HEMS Activation times
 

In my part of the world (Multi Engine EMS) we are expected to be airborne (not engine start) within six minutes of receiving the first call of activation for primary emergency flights. In my opinion this is dangerously short, is this normal for other countries?

We are 5 minutes(single engine ops with b3/b4). We have looked at various ways off optimising the time to include a proper walk around, chk oil levels etc. We convinced our clients to change the wording to "strive to be airborne within 5 min but the contract requires within 10 min". Maybe it was made easier as we could use the argument that alll our operating basis are on airports subject to ATC clearance. We now basically operate practically to pre start checks within 5 min.

Launch times
 

My pet peeve. :mad: When I worked EMS some nurses would throw a s#@! fit if we were not off the ground in 6 minutes. I think it is just management induced self imposed stress. Never get in a rush or you might fly away with a battery cart for a sling load :bored:

Fly safe

VP - if you have already done a walkround and checked the oil levels then, when you get a shout, why should you want to waste time doing it again? EMS or SAR aircraft should be prepped and ready to go so that you can strap in and start up.

Therein lies the rub. EMS aircraft are NOT on a life saving mission. They are transporting passengers ,just like any other charter operation. If we ,a s pilots, get that into our system we would save ourselves and others a lot of grief.
Alt3.

@alouette3: That is definitely wrong.:= In rural areas the HEMS is on live saving missions. Not every time but sometimes.

Call to airborne in 4 minutes. First thing in the morning you do your preflight checks and a short ground-run with system checks and everything is safe and according to the book, also in a rush.

Crab, we do 2-3 flights a day and over weekends 1 can be a mountain and/ sea rescue in between transfers/mva's/etc. During the aircraft on ground time at base we have rescue and/or ambulance staff repacking and replenishing their jumpbags/rescue equipment/running out the hoist/checking the cargo slings/engineers rechecking all good/aircarft being washed after sea exposure or it's 2 daily wash. We have an aircraft landing, starting refuelling and replenishing and within 5 min after shutting down a different call comes. We need to do between flight, clean/sterilise and prepare aircraft for next mission. It may only be a Squirrel, but I would rather know eveybody checked everything before I select "Idle" than wondering later. Thus we decided to convince the clients to give us the extra time dependant on situation. Bare in mind our next flight can be anything from a mountain/ sea rescue to a 1.5hr/per leg trauma transfer. The platform can do it easily with propper planning and checking-isn't a couple of minutes worth it?

Spencer17:
I am at a rural location. When we get a hospital transfer request, it is because a rural hospital is in way over its head with a patient and they need the patient to be flown to a larger hospital in a metro.
The fact of the matter is the call for a helicopter goes out a few hours after the patient shows up at their doorstep.After that if I launch in 5 minutes or 15 is not going to make a life or death scenario. After all what happens if I can't go due to weather?They will stick him in an ambulance and send him on a 2 hour trip anyway. I do agree that I can reduce the time I take. Preflight, log book check,weather,WAT checks etc can be done and canned. But there are certain things theat HAVE to be done prior to lift:external power disconnected, baggage stowed,tie downs removed and then there is the check list to be done completely, thoroughly and wthout distraction.Being single pilot, I have a flow memorised for start and use my check list as a "Do and Verify" list rather than a "To Do" list.All told, it takes me about 8 minutes to pull pitch. If you are in a twin it might take longer but it has to be done right everytime all the time to avoid trying to launch off a rooftop with one engine in idle.
My point is , our actions should not be dictated by patient considerations but by the fact that we fly helicopters for a living and not, to save lives.
If there is a scene call the only thing I cut out of my launch procedure is GPS programming. I launch on a bearing and distance. Settle down at cruise, get the lat. longs. and program as I go. That is the only concession I make for the perceived "urgency" of a scene call.
Alt3.

VP, we do the same, day and night, VMC or IMC - our required response is 15 mins 0800 - 2200 and 45 mins 2200 to 0800. If the engineers have serviced the aircraft after one job I'm not about to waste time checking oil levels before launching on the next one.

However if it is neccessary to exceed response time in order to do the job safely then we will take any flak that comes and make that decision.

But it is also possible for us to get airborne in under 5 mins from the call if we have to.

