Helicopter EMS Issues in the USA
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I am sure I am not alone in this frustrating scenario.
More unnecessary deaths for what?
Absolutely for what???
Can someone please confirm that: “night-vision gear” actually means “Night Vision Goggles” (NVG's) flown in Night Visual Conditions by qualified (NVG) Flightcrew?
Do we expect the FAA must surely act soon?
Nope.
More unnecessary deaths for what?
Absolutely for what???
Can someone please confirm that: “night-vision gear” actually means “Night Vision Goggles” (NVG's) flown in Night Visual Conditions by qualified (NVG) Flightcrew?
Do we expect the FAA must surely act soon?
Nope.
Thread Starter
EMS does not save lives!
EMS provides a safe, efficient method of transporting passengers who have on-going medical illnesses or injuries.
If you think anything else....and work in the Helicopter EMS business you are part of the problem....not the fix.
You are not heroes, angels, or sky gods.....but good folks doing a valuable service to the community.
If a life is "saved" because of the rapidity of the transport....then that happens to be good fortune, good luck, or simply Fate working its way.
EMS provides a safe, efficient method of transporting passengers who have on-going medical illnesses or injuries.
If you think anything else....and work in the Helicopter EMS business you are part of the problem....not the fix.
You are not heroes, angels, or sky gods.....but good folks doing a valuable service to the community.
If a life is "saved" because of the rapidity of the transport....then that happens to be good fortune, good luck, or simply Fate working its way.
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Sasless, I guess if you say it enough, maybe you will get to believe that. For those of us that know better, we're not going to change your mind.
That having been said, of course there is room for much improvement. I have a list of complaints I have with the air ambulance companies. Each one of us that flys or flew HEMS knows the risks and always has the option to turn down an unsafe flight. Because a helicopter crashes while cutting the margin too close, and I'm not saying that is what happened in the most recent Arkansas crash, does not mean that you would have made a different choice under similar circumstances. We can improve the safety record. No doubt about that. I think that the NTSB is on the right track with NVG, auto-pilot and proximity warning. You may feel differently. That doesn't make you part of the problem. It just makes you another facet of the solution.
That having been said, of course there is room for much improvement. I have a list of complaints I have with the air ambulance companies. Each one of us that flys or flew HEMS knows the risks and always has the option to turn down an unsafe flight. Because a helicopter crashes while cutting the margin too close, and I'm not saying that is what happened in the most recent Arkansas crash, does not mean that you would have made a different choice under similar circumstances. We can improve the safety record. No doubt about that. I think that the NTSB is on the right track with NVG, auto-pilot and proximity warning. You may feel differently. That doesn't make you part of the problem. It just makes you another facet of the solution.
Last edited by fly911; 3rd Sep 2010 at 15:41.
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If you're in this business to save lives, you're in the wrong business. I don't save lives, I just carry breathing cargo. We may reduce morbidity, but we rarely, if ever, save lives.
Night vision goggles are great technology, but like any other technology, can be dangerous if not used properly. NVGs let you fly into increasingly poor weather without knowing it until it's too late, if you don't look under them and keep track of the unaided visibility. It's too easy to get into IMC without knowing it, and then it can be too late, especially in a 206, with insufficient instrumentation to fly safe IFR. Transitioning from VMC to IMC unexpectedly is difficult enough in a well-equipped IFR ship, nevermind a 206.
All that said, it's too early to speculate on the exact cause of the crash. Video of the crash scene shows an almost perfectly vertical impact - no trees or power poles or lines show any evidence of any damage, other than fire damage above the pine tree above the scene. There are numerous possible explanations of that, and I haven't seen anything to point toward anything more than any other.
Night vision goggles are great technology, but like any other technology, can be dangerous if not used properly. NVGs let you fly into increasingly poor weather without knowing it until it's too late, if you don't look under them and keep track of the unaided visibility. It's too easy to get into IMC without knowing it, and then it can be too late, especially in a 206, with insufficient instrumentation to fly safe IFR. Transitioning from VMC to IMC unexpectedly is difficult enough in a well-equipped IFR ship, nevermind a 206.
All that said, it's too early to speculate on the exact cause of the crash. Video of the crash scene shows an almost perfectly vertical impact - no trees or power poles or lines show any evidence of any damage, other than fire damage above the pine tree above the scene. There are numerous possible explanations of that, and I haven't seen anything to point toward anything more than any other.
