft when a flight plan is not filed; the conduct of operations in accordance with the OpSpecs; the qualification and allocation of crews to flights; and, most importantly, the system and control of dispatch (all contained within Notice N 8000.347.)

As I indicated before, this was one of the subjects discussed with the Rapporteur of the ICAO HEMS WG in our exchanged of emails - an excerpt of which is shown below:

Although the policy of choosing, and following, the en-route policy is an important issue, in my mind the real issue is the escape strategy once it becomes doubtful (it is rarely clear) that the flight cannot proceed at the assigned level (or with the encountered in-flight visibility). In a number of cases (with IFR twins as well as VFR singles) it is the gradual and insidious degradation of visual cues that results in loss of control. Early recognition of the onset of such conditions is the key to avoiding the consequences of a loss of control in a degraded visual environment.

It is only when company culture (management and pilot attitudes) accept that early and decisive action can avoid the (probably not inevitable – making this a difficult call) consequence without recrimination (from management or from other pilots) and effect on personal reputation and ego, will the required change on attitudes be achieved (sorry about the complex sentence). This is much easier to achieve in a two-crew environment (two pilots, or one pilot and a trained HEMS crew member).

It is not difficult to conclude that two of the most important elements with respect to HEMS safety are the company culture (substantially affected by the business model) and operational control (once again substantially affected by the business model). Whilst the business model may not be something that can be influenced by a committee such as yours (or even by ICAO), culture and operational control most certainly are.

I have forwarded you the FAA guidance on operational control because it does (in my view) have relevance to the dispatch and continuation of any HEMS mission. Note, particularly, the operators responsibility with respect to the dispatch of any HEMS flight – regardless of the remoteness of the operation.
Jim
JimL is online now  
Old 9th Jan 2012, 19:21
  #236 (permalink)  
 
Join Date: May 2002
Location: Downeast
Age: 75
Posts: 18,286
Received 500 Likes on 208 Posts
It is only when company culture (management and pilot attitudes) accept that early and decisive action can avoid the (probably not inevitable – making this a difficult call) consequence without recrimination (from management or from other pilots) and effect on personal reputation and ego, will the required change on attitudes be achieved....
JimL,

Add in the Hospital Management and Med Crews (Customer)....and I would call that a nearly perfect statement.

Along with visual cues being lost....the distinction between Customer/Crew gets all murky as well in the EMS world. Part 135 and reality are oft times too separate concepts regards that issue.

Med crews not employed by the Operator are not Crew ever....under the rules....but are passengers. Hence some built in conflict.
SASless is online now  
Old 9th Jan 2012, 22:23
  #237 (permalink)  
"Just a pilot"
 
Join Date: May 2001
Location: Jefferson GA USA
Age: 74
Posts: 632
Received 7 Likes on 4 Posts
Effective operational control could be a very beneficial

but it still gets down to the loose nut behind the wheel, as posted earlier. Environmental info (weather) is historical at an op con center and doesn't have the value it should have with local experience adding perspective. Either the op control is too conservative or relies on the PIC, which can put us right back at the start, PIC continuing into a bad situation. I have had the op con raise issues for discussion, which I find helpful in that if I can't explain my plan convincingly then it's probably not well founded anyhow.
And even with effective op con, how do you prevent the killer errors: descending at night to reestablish VFR surface reference; continuing into adverse weather VFR in the hope of better weather; continuing confused about fuel aboard and endurance; and that most fatal of all maladies, get-home-itis? If the PIC isn't appreciative of the very real and immediate prospect of killing oneself, then how does somebody without immediate information make the call before the crash that's soon to follow?
The answer is the root cause- why are pilots so much more intellectually challenged at night in these decisions? Invulnerability is certainly a problem, but most pilots are not sufficiently trained in self assessment for the abrupt night shift change and/or night ops in general... My opinion.
Devil 49 is offline  
Old 9th Jan 2012, 23:20
  #238 (permalink)  
 
Join Date: May 2002
Location: Downeast
Age: 75
Posts: 18,286
Received 500 Likes on 208 Posts
Devil,

I don't think pilots are anymore intellectually challenged at night....just the ramifications of a bad decision are greater than in the day time. It all gets down to being able to "see".....and as we all know it can get too dark to think let alone see.
SASless is online now  
Old 10th Jan 2012, 16:32
  #239 (permalink)  
"Just a pilot"
 
Join Date: May 2001
Location: Jefferson GA USA
Age: 74
Posts: 632
Received 7 Likes on 4 Posts
SASless,
I have a hard time accepting the premise that the US HEMS higher night accident rate is due solely to vision.

