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"Medical evacuation helicopter crashed"

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"Medical evacuation helicopter crashed"

Old 27th Oct 2008, 22:39
  #41 (permalink)  
 
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DTibbals53

"Not for profit is not for real ..."

Good way to put it!

WIII
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Old 27th Oct 2008, 23:47
  #42 (permalink)  
 
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Other countries can legislate as they like, but that won't affect the USA. The FAA is required by law to consider the economic impact of every new regulation, or change to existing regulation. Under the current regime, there is absolutely no interest in doing anything that might affect the profits of any corporation. Whining, wailing, and gnashing of teeth have no effect. As for NVGs, most of them are going to Iraq, and there is an acute shortage of them for civilian use. Several companies want to start using them, but simply can't buy enough to cover their needs.

Medical information may come with the flight request, but it's usually sparse, mostly just whether it's a trauma or medical patient. I don't want to know much about the patient's condition, but the med crew in the back does. They want to plan their actions, and know what to take with them from the helicopter. I usually try to get some patient information for them, but it never affects my decision about flying. Like someone said above, this is no place for young and inexperienced pilots. There are a few around, though, and they will either learn to be cautious or die. Most of us are old and nearing retirement, and not prone to risking our lives. Some of us always will, though, and legislation won't change that. I would love to be flying a modern twin with a 2-pilot crew, nicely IFR equipped, but I've come to realize that's just pie in the sky. Never happen, GI, no matter how much the other side of the pond complains.
Gomer Pylot is offline  
Old 28th Oct 2008, 09:22
  #43 (permalink)  
 
Join Date: Jun 2007
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A question that might be related to the comments about the tower being unlit.
How many of you have ever reported a tower's lights as being off? Who do you report it to? Was any action taken? Did you record the fact that the tower was reported as unlit??
Same experience. Many towers unlit, NOTAMed for years, reports ineffective. After one report about a tower I missed (at night) by about 5 feet within the control zone (1 mile from the airport) I was told that only the highest tower in the area needed to be lit. I can't remember how far away it was but I had seen and, I thought, taken a flight path well clear of it for my (helicopter) into wind approach not aligned with a runway.
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Old 29th Oct 2008, 04:14
  #44 (permalink)  
 
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Devil 49,

Perhaps a question to the owner of the tower as to which insurance company carries his liability insurance might rev him up a bit about improving the situation. Perhaps suggesting he is maintaining a public nuisance and thus increasing his risk of legal troubles would get him to thinking. Contact with his insurance carrier might also provoke a positive response.

Hit'em in the pocket book Bubba!
SASless is offline  
Old 30th Oct 2008, 00:06
  #45 (permalink)  
 
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Swampy and others,
Why dont you guys use a calculated Lowest safe altitude that guarantees you clearance from the nearest highest obstacle regardless of lighting serviceability?
helmet fire is offline  
Old 30th Oct 2008, 03:13
  #46 (permalink)  
 
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Helmet Fire

We often land away from familiar areas, and away from certified Heliports, Airports, etc.. The problem with the Chicago aircraft was, as best I know, was experienced upon departure from one of the scene flight points of origin. I am sure that once he was established in cruise, if he had been so lucky, he would have used your suggestion.

Not trying to call you out, but merely trying to explain to some who may not understand the environment in which US EMS operates.

DTibbals53 is offline  
Old 30th Oct 2008, 04:09
  #47 (permalink)  
 
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Here in Oz I can recall at least three accidents resulting in around ten fatalities in which the common thread was:
a lack of "risk vs gain" philosophy,
wrong helicopter,
wrong crew qualifications, and
bad weather or lack of visual cues.
HEMS is not war - as a PIC you just have to learn to say NO - there is always another way.
Australian HEMS has learnt the lessons - the cowboy operators have largely been weeded out - the HEMS now have proper equipment - twin SPIFR - NVG - CRM training - support from non aviation management should a mission be declined ie your job is not at risk.
I'm afraid from the outside looking in it APPEARS that US HEMS has a press on at all costs attitude.
Mind you an assessment of accidents per hours flown may provide interesting reading for comparison purposes.
GAGS
E86
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Old 30th Oct 2008, 13:26
  #48 (permalink)  
 
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So, if there are a lot of towers that are unlit - and one of the basics of VFR is to see and avoid obstacles, how can anyone still say night flying can be anything except IFR???
What we need is precise low altitude routes, realistic fuel reserves and quick clearances - radar coverage would be nice, but the piston engine FW world got around without it for a long time.
Or something else that provides us with some better safety.
Shawn Coyle is offline  
Old 30th Oct 2008, 13:52
  #49 (permalink)  
 
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Shawn, we came full circle then.

What we need is a capillary low level IFR structure.