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Gomer, I guess that it's a matter of perspective. True, it's ususlly the med crew that does most of the saving going on, but if you're not helping to save lives, maybe you are in the wrong business. Go argue the "Golden Hour" with a trauma surgeon. At $15,000 a pop, you'd think that there would be a lot less air ambulances if no lives were being saved. If you aren't helping to save lives, then you might just be doing something wrong. I've argued with ATC to make the fighters wait to take off until I get through their route of departure rather than have me circumnavigate their airspace. There are a lot of pilots that won't put forth the effort. The paycheck will be there at the end of the week if this patient makes it or not. If you aren't helping to save lives, then you just might be in the wrong business.
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Trying to save a life is, IMO, the root cause of most EMS accidents. It's a business, and this is a job. You forget that at your peril, and at the peril of the crewmembers in the back, and of the patient in the back.
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Gomer, then by all means don't forget that! Your cause and effect remark is a little like saying that flying has been shown to be the root cause of air crashes. If you can't try to help someone survive without loosing sight of how to fly your aircraft safely, then by all means don't! Thousands of EMS flights are performed safely every year by caring individuals. Your opinion is your opinion. Don't try to ram it down everyone elses throat. Safety needs to be improved. We can improve it. And we should. But if you are there to tell HEMS pilots not to give a damn if their patient lives or dies, otherwise they are in the "wrong business" you are way out of line.
Thread Starter
Sasless, I guess if you say it enough, maybe you will get to believe that. For those of us that know better, we're not going to change your mind.
The "We're out there fighting death...stealing lives away from the ol' Grim Reaper himself....we pluck them from the very edges of that deep abyss..." mindset is what get folks killed.
If one is a professional then one makes professional decisions based upon facts, data, protocols, and recognizes limits. If one cannot separate one's emotions from one's professional life....you ain't no Professional!
It is a job....a very risky job....that carries a certain kind of satisfaction about doing something good while at work....but it is just a way of paying the rent....nothing more. You might as well haul dead trees, boxed freshly caught Salmon, or Bubba's out to the oil rigs....EMS is just another one of the taskes we can do with a helicopter.
Open your eyes and watch how people go about the work....folks in Trauma Centers do not wear fancy Nomex Flight Suits....big ol' boots....chic Flight Helmets....or do PR's (admin flights devoted to showing the flag) like Helicopter EMS folks.....but do the very same kind of work but do so inside a building. Ground based Paramedics/EMT's and their ground ambulances do the same work....but definitely do not go the flashy road.
See where I am headed with this?
If you fall into the trap that most EMS operations set for themselves....and do not screen effectively for it....and do not weed out those that are susceptical to taking on that John Wayne....Type "A" mentality with all its vulnerabilities.....in time disaster will happen. It is a matter of time only!
Back to your quoted comment.....I heard exactly that when I took the position I do....while working at several EMS locations. You are exactly correct in one thing....I shall never change my mind on this topic.
EMS is about providing skilled emergency medical care to sick and injured people....providing them safe....operative word...safe....efficient air transportation to locations where they can be rendered medical treatment.
Note....no where in there did I say....mention....suggest.....opine....anything about "saving lives". The "Golden Hour" concept says lives will be saved if proper medical TREATMENT is obtained. That is the Trauma Center, Heart Specialist, or similar modern facility and staff the EMS crew delivers the patient to and not just the EMS crew alone. The EMS crew is part of the system....and play an important role....but are not the be all...end all!
In flight break up?
Let's line up the odds....of a catastrophic in flight failure....and have it happen on a dark foggy, rainy, night over a very dark un lit area, while on a Helicopter EMS flight in a Bell 206 with no Stability/Autopilot system. Does anyone care to offer opinions as to the odds Inadvertent IMC while flying on NVG's could lead to such an in-flight break up sequence?
No one knows what happened to this aicraft that resulted in the death of three very fine people....and we should be careful to qualify our statements in that regard. An investigator looking into this tragedy will be having some of these very same thoughts while looking at the evidence.
If we look at history....and the long record of fatal EMS crashes in the United States....how many similarities will we find to other IIMC events?
Last edited by SASless; 3rd Sep 2010 at 22:49.
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Now this is an interesting discussion.
fly911, I assume, by your moniker,you are an EMS pilot.I respect your passion and your attitude. But,I have to say, you are a little off track here. Can you explain to me why, for the longesst of times, the pilot in an EMS outfit is not given the condition of the patient? I am assuming your company does the same. Can you explain why the "lifesaving angels" in the back have the option to turn a flight around under the "three to go and one to say no" principle?These have been put in place for a reason.
