EMS helo safety-time to halt a national crisis

NTSB urges EMS community to examine fatalities.

By Woody McClendon
ATP/Helo. Eurocopter AS350B3

NTSB Member Robert Sumwalt presents suggested remedies and solutions to the audience during the AMTC conference in Oct 2008.

Early on Sep 28, 2008 in a forested suburb of Washington DC, a Maryland state trooper stares into the wreckage of a Eurocopter SA365 Dauphin 2. A piece of the fuselage carries the Maryland State Police logo. There are 4 body bags.

In one is the pilot-a retired trooper he knew well-the others contain the 2 medics and a patient. As they go about their grisly tasks, the people around the scene-investigators, law enforcement from local, state and federal agencies, and a few EMS techs-are silently asking themselves how this could happen to a superbly equipped helicopter flown by a highly trained pilot with years of experience on the Dauphin.

A greater tragedy than the loss of life-if there can be such a thing-is that this was the 6th accident of the year to hit the US EMS helicopter community. This was the 6th time in 2008 that a normally functioning helicopter flown by a competent, current pilot had crashed.

A grim opinion of the EMS helicopter business was published in the Chicago Tribune after the crash of a Bell 222 in Oct 2008-an accident that claimed the lives of the 3 crewmembers, all local residents.

Throughout the year just ended, 23 people died. Given the relatively low annual hours flown by EMS operators, when those fatalities are normalized against comparable statistics for commercial air carriers and charter jets the accident rate for EMS operators is disturbingly higher than any other type of operation.

The EMS community, government agencies and manufacturers are committed to ending this tragic pattern. NTSB is taking the lead, with a hearing scheduled for early 2009 to bring all available assets to bear on identifying and implementing solutions.

Sumwalt addresses fatalities occurring on Part 91 flight segments-those with no patients aboard.

NTSB Member Robert Sumwalt, who will preside over the February hearing, presented a series of board recommendations at the Oct 2008 Aeromedical Transport Conference (AMTC) in Minneapolis MN. They were:

EMS safety issue 1-operations without patients on board

Positioning flights operated under Part 91 deviate from Part 135 weather minimum and crew rest requirements, resulting in a number of weather and pilot-fatigue-related accidents. NTSB recommendation-FAA should require all EMS operations to be under Part 135 rules.

EMS safety issue 2-flight risk evaluation

A true program of risk evaluation, if used before every flight, should identify potential hazards and facilitate sound go/no-go decisions. Proper risk evaluation might have prevented a number of accidents. NTSB recommendation-FAA should require risk evaluation for all EMS missions.

EMS safety issue 3-flight dispatch procedures

A properly established operations center can provide pilots with route information, risk assessment, en_route and scene area weather and flight following. NTSB recommendation-FAA should require EMS operators to implement and employ flight dispatch procedures.

EMS safety issue 4-TAWS

Terrain avoidance warning systems (TAWS) are required on all turbine-powered airplanes with 6 passenger seats or more. TAWS/EGPWS has reduced CFIT accidents in airplanes by almost 500%. Some EMS accidents might have been prevented with TAWS.

NTSB recommendation-FAA should require all EMS operators to install TAWS equipment. Sources within the EMS community agree that implementing these critical issues would have a significant impact on accident reduction.

NTSB recommends mandatory predeparture risk evaluations for all EMS helicopter missions.

Many also believe that efforts should be focused on further improvements in operations, training and equipment, the ultimate goal being to eradicate fatal accidents just as commercial air carriers were able to several years ago.

As one key EMS manager puts it, we must concentrate on those final terrible minutes in each of the 6 accidents that occurred in 2008, along with the stream of similar tragedies in previous years. NTSB investigators use current-generation graphics tools to build models of the last minutes of a fatal flight.

Once those graphics from the string of EMS accidents are developed, they should be analyzed thoroughly to determine what went wrong and why.

CRM and CFIT solutions in the jet community

In the late 1970s, commercial air carriers recognized that lack of communication and poorly defined duties between crew members were a major cause of accidents. A team of industrial psychologists attacked the problem and developed CRM as the solution.

Today the flying pilot/nonflying pilot concept is fundamental to all commercial airplane operations, along with established practices for clear communication between crewmembers. CRM is widely credited with a significant reduction in flightdeck confusion and a marked decrease in accidents.

During the same time period, a disturbing series of fatal airliner and corporate jet accidents occurred-a haunting precursor to the tragedies plaguing the EMS community today. Study of these accidents resulted in a set of conclusions labeled controlled flight into terrain (CFIT).

A major push by safety organizations, jet operators and manufacturers produced a series of training programs focused on the factors contributing to CFIT events.

Responding to industry calls for a system to warn pilots of dangerous terrain, avionics manufacturers developed ground proximity warning hardware-culminating in the latest version, enhanced ground proximity warning system (EGPWS)-that provides a 3D color terrain picture with ground proximity warnings in red and yellow.

The resulting heightened awareness by flightcrews, along with fleetwide installation of EGPWS, reduced CFIT occurrence in the jet transport community from a high of 9 fatal accidents in the early 1990s, killing hundreds of people, to 2 in the most recent year charted.

Applying CRM/CFIT solutions to EMS helicopters

One potential solution to the CFIT issue identified in EMS helicopter accidents has caught the interest of some managers in the EMS business-implement some of the CFIT and CRM techniques now common in the airplane community to the EMS helicopter world.


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