More AWOS III, more GPS approach procedures and the aircraft equipment and crew training qualifications necessary to meet those standards.

We came back to cost vs. profit.

We came back to the FAA not being in a position of strength to enforce those standards.
I think that most (if not all) pilots involved with this industry long enough already know what we need, but those pilots (ironically in Operational Control) have no authority over whether spending the money is worth it.
The technology is already here and ready to be applied, it's the mindset that's lacking.
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Old 30th Oct 2008, 22:24
  #50 (permalink)  
 
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I agree. We need something that is better than what we currently have!
Shawn Coyle is offline  
Old 30th Oct 2008, 23:43
  #51 (permalink)  
 
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For most EMS, IFR as it is currently configured is worthless. You simply can't do an IFR approach to an unprepared scene. Nor can you fly an approach to the hospital. I often fly to scenes 5 miles or less from my depaarture point. IFR simply won't work, even if I had an IFR capable aircraft. That isn't the answer. An autopilot, and proper TAWS and TCAS might help, but I have the TAWS, mostly, in the GPS. I don't have a good answer to preventing all the EMS accidents, I do know that IFR is not the answer. It can work for some transfers, but I do mostly scene work, and IFR simply isn't possible.
Gomer Pylot is offline  
Old 31st Oct 2008, 09:15
  #52 (permalink)  
 
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Gomer,

I totally agree with your analysis; those who call for IFR as the answer have little understanding of HEMS (which, essentially, is a VFR activity) and have never been involved with the provision of let-down procedures (for which formal obstacle clearance - in accordance with precise criteria - has to be provided).

In "Human Error Associated with Air Medical Transport Accidents in the United States", Albert Boquet discusses all of the issues and concludes that there are no definitive answers. However, two passages from the Discussion Paragraph stand out:
So where does this leave the HEMS? While it is easy to sit back and in retrospect “arm chair quarterback” an industry that has become a mainstay of emergency medicine, the answers will not be as simple as they seem. Number one on the list to be addressed are operations in degraded conditions. The obvious recommendation here are IMC equipped aircraft and pilots who are truly instrument certified. While this may seem counter-intuitive for an industry that operates under VFR rules, the number and severity of accidents that occur in weather and in night conditions coupled with the number of weather-related violations indicates that the time has come to consider IFR currency and similarly equipped aircraft.

Another solution that has been batted about are dual crew and dual engine aircraft. However, this presents problems for smaller operations, due to the increased expense of these aircraft and higher costs associated with additional crew-members. Night vision goggles (NVGs) have also been suggested due to the number of accidents that occur at night. However, this is not supported by the data. Specifically, there were no more accidents at night compared to daytime operations. And while the severity of accidents occurring at night are greater in terms of fatalities, most of the night-time accidents occurred in IMC, where NVGs would have been of no use Furthermore, NVGs do not increase visibility of wires and fence lines which pose problems at landing and take-off sites.
I'm not sure that the last paragraph above resonates with the industry view: for solutions in the large:
It should be understood that any operation has a certain amount of risk associated with it, and HEMS operations are no different. But there are two ways to go about reducing this risk. One is to make the operation safer, in other words, to reduce the probability of an accident. The second is to reduce the exposure to the environment within which the accidents take place. While most of the efforts are focused on the first solution (with little success), the second solution is often ignored. However, it may be time to ask, how many of the operations flown are true emergencies? Should HEMS operations be used to transfer stable patients, and if so, under what conditions should these be considered? How are go/no go decisions made, and by who? At what point should a transport be turned down?
Jim
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Old 31st Oct 2008, 14:13
  #53 (permalink)  
 
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I'm not advocating IFR as it is currently practiced, but something that fits what we do - Canada's National Research Council has already flown a system that will give you an IFR approach to any point you nominate - and that was over two years ago.
We have pretty good knowledge now of the terrain and cultural features like towers, and in the US, have very precise navigation thanks to WAAS GPS. Why aren't we putting all that together to make things really work for us?
Combined with NVG for when you get close to the landing zone and have no choice but to be VFR, we could make a significant difference in our safety record.
But it's going to take a large change in mentality from the '5 hours training is all you're going to get and you'd better be able to hack it on that' that currently prevades.
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Old 31st Oct 2008, 14:35
  #54 (permalink)  
 
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I agree that pilots should be IFR qualified, and AFAIK most, if not all, companies require an IFR rating for EMS pilots. Having the aircraft IFR qualified would also be advantageous, both for inadvertent IMC and for safer cruise in VMC. I know that Sikorsky, and perhaps others, have demonstrated IFR approaches to a hover, to confined landing areas. With the proper equipment it might be possible to do roll-your-own instrument approaches to scenes, provided you can be assured of getting accurate coordinates. However, the present regulatory environment won't permit that. Bureaucracy always moves slowly, and permission to do Part 135 IFR approaches and departures from ad hoc locations isn't going to happen any time soon, nor are most companies willing to pay for the capability. I hope it happens sometime, but in the short term, a decade or so, it ain't gonna happen.
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Old 31st Oct 2008, 15:00
  #55 (permalink)  
 
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Shawn

Agree.