My limited civil and military experience was that we were never 'late' getting to a scene - there was always a long period sitting on the ground while things got organized, etc.
The only exception was when we got called out to remote areas where the ambulances couldn't get to quickly, or where there wasn't already someone taking care of immediate first aid. But these were not the majority of the calls.
Even then, I doubt that there's more than a couple of percent of patients for whom the time of arrival of the helicopter is critical for survival.
(Does anyone have any stats on this?)

What difference would a couple of minutes later make to the whole thing?
Don't rush the checks, don't rush anything - go as fast as you can when airborne, but if you're a minute or three late getting off the ground and safe, it's better than on time departure, but not prepared.
Do you see the airlines hurrying their checks when they're late? And they have a lot more money tied up in being on time than the EMS business.

From Crabs present base, (Chivenor UK) but in the mid '80's, we did an 8 minute, (telephone call to landing back at base with the casualty) wet rescue; an exhausted swimmer out of the River Taw.

It was in a Wessex however, not a Seaking!

These days (UK HEMS) we lift in about 2-3 minutes from the call, but no one is counting.

Alt3

I completely agree with your approach. Life saving mission or not, I am not about to become a victim by letting anyone urge me in to rushing and making mistakes. Once the pushing starts, though not often at all, I start pushing back, AND, slowing down.

Some mistakes are not forgiving, and forever; and can take others right along.

WIII

Oil, fluid and O2 levels are checked in advance of our flight requests, however, I will never board the aircraft without doing a 360 walk around.

I have no idea whether somebody has tampered with the aircraft, or run into it with a vehicle, or a perhaps a mechanic forgot to lock a cam fastener, or a medical crewmember plugged an extension cord in or left the baggage door unlocked, or sombody walked under the tailboom and broke an antenna.

Of course you have to do a walk around. And "strive" should be the most that any of us offers a customer.

I always do a walkaround, no matter what. It doesn't take long, less than a minute, but I always walk competely around the aircraft. If the patient dies because I take an extra 30 seconds to make sure nothing has gone wrong with the aircraft, then the patient was going to die anyway. I don't waste time, but I never hurry. Hurrying will get you hurt. I take off when I'm ready, not before.

I refuse to rush and always walkaround, especially after I screwed up once after rushing. We are given 20 mins VFR and 30 mins IFR (SP IFR in a 412), SAR jobs often need 45 mins. In eight years I've never seen a job that response time made a significant differance. Any med crew should be told to butt out with respect to response times.

After a pilot of ours did a face plant trying to leap the barriers around our pad in a single stride, and a bird took off with an engine plug still installed (landed after the gauges hit the red, then tried again and ended up nearly balling it up), we adopted the philosophy of "slow is smooth, and smooth is fast", something I had heard before.. We had twins and were operating in Iraq, launching routinely in 6-7 minutes. Worked out well.

Oh and we left the tiedowns off then as well. Walkaround always, which included a peek into the intakes. Never had a problem.

Mike

hems & sar in Italy
 

Hello,

About Hems in Italy we perform as follows:
a) 3 minutes take off (from call to t/o although time is flexible) for primary flights in daytime sunrise-30min to sunset+30min, weather conditions permitting.
b) Time required for planing mission for secondary flights (e.g.: hospital to hospital transfers) in daytime or nightime; usually you don't go over 30 minutes.

Prerequisites are:
1) the heading contractor of HEMS system is the government.
2) all we are flying twin engines operated by private air transport operators.
3) crews are alwais close to the helicopter in duty time and it is supposed they perform checks when starting their service.
4) night service is unaided with two pilots. Day time may be single or two pilots.
5) the medical system requires 3 min because of the "stay and play" approach to the emergency. We have 1 reanimation anaesthesist and 1 reanimation nurse on board, paid by the contractor.
6) due to lack of remote areas and plenty of moutain areas (Alps & Appennine) of some high, usually HEMS merges and overlaps with SAR; so we have medic/nurse crew members using hoist in certain rough countys.

Maeroda

I wonder what sort of mad dash the two medi helicopters were in when they collided in Arizona recently?