What Gomer is trying to say is that we are in the transportation business.The words Air Ambulance or Emergency Medical Services or Mission ,all preload the pilot into a lifesaving mindset and that has proven to be dangerous.If you look at the accident statistics of any 135 operation (fixed or rotary), it is squeaky clean compared to a 135 EMS operation (fixed or rotary). A good reason for that: ever heard of the White Knight Syndrome?
Yes, we provide a valuable tool for the communities ,especially in rural America, for a crtically ill patient to fly to center for higher care. We certainly shave off time for an accident victim to make it under the golden hour.But,if your focus to accept or decline a flight is based on "saving a life",I am sorry, you are barking up the wrong tree.Leave all that BS to the folks in the back. Most haven't even left the Ambulance yet. You and I are paid to fly as professionally and safely as possible without thought to the outcome of the patient.You know as well as I do how hard it is to abort or divert when a patient is already on board. We don't need to make our lives tougher by putting ourselves under pressure from the word go. If I really wanted to save lives ,I would have joined the Coast Guard.
So why am I doing this? Because I like to fly.Plain and simple. If I were offered a job flying oil workers in the GOM tomorrow on terms I like, I would take it in a heartbeat.
Sorry for this long and preachy post.No hard feelings.
Alt3.
fly911, I assume, by your moniker,you are an EMS pilot.I respect your passion and your attitude. But,I have to say, you are a little off track here. Can you explain to me why, for the longesst of times, the pilot in an EMS outfit is not given the condition of the patient? I am assuming your company does the same. Can you explain why the "lifesaving angels" in the back have the option to turn a flight around under the "three to go and one to say no" principle?These have been put in place for a reason.
What Gomer is trying to say is that we are in the transportation business.The words Air Ambulance or Emergency Medical Services or Mission ,all preload the pilot into a lifesaving mindset and that has proven to be dangerous.If you look at the accident statistics of any 135 operation (fixed or rotary), it is squeaky clean compared to a 135 EMS operation (fixed or rotary). A good reason for that: ever heard of the White Knight Syndrome?
Yes, we provide a valuable tool for the communities ,especially in rural America, for a crtically ill patient to fly to center for higher care. We certainly shave off time for an accident victim to make it under the golden hour.But,if your focus to accept or decline a flight is based on "saving a life",I am sorry, you are barking up the wrong tree.Leave all that BS to the folks in the back. Most haven't even left the Ambulance yet. You and I are paid to fly as professionally and safely as possible without thought to the outcome of the patient.You know as well as I do how hard it is to abort or divert when a patient is already on board. We don't need to make our lives tougher by putting ourselves under pressure from the word go. If I really wanted to save lives ,I would have joined the Coast Guard.
So why am I doing this? Because I like to fly.Plain and simple. If I were offered a job flying oil workers in the GOM tomorrow on terms I like, I would take it in a heartbeat.
Sorry for this long and preachy post.No hard feelings.
Alt3.
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Tottigol,
Recently heard of a case where the crew expressed their reservations about the weather and did not want to return to base (patient transport was complete). Well, our hero leaves them behind and heads right back home. I am not sure he still has a job but it certainly fits your "one to fly and two to cry" category.
Alt3.
Recently heard of a case where the crew expressed their reservations about the weather and did not want to return to base (patient transport was complete). Well, our hero leaves them behind and heads right back home. I am not sure he still has a job but it certainly fits your "one to fly and two to cry" category.
Alt3.
Thread Starter
Also known as the "One Dissenting Vote Rule"....anyone "chickens out"....the entire crew chickens out! The collary rule is...."Chicken out early!"
I always accepted the fact when the other guy asks me...."What do you think of this weather?".....it was not a question but a statement! He is probably thinking he doesn't care for the weather at all and is trying to politely raise the issue.
I also pondered....if one replaced the fancy custom flight suits with the old Army two piece Nomex....in Olive Green....went to flat black helmets....changed boots to say....the old Army throw-a-way black plastic soled boots....how many of our Helicopter EMS medical crews would hang around? In plain language....make the work dress dull and drab....remove the luster from the job....would we see a dimunition in the type "A" personalities that we find so prevalent in the EMS operations? How many of these folks are really doing it for the work and not the flash?
I always accepted the fact when the other guy asks me...."What do you think of this weather?".....it was not a question but a statement! He is probably thinking he doesn't care for the weather at all and is trying to politely raise the issue.
I also pondered....if one replaced the fancy custom flight suits with the old Army two piece Nomex....in Olive Green....went to flat black helmets....changed boots to say....the old Army throw-a-way black plastic soled boots....how many of our Helicopter EMS medical crews would hang around? In plain language....make the work dress dull and drab....remove the luster from the job....would we see a dimunition in the type "A" personalities that we find so prevalent in the EMS operations? How many of these folks are really doing it for the work and not the flash?