My 2-cents, again.

I think the biggest and most beneficial hurdle is just getting operators to transition to a requirement that an IFR flying standard, and currency in such, be met by all HEMS pilots, irrespective of the helicopter they fly.

Currently, at many if not all HEMS operations, those pilot's flying VFR-only machines get a six month check to assess ability to recover from inadvertent IMC. That does not exactly breed confidence, or willingness, in one's ability to exercise prudent professional beahior by intentionally climbing in to IMC to avoid the dangers of scud running when that environment becomes an inadvertent fact.

As we know most operators do allow pilots extra flying time between checks to get hood time. That could be put to further use in meeting such a standard.

My thought is a 135.297 instrument check, with provisos for flying a non-IFR certificated machine, could at least be a company level training and checking solution for VFR HEMS operations, and obviously legal one for those flying IFR.

To me this is a natural place to start and should be somewhat easy and cost-effective to implement as most required elements appear to be in place.

The idea would certainly have follow-on benefits when the industry finally realizes that IFR has to be part of the solution to the accident rate.

Thanks.

WIII
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Old 1st Nov 2008, 12:40
  #56 (permalink)  
 
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An IFR mentality would help a lot - a more deliberate approach to all the flights might make a difference.
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Old 1st Nov 2008, 13:37
  #57 (permalink)  
 
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WWIII:
I agree with everything you say about the training. However, even if the training/practise is on a monthly basis ( in the perfect world) I would still hesitate to intentionally climb into IMC in an unstable platform such as an AS350 or a Bell single.The only option, then, is to avoid getting into a situation where scud running is possible.That brings us back to the whole pilot decision making thing.

Alt3.
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Old 1st Nov 2008, 16:16
  #58 (permalink)  
 
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A 3

Yes, I agree, thinking round the loop via ADM is the right process; and taught by training organizations regularly because it is worthwhile. It should keep a pilot from entering a flying environment in which IMC skills will be required - but it is not fool proof, thereby the need for real confidence via training and currency in IFR flying to hone one's ability to handle IMC, altered plains of reference, no horizon, etc. type flying when those realities of our world appear.

I don't know any HEMS pilot who does not have an instrument rating. Why not develop this line of defense against loss of control associated with IIMC, CFIT, altered planes of reference etc. by requiring appropriate IFR training and currency for the make/model helicopter being flown? Right now the IFR flying requirements for pilots flying on VFR-only operations are insufficient to meet the threat - I have no trepidation in making that statement.

I too would hesitate to enter IMC in any unstabilized helicopter. That reluctance should serve us all well, but, unstabilized SPIFR can be accomplished if the pilot is properly trained and current. I know that sounds a bit on-the-limb but having intentionally operated unstabilized helicopters IFR under the Bermudan Registry, and a couple unintentionally on the US Registry, I assure you it can be done; albeit nowadays acceptable only as a last line of defense, which is what we are discussing.

This certainly is an idea that can be implemented now, and built upon should VFR HEMS operations morph in to IFR ones.

Thanks.

WIII
WhirlwindIII is offline  
Old 1st Nov 2008, 16:28
  #59 (permalink)  
 
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WWIII:
Everything about the training you suggested is right on. It would also be a simple fix to give the singles a litlle stick trim/mag brake to make them reasonably stable. At least then, the confidence to keep it right side up if the unthinkable happens, and ,as a last resort, will improve.
In my previous life, I flew Alouettes with a rudimnetary SAS.It permitted us to operate out at sea at night from deck. Kept us upright and was a great confidence builder and training for advanced aircraft in the future.

Alt3.
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Old 1st Nov 2008, 18:55
  #60 (permalink)  
 
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A 3

Offshore night, especially on a moonless/overcast night with weather, is serious business. You obviously know the territory and the value of the training standard I propose.

Every bit of equipment helps up to the point where its employment serves to confuse the situation. I tell folks to use what they need first (KISS principle), then add on a few bits and pieces as supporting information - any confusion which arises is probably conservative grounds for a second opinion, an overshoot/missed approach, etc.

Most pilots received their instrument flying certification in unstabilized helicopters so a lot of them do know what is expected in this area.
Training and maintaining one's IMC currency to a high standard, then using those skills for real, in a pinch, is certainly not an unrealistic expectation for HEMS pilots. As things go it would probably add some confidence to the equation, and a measure of pride and respect to our profession as well.

I'll get off me box now!

Thanks.

WIII
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