I guess some of you guys just don't trust your engineers then - I know I can strap in and start without doing a walkround on a scramble. A cursory 360 wander round the aircraft is a waste of time, you either do a complete pre-flight or don't bother at all - it is like chanting a mantra "I've walked around the aircraft so everything must be OK".

Can't agree, Crab. Never take the quick way to the cockpit door. A panel left unlatched can kill, and has done.

Secondly, being still in the mob, you have always led a sheltered life with "engineers" to do your aircraft level checks and replens etc and someone else to sign as having checked. Not everyone has those luxuries. I'm not in a life saving role these days but often the need to get airborne can still be pressing. I have no-one to do stuff for me these days so no-one but me should open any panels once the aircraft is out on the tarmac. But it has been known for some helpful soul to open and not shut. Also, I might get interrupted in mid-check and forget something, so a final pre launch look-around gets done every time as far as I'm concerned.

Crab:
We do trust our engineers/mechanics.But we verify that they have done their job.They expect us to.
The walk around is not about checking the aircraft again. It is about checking if latches are closed,baggage has been stowed,and everything is clear. In between flights, it is about checking if any new problems have cropped up: you may have sprung a leak or your T/R might have done some weed whacking coming into a scene etc.
I suppose you think that the airline pilot who walks around his 737/747/757/767, sometimes in freezing weather, is also wasting his time------?
Alt3

My personal motto is: "Assumption is the mother of all fu:mad:ups!!!!!"

I trust all my fellow workers whether it is a engineer/ pilot/ paramedic/ sister/ doctor/crewman etc. I however know how many times I thought I did something/forgot to do something/ plainly made a mistake. Busy with preflight and the paramedic asks about a flight/ somebody wants to schedule a meeting/ somebody comes to say hallo. Nobody will convince me they never had a destraction while doing preflight/ a engineer doing maintenance/ medical crew replenishing etc. I am sorry, but the only thing I have is extra eyes=prevention. I do not mind, and in effect by us it is part of procedure, for the med crews to walk around the aircraft again after start waiting for the stabilisation period just for incase. I have engineers insisting on a check after 1 did balancing adjustments and another duplicate inspection. WHY? Because we can and all of us sometimes see what we want to see!!!!! Why not take the lifesaving extra min/2 at the most:ugh::ugh:

The same sort of pressures can get applied in police work too. SoPs vary quite a bit.

Many times I have been told how "good" a pilot is for lifting from the spot (without looking behind him before he goes). Maintain your own standards.

I didn't say I don't do a walkround - I just don't do one on a scramble because the aircraft is already prepared. As the pilot, my job is to get the aircraft started quickly, the other members of the crew will join me during the start and may well cast a glance over the aircraft and there are 2 engineers as the start crew, also looking for any leaks or problems that might affect the aircraft.

If this is being pampered then long may it continue but our engineers are civilian now, the colour of their overalls doesn't affect their professional competence - they are very firmly part of the team with a crucial role in flight safety.

BtW how may pilots do a post flight walkround - which is much more important? Alouette - I can't believe you would leave it until the next flight to check if your TR had sustained damage on the previous one.

Can the requirement to be airborne within a certain time period, whatever the reason, be legally enforcible on the Captain? Surely the over-riding factor is safety and if the Captain needs to take longer because, in his opinion, that is what is required then so be it.

Crab, we enforce the "between flight" You land and shut down =you check! This does not take time(1-2 min) or a brain surgeon, but it does bridge the question of "when is the last flight of the day?" It does ensure a crew being able to hand over a aircraft with knowledge and not assumptions.(they had to land to hand over) Again. the new crew will double check aaand it is not to question the previous crew. Different eyes sees differnt things!

Crab, yes you are pampered, no-one mentioned the colour of overalls, only the fact that you have someone in overalls to help you. ;)

Horses for courses. Some of us have no-one else to do the daily check A, the walk round checks and post flight checks after every sector. Same with some refuels and oil top-ups, and towing the aircraft in and out of the hangar. My aircraft often doesn't see a qualified engineer for 50 flying hours unless something goes wrong with it.

It's similar for many UK HEMS and Police ASUs.