Not being able to see complicates issues that arise, but I won't continue into an area lacking visual reference in the daytime, and I won't at night. In fact, acknowledging the physiological visual issues at night makes me far less likely to continue into the blackness.

I'm unhappy with the prospect of a precautionary weather landing, but I'll land before I continue at the risk of an IMC and the emergency that entails in a VFR ship. My perception is that this attitude is the acknowledged norm, yet inadvertent IMC and loss of control happens too frequently for me to not to believe something changes a fundamental attitude.


I won't transit cross country at an altitude less than reasonable obstacle clearance, much less lower than 500 AGL. This too is a common position amongst my peers, but CFIT happens at night in circumstances that make me think there's a poorer appreciation of the risks at night.


These events occur single/twin, VFR/IFR (even with autopilots), and even dual pilot, although it's much more exceptional in a 2-pilot crew. The common factor is that all of my observations are day/night rotations. But the only all night crews I've ever observed were PHI's night crews...


I've also observed frequent cavalier attitudes towards nights, as mentioned in my previous posts, in the pilot pool. It's reasonable to think that if I've seen pilots burning the candle at both ends, then it's happening elsewhere and is at least potentially contributory.


I have my own improvised self assessment routine based on my experience, and there is a difference in intellectual agility while I am shifting to nights. To date, I've always been adequate to the challenge, but I can see the approximation to the designated driver situation- it's better to decide before you're snockered...

Perhaps this is all me seeing what I expect to see based on a laymen's reading of the documentation. But the evidence is widely available that jet lag (in the vernacular) should be a factor considered with greater weight in duty schedules. Ten hours of uninterrupted rest is not sufficient to realign circadian cycles to enable approximate 100% intellectual capacity when awake and on duty. It's not sufficient time to realign sleep cycles so that one sleeps and rests efficiently between duty periods to maintain 100% intellect. It's also likely that the poor sleep will be of inadequate amount, accumulating fatigue impairment. These issues are widely discussed everywhere except in aviation. Until an airline crew plows it in after poor rest on the commute to a duty period...

Last edited by Devil 49; 10th Jan 2012 at 16:40. Reason: clarity
Devil 49 is offline  
Old 10th Jan 2012, 19:21
  #240 (permalink)  
 
Join Date: May 2002
Location: Downeast
Age: 75
Posts: 18,286
Received 500 Likes on 208 Posts
How many pilots show up for a night shift having been up and about all day instead of crawling into bed and getting as much sleep as possible immediately before starting work?

The key is to start with a "Sleep Bonus" rather than a "Sleep Deficit"....and some guys work second jobs...take care of personal business and rely upon what sleep they can get while on duty during the night shift.

You see it at your base I am sure....and I have seen it at the bases I worked. The guys show up saying they are looking forward to a good nights sleep.

The first shift of night time is hard....as one is just beginning to have to adjust your sleep period from a normal routine. As the nights proceed...the ability to sleeep during the day time improves but as you rightly state...is not as good as a normal routine.

When working permanent nights....using blacked out windows on the bedroom....setting the Air Con to "Freeze"....turning off the telephone and disabling the doorbell....and offerering murder and mayhem to the a-hole next door that delighted in mowing his yard under my window when he knew I was trying to sleep.....I tended to get plenty of rest. The key being....no change of routine....until the weekends when the Wife was sleeping nights and I was sleeping days (not....as I was young then and sleep was a second or third priority).

Humans are not nocturnal creatures once we pass the age of about thirty or so.

If visibility is not a key factor....why have the use of NVG's cut down on the numbers of EMS accidents during night flight?
SASless is online now  


Contact Us - Archive - Advertising - Cookie Policy - Privacy Statement - Terms of Service

Copyright © 2024 MH Sub I, LLC dba Internet Brands. All rights reserved. Use of this site indicates your consent to the Terms of Use.