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FH1100,
Yes the number of engines makes a difference. Singles are single pilot VFR, twins are 2 pilot IFR. Singles are crashing with monotonous regularity in USA at night and bad WX because they are flying beneath cloud and becoming CFIT statistics or getting disoriented and crashing.
Twin engine machines firstly have two pilots - one of whom can be detailed to get a last minute weather check whilst the other preps the machine. Then they can discuss the weather and their options before departure. if they choose to go then they have the option of flying above fog or in cloud to get to the destination and if they can't land then they divert because they have the equipment and fuel reserves to do that.
John R81,
If this VFR machine came apart in the air whilst flying in fog (cloud) then my guess is that it came apart due to unintentional aerobatics caused by loss of situational awareness - not mechanical failure.
What concerns me most is not why these pilots keep doing it - it is why the medical crews blindly follow them to the scene of the accident. The medical crews that i fly with (in a 2 pilot, twin engine machine) want a detailed weather brief before they will go anywhere. They have no intention of following me to an early grave.
Yes the number of engines makes a difference. Singles are single pilot VFR, twins are 2 pilot IFR. Singles are crashing with monotonous regularity in USA at night and bad WX because they are flying beneath cloud and becoming CFIT statistics or getting disoriented and crashing.
Twin engine machines firstly have two pilots - one of whom can be detailed to get a last minute weather check whilst the other preps the machine. Then they can discuss the weather and their options before departure. if they choose to go then they have the option of flying above fog or in cloud to get to the destination and if they can't land then they divert because they have the equipment and fuel reserves to do that.
John R81,
If this VFR machine came apart in the air whilst flying in fog (cloud) then my guess is that it came apart due to unintentional aerobatics caused by loss of situational awareness - not mechanical failure.
What concerns me most is not why these pilots keep doing it - it is why the medical crews blindly follow them to the scene of the accident. The medical crews that i fly with (in a 2 pilot, twin engine machine) want a detailed weather brief before they will go anywhere. They have no intention of following me to an early grave.
Epiphany, that may be the case in Australia but not in the US. There are plenty Single Engine IFR machines out there (quite possibly also including some dual pilot ops, others here may know better), as well as Single Pilot IFR twins.
Singles are single pilot VFR, twins are 2 pilot IFR
Yep...plenty of twin engine/IFR machines including 412s, AW139s etc operating in the SAR/EMS industry in oz single pilot (albeit a crewman often occupies the LHS in a kind of non flying co pilot role).
Avoid imitations
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In combined Casevac/SAR unit I flew for there was categorisation of patients. Category A was highest (life or death), so we knew up front what we were facing.
Point to bear in mind: the patient is but one life. The crew was/is three, or four lives if it was a SAR mission. Apart from that, the loss of the aircraft itself might mean that other patients may not be rescued afterwards.
Having first flown helicopters with night vision devices in the late 1970s, (with PNGs, which pre-dated "NVG") I've always been concerned about them being used in circumstances where an IFR reversion/recovery is not possible. I've previously given advice to some via this forum. My advice is that I would not choose to work for an NVG, non IFR capable helicopter unit. Too risky in my book. As an instructor, I helped get RAF rules changed back to something more sensible when new weather limits for NVG operations were introduced which allowed flight in visibility worse than for unaided flight!
These tragic accidents seem to reinforce my point.
Point to bear in mind: the patient is but one life. The crew was/is three, or four lives if it was a SAR mission. Apart from that, the loss of the aircraft itself might mean that other patients may not be rescued afterwards.
Having first flown helicopters with night vision devices in the late 1970s, (with PNGs, which pre-dated "NVG") I've always been concerned about them being used in circumstances where an IFR reversion/recovery is not possible. I've previously given advice to some via this forum. My advice is that I would not choose to work for an NVG, non IFR capable helicopter unit. Too risky in my book. As an instructor, I helped get RAF rules changed back to something more sensible when new weather limits for NVG operations were introduced which allowed flight in visibility worse than for unaided flight!
These tragic accidents seem to reinforce my point.
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Mmmm ...
Yes but in Australia DOES NOT ALLOW VFR flight at night at 500' agl does it ? ... perhaps for a start THAT is something the FAA needs to address ....
Yes but in Australia DOES NOT ALLOW VFR flight at night at 500' agl does it ? ... perhaps for a start THAT is something the FAA needs to address ....