I'm no longer doing either, but operating as single crew these days, I have no-one down the back to help spot errors. I can make a mistake as much as anyone else can who touches a door or filler cap, be it passenger, engineer, refueller or pax handling staff, so my mantra must be a personal cross-check of the exterior whenever I can. :)

Crab:
I am sorry ,I should have worded it better. By next flight, I meant the next time I launch. At my location, a flight is typically a three leg affair and I check for leaks and damage, between legs(that sounds awful but you know what I mean!!!).
Also, I do a complete walk around after the final flight/leg too. During that time, I do an AD check(my helicopter has two daily airworthiness directives to be complied with), and make sure the cockpit is set up and organized for the next launch/incoming pilot.
And ,no, we in the US EMS business do not have ground crew saluting and seeing us off. In that respect,yes, you are pampered.
Aalt3.

Our emphasis is on being 'focused' not fast. I've found that fast results in hurried results in mistakes. 'Focused' actually tends to result in quicker launch times.

That being said it is the borderline weather that deserves and gets the extra minutes of study. I routinely check the weather about every three hours but when paged for a flight I always recheck it. Easy when it's severe clear or zero/zero, but another thing all together when it's right on the edge.

A final note. If one of our medical crew ever pitched a "s#@! fit" over time to launch at one of my pilots they would be temporarily off flight assignment in a New York second subject to review where they would be permanently removed...

Every one of us has a different environment that we operate out of.

I suppose that if I was sitting on top of a secure roof-top pad, instead of on the GA ramp at an airport with no security or locked gates, then I might feel differently. I will take a good look at everything before I go.

And yes, I do a post-flight inspection every time that I get out of the helicopter.

For me, the powers that be, whether management or med crew, can demand whatever liftoff time they like. I'll lift off when I lift off. If they don't like it, then something will change, whether it's my place of employment or theirs. I don't take any crap from med crews about flying, just as I don't give them any about medical stuff. As I said above, I don't waste any time, but I don't hurry. Hurrying will inevitably lead to increased times, and often an aborted flight. Having a routine and sticking with it no matter what helps to keep launch times down and prevent mistakes. I'm another without a ground crew to assist. We get a mechanic (engineer) when an inspection is due or the ship is grounded. There's me, the nurse, and the medic. One takes care of the medical equipment, one operates the battery cart, and we launch ourselves. If there is any check of the aircraft, I do it, both before and after the flight, including fueling, replenishing oil, and servicing the oxygen. I also do most of the preventive maintenance - changing light bulbs, etc. I would love to have multiple ground support personnel, but that won't happen. You live with what you have, or you leave. I can live with things the way they are, as long as I'm careful and do a walkaround before and after every flight.

Does anyone have a set of guidelines (I hesitate to call them rules) about what to do and not to do? Guidelines such as:
No running. Even if you're late - don't run. If you fall you'll be even later.
and so on.

