St Vincent Healthcare HELP Flight—big sky lifesavers

Billings MT-based operation uses EC135 and King Air 200 for medevac services in Montana and neighboring states.

St Vincent Healthcare HELP Flight helicopter pilots and crews use the same NVGs as the US military to help fly safely into and out of tight spaces in low light conditions.

Finding pilots to work for HELP Flight has not been a problem, says Coble, mostly because, as he says, "Montana is a great place to live—they want to live here."

Most of the helicopter pilots are of the Vietnam Era and are about to retire. One pilot who retired recently spent 20 years at HELP Flight and another who is about to retire has been a pilot for the program for 25 years. HELP Flight also benefited from elimination of the helicopter program at the other medical facility in Billings, which yielded an experienced air ambulance pilot.

All of the necessary replacements have already been hired. While the hiring is technically done by Metro Aviation, Coble has a say in the process.

Pilots for the fixed-wing side are also reportedly standing in line for the job. Several years ago, the Billings-based airline Big Sky went defunct, leaving a glut of well experienced Beech 1900 pilots in the area. Also, a local collegiate flight program, Rocky Mountain College, produces a steady stream of qualified applicants. Edwards does the hiring of these pilots but, again, Coble participates in the interview process.

Elite certification

Because HELP Flight is accredited by the Commission on Accreditation Medical Transport Systems (CAMTS), the pilot-in-command (PIC) of each aircraft must meet particular requirements.

For the helicopter, which is operated with 1 pilot, the PIC must have 2000 hrs TT, of which 1500 must be PIC and 1000 PIC in a helicopter. At least 500 hrs of turbine time are required and an ATP certificate is encouraged. Initial and recurrent training is handled by Metro Aviation.

For the King Air, which is operated with 2 pilots for added safety, the PIC must have 2000 hrs TT, including 1000 PIC, 500 multiengine PIC and 100 night PIC. An ATP is re­quir­ed for the PIC and highly en­cour­aged for the SIC.

According to King Air Capt Joe Lynch, hiring is competitive. He adds, "SICs need a multiengine com­­mercial, but no minimum hours are specified." Fixed-wing pilot training is sponsored by Edwards and, according to Lynch, "is a combination of inhouse Part 135 training and simulator training, which takes place at SimCom in Scottsdale AZ."

Lynch also notes that pilots must go through 10 hrs of air-ambulance-specific training which includes learning how to help load and unload patients as well as how to handle patients in critical medical situations.

The helicopter pilots generally stick to a 7 days on, 7 days off schedule, although there is some variation. They work 12-hr shifts which cycle on and off at 6:30 am and 6:30 pm. Helicopter pilots have their own facilities to use at the hospital, including an office area with a TV and computer with Internet access, as well as a sleeping room, as they are required to be on-sight while on call.

Only the adult/pediatric medical crews are required to be on site at the hospital. They are on 24-hr shifts and have their own sleeping quarters while sharing the common areas with the pilots.

King Air pilots work 12-hr shifts, divided into day and night with day shifts beginning at 7:00 am and night shifts at 7:00 pm. Lynch says that the schedule is usually 7 days on, 3 off, 7 on, then 4 off.

Both aircraft undergo a phased maintenance in­spec­tion. The helicopter has a 50, 100, 400 and 800-hr inspection cycle. These occur in the hangar at BIL at the hands of Metro Aviation mechanics. King Air maintenance is handled by Edwards employees in their hangar at the opposite end of the airport.

The King Air has a 4-phase maintenance cycle which occurs each 200 hrs. This generally means that the aircraft completes an entire cycle in a calendar year. Each does its own minor and major maintenance work, although Edwards sometimes uses a local avionics shop when the need arises.

If the fixed-wing aircraft is down for maintenance, a backup King Air is available for use. If the helicopter is down, a Metro Aviation ship, located in Spokane WA can be used. Also, the other local hospital has 2 King Airs, so they assist HELP Flight in times of need. And, of course, HELP Flight often assists the other medical facility when its aircraft are unavailable.
Safety through avionics and management systems

The EC135, built and outfitted initially for 2-pilot IFR operations, has been retrofitted for single-pilot use and is typically dispatched with 2 medical persons—a nurse and a paramedic. But the IFR goodies remain, including a KLN90 GPS, soon to be replaced or augmented by a GNS430.

The chopper is fitted with ITT ANVIS 9 Pinnacle 4949-2 night vision goggles (NVGs). Coble cossets his 4 NVGs lovingly, noting that they are "just as good as the military is using." Not only does the pilot wear them—so does at least 1 of the medical personnel.

The EC135 has satellite tracking and ACARS-like text messaging. It is also equipped with a satellite phone. Soon to be installed, when room is found in the cockpit, is a helicopter terrain awareness and warning system (HTAWS).

The King Air is fully IFR equipped and, although only 1 pilot is required, St Vincent Healthcare requires 2. Generally, there will be 2 medical personnel on board, but more can be added in case of special needs. The aircraft has KLN94 GPS, an EX500 with traffic display, radar, ground proximity warning and UHF radios (solely for use by the medical staff).

In fact, HELP Flight uses an antenna on top of a nearby mountain to maintain communication with their aircraft in all but the furthest (or lowest) places in the region. But if out of contact via radio, the King Air crews can make a call on their satellite phone. All stations in the aircraft are linked to an intercom system with Bose headsets for all.

This is important so that medical crews can update the pilots on the status of their patient and the pilots can tell the crew about delays and other concerns. The unique thing about this King Air, Coble notes, is that it was built as a dedicated air ambulance. "It wasn't retrofitted like many other aircraft," he says. "This aircraft has dedicated mounts for almost every piece of medical equipment."

The King Air can be decked out for whatever mission on which it is needed to embark—swapping medical equipment is easy, giving the aircraft added versatility and functionality.

Five different levels of safety oversight are in place at HELP Flight, which uses a safety management system (SMS) for monitoring and tracking safety issues. The hospital system also has safety standards with which to comply. Edwards has its own program which includes a variety of SMS tools to help guide go/no-go decisionmaking and personal limitations.

Metro Aviation also has its own safety protocols and, finally, CAMTS has minimum safety requirements and standards with which to comply.

Whether it be a horse-related injury that leaves a rider stranded in the Absaroka Mountains, trauma due to an traffic accident on a remote stretch of Montana highway, or the unexpected arrival of a premature baby in a small town like Sheridan WY, HELP Flight will do all it can to get the patient to high-quality medical care as quickly and safely as possible.

When every minute can count, use of aircraft for medical transport can mean the difference between life and death. In the wide stretches between towns and medical facilities that exist in Montana and surrounding areas, HELP Flight is performing an essential service that can make all the difference.

David Ison has 25 years of experience flying aircraft ranging from light singles to widebody jets. These days he is an associate professor of aviation at Rocky Mountain College in Billings MT.


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