EMS helo safety-time to halt a national crisis

NTSB urges EMS community to examine fatalities.

NTSB calls for FAA regulations requiring formal dispatch procedures.

One of those is to have 2 pilots with clearly defined roles as flying and nonflying pilot. Traditionally, the flying pilot is dedicated to hand flying the airplane and/or managing the autopilot, and overseeing the navigational situation.

The nonflying pilot manages systems, performing checklists in coordination with the flying pilot, and while looking ahead at the navigation situation and planning system updates to feed to the flying pilot.

Two-pilot operations would not be practical in the small, single-engine helicopters that are increasingly popular in EMS operations. The cockpits in twin-engine helicopters are designed for 2 pilots-thus adopting a 2-pilot format would facilitate (and in fact drive) a transition to all twins.

Single-engine, single-pilot helicopters might still find limited application in well-lit, short-range urban operations. That limiting concept brings another set of assumptions with it that would be in the calculus should the EMS community consider transitioning to all twin-engine aircraft.

What would 2-pilot operations look like in the scenario of night scene landings (the highest workload task in EMS operations)? Here's a rough take on the pilot duties. The nonflying pilot:

• determines scene location
• enters lat/long position into FMS
• assesses computed route on MFD to determine optimum safe altitude
• cross-feeds route to flying pilot's FMS and sets autopilot/flight director altitude to optimum safe altitude, advising flying pilot as appropriate. Closing on the scene, the nonflying pilot:
• begins assessing the surrounding terrain using synthetic vision system (SVS)
• determines an initial approach course to the scene to remain clear of terrain
• builds a final approach course in the FMS, determining a minimum descent or decision fix-the "safe final point"
• cross-feeds the approach data to the flying pilot along with the approach and missed approach brief
• evaluates the close-in scene using enhanced vision system (EVS) to identify wires, trees and other obstacles
• monitors the approach "eyes out" with NVGs
• calls the safe final point to the flying pilot At that call the flying pilot goes head-up. If wearing NVGs he/she flips them up and completes the landing.

If the nonflying pilot does not establish clear ground contact, he/she does not call the final safe point and the flying pilot initiates the missed approach.

NTSB urges mandatory TAWS implementation aboard EMS helicopters.

Investigators have found that weather-related accidents are more likely to occur on the non-patient Part 91 legs. The homeward-bound leg after dropping off a patient is statistically highly probable for a weather-related event.

Flying a twin-engine helicopter, the crew would have the option to simply file an instrument flightplan (IFR) home, either to their base if they have an approved approach, or, if not, to the nearest IFR airport, with a VFR transition to their heliport. This would essentially eliminate the threat of accidents caused by attempting to fly VFR in deteriorating or marginal weather on non-patient legs.

An alternative to 2-pilot ops

EMS operators are unlikely to be supportive of the major investment in equipment, personnel and training that this concept would require. If this is so, why not use it as a model and identify components within its framework that could be applied to single-pilot VFR operations to make them safer?

To define the problem we must start by analyzing the workload in the single-pilot environment, looking for spikes and areas of potentially intense confusion from excessive input. The aircraft design community uses analytical tools for assessing pilot workload that have been applied successfully to several flying issues.

Bell 412 crew loads a patient hoisted out of a disaster scene.

To that end, a series of informal workload studies using helicopter flight simulators-informal in the sense that investigators would be looking for gross spikes in cockpit workload-could be useful in adapting the 2-pilot approach and landing process to single-pilot operations, as well as identifying specific points of cockpit confusion and loss of situational awareness.

Simulators are particularly useful for such studies because initial conditions can be set to precisely the same values for each evaluation pilot, and video and audio sensors can be positioned around the pilot to record the optimum productive data without concern for compromising safety of flight.

Simulation studies should be based on EMS flight scenarios that pilots have identified as the most challenging-for examples, night scene landings in unlit rough terrain, and day or night scene landings in urban surroundings with numerous emergency vehicles in motion around the landing zone (LZ).

The simulations should also include a medical crew in the simulator cab going through their normal pre-arrival preparations, including intercom chatter and patient information exchanges with ground personnel.

The sim instructor should assume the role of dispatcher and LZ coordinator, injecting questions and input typical throughout the mission profile. Study results would identify workload spikes created by distractions, tight LZs, obstacles dangerously close to the helicopter's flightpath, multiple channels of simultaneous radio traffic and medical crew demands on the pilot.

Procedural and equipment solutions could be deployed with the objective of reducing pilot workload to within safe limits and smoothing out the task flow to prevent overload. Workload analysis and application of CRM techniques parses a chaotic, high-workload process into a series of manageable tasks.

Today, EMS helicopter pilots somehow complete all the fundamental preparatory tasks in one form or another before a scene landing. A more defined process emulating the one used successfully in airplanes could be a powerful safety tool.

Solution 1-CRM-based procedures

The first of those solutions could be CRM-related cockpit concepts. As an example, most single-engine helicopters are equipped with takeoff and landing checklists by the manufacturers.

Using CRM, an additional approach checklist might be designed detailing a crew self-brief on the landing scene, based on preliminary information the pilot will accumulate.

He/she assesses wind speed and direction, and weather and terrain features in the area from observation, and begins to define the constraints to the approach as well as a missed approach or "escape" plan.

The pilot will also set the GPS coordinates for the scene in the navigation computer. If no GPS data is available, the pilot could, before departure, find the scene on a map, mark its location, and have it folded and ready to consult on arrival in the area.


1 | 2| 3| Next