Hello,
As I had a chance to observe several police and HEMS/SAR operations (and am working for one) I am humbly putting forward my observations:
in Austria, OAMTC crews, flying EC 135s with Pilot and HEMS crewmember and doctor on board. (Swiss REGA works similar way)They regularly take off within three minutes ( not a required standard!) when weather is not an issue and flight is within designated operating area, which is fairly small for each base (about 50km circle). They have carefully prepared procedures -and also hardware, like crew quarters are only a few steps away from helicopter, movable helipad(on rails) allows single person to push helicopter out of hangar in half a minute, etc.
Helicopter, weather, medical stuff etc. is checked and prepared in advance and regularly updated-rechecked, no one except crew has acess to helicopter on duty, etc. Even kitchen could be modified - imagine coming back from a mission, finding burning home base, as someone left pan full of cooking oil on cooking plate!
As soon as request for takeoff and location is received, pilot goes out, doing start up. HEMS crewmember, responsible for tactical navigation, comes later with the details of destination, situation, etc.
I had a chance to fly with several UK police helicopters - mostly liftoff occoured in about 3 minutes after phone rang. Shortest scramble I witnessed was 1min 45 seconds from bell ringing to liftoff - and I swear, I never witnessed any rush - everything going on smoothly, as it was done thousand times before on a predetermined procedure, that was developed and finessed out thru experience.
Even big Bristows S61N SAR I had a privilege to fly aboard, was airborne within 5 minutes if needed. Everything prepared, special checklists in use, a lot of proffesionalism, and there never was any rush - everything went smoothly, but with no delay. Mind that crew has to put on immersion suits too!
Flew with RAF SAR Sea King too, but response time was a bit longer - also due to the fact that crew quarters were far away from helicopter, so a van was used to get there.
Where I fly, we regularly take off with Bell 412 in 5 - 6 minutes after the call, if weather and mission planning is not an issue. If there are doubts, it can be 10 or 20 minutes - until pilot, or better say, crew is happy with the decision to go. Still, preflight checks are done and myself as crewchief am doing final walkaroud when engines are already running - we caught two hydraulic leaks in the last two years this way. It is an added bonus, that crewchief is most of the times also licensed engineer, so snags can be often sorted out quickly.
In my humble opinion, short take off times (3-5 min) can be achieved safely under certain conditions, but the whole organisation must be adapted to such operations - including outfit of hangar, communications, crew quarters, personal equipment (boots with zippers, for instance,) etc.
If you approach this issue with "airline" or "Point A to point B transport of medics and patients" thinking, you will either achieve unacceptable scramble times, or you will skip safety. Truly, few seconds will hardly mean anything to a patient condition, but in rescue/HEMS business (also police ) there could be a big difference between 5 and 15 minutes takeoff time on final outcome, not to mention the decision to take off at all. Agree that there is no point in trying to catch some predetermined takeoff times, not only from the safety point, but also from the patient point - there is no sense in trying to reach that patient, only to tell the medics, waiting with him, that you cannot reach them - time lost that could be used to move patient with ground transport. It is even worse, to load the patient and then try to figure out where to deliver him, as planned destination hospital is out of reach due to storm that just developed.

Stay safe! :)

hoistop :ok::ok::ok:

skadi

It takes longer than 2 minutes just to start the engine(s) and do the checklist, if you do it right. I defy anyone to start a non-FADEC turbine engine in under a minute, after getting into the cockpit and strapping in, doing even a cursory check of the cockpit before and after the start, and stabilizing the engine. With a Rolls-Royce engine, you have to stabilize it at idle for a full minute before even advancing the throttle, and it takes time to get to 100% rpm unless you risk overtemping and overtorquing. Even if it takes me longer than 5 minutes to lift off, we often get to the scene before the ground personnel are ready for us, and I've reached many scenes before EMS even arrived, so we had to circle. All this emphasis on short lift times is something I just don't understand. It doesn't help the patient or the crew, especially if the flight is aborted because of problems caused by hurrying. I don't waste any time, but I never, ever hurry.

Gomer Pylot:
You read my mind.:ok:All this talk about three- minute- launches in twin/complex helicopters is a wee bit supicious.I currently fly a single but even that takes at least about two minutes to spool up and be ready to go.
Unless you are a military SAR/CG guy, there is no such thing as a "scramble".
Shawn, to answer your question, my company frowns upon running to the machine.Sometimes my med crew tend to do that and I use that as an opportunity to slow everybody down.
Alt3.

Nobody should run to the aircraft unless they are being shot at. My company does not allow running.:=

GOM wrote
.

Why that, thats the advantage of HEMS, to be faster than the "groundtroops".
Thats the philosophie of HEMS in Germany and other european countries. Many times we are the first ones on scene and could treat the patients before the EMS arrives. These minutes are in many cases essential for the health of the patients.
By the way, an emergency doctor is always member of the crew ( at least in germany, austria, netherland and suisse )

skadi

HEMS
 

And in Portugal the emergency doctor and nurse are also members of the crew.

I've never seen anyone run to the aircraft. I've never even seen anyone consider running to the aircraft. At the speed most of us can run, you're only going to save a few seconds, so why bother? If the patient is going to die within 10 seconds, then the patient is going to die. Everybody dies. It's not worth killing more people in a futile attempt to save one.

We never land without having ground personnel secure an LZ, and we never start treating patients before the EMS personnel call for us. We have no legal standing for doing that, and it would be severely frowned upon. We're a private company, and only do transports when called by ground EMS or hospital personnel. Thus getting to the scene early is a waste of resources. I understand that it's different in much of Europe, and other countries of the world,but we're not in Europe or other countries of the world.