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Thursday, October 1, 2009

Beyond Regulations

By Joy Finnegan, Editor-in-Chief

I hadn’t wanted to write such a serious piece on my second month as editor. But the Washington Post series called "Fatal Flights" that was published at the end of August and the National Transportation Safety Board (NTSB) hearing on September 1 left me no choice.

If you are at all involved in helicopter emergency medical services (HEMS), you have probably already reviewed the NTSB recommendations to the FAA.

These recommendations include, among others:

  • developing scenario-based helicopter emergency medical services pilot training;

  • requiring implementation of a safety management system program;

  • requiring installation of flight data recording devices;

  • permitting the helicopter emergency medical services Aviation Digital Data Service Weather Tool to be used as an official weather product;

  • requiring installation of night vision imaging systems; and

  • requiring autopilots, and that pilots be trained to use the autopilot if a second pilot is not available.

The lead item in this month’s Rotorcraft Report section details a new approach that NTSB is taking in making safety recommendations to other agencies. This new approach includes tying operator reimbursement to a safety standard (see New Weapon in Aviation Safety Wars, page 10).

But remember, all of these are simply what they are termed: recommendations. There is no guarantee any of these will be regulated. Depending on who you ask, that can be a good thing or not. But this isn’t a discussion about how much regulation is needed. It is a discussion that goes beyond regulation.

The Post’s three-part series examined the "Deadly Cost of Swooping in to Save a Life," as the first article in the series was titled. If you haven’t read this series, I highly recommend it. Links to the series are on our Rotor & Wing Facebook page.

For the U.S. HEMS industry, 2008 was the deadliest year on record, with numerous accidents and 28 fatalities. In spite of that disturbing statistic, I believe it is important to note here that approximately 400,000 patients and transplant organs are safely transported by helicopter each year. And to those who do this important work I want to thank you for this amazing service.

Several areas of concern were highlighted in the articles. One of these is the practice of hospitals to "helicopter shop." Helicopter shopping means that if the weather is marginal and one transport group turns down the flight, the request is then made to another and another until someone says, "Yes, I’ll take the flight." Of course in this situation, the caller isn’t going to proffer the information that HEMS colleagues only miles away have already refused the flight.

This practice has been cited as a contributing factor in fatal crashes in several states. I ask you: is there a better way for the HEMS community to communicate amongst themselves about the conditions and whether or not they have turned down a flight, so that others nearby may take that information into consideration when evaluating their go/no-go decision? Could something as simple as a phone tree amongst close proximity operators be a low-tech way to improve the information on which you base your decision? You may counter that you would never share information with a competitor. Competition is fierce these days, but these are lives (including yours) we are talking about.

Another area of concern the Post article talks about is the pressure from within a company to accept a flight regardless of weather. It is hard to believe that in 2009, we are still talking about working environments where pilots are derided for making sound judgments. But apparently, there are still managers out there questioning their pilot’s judgment.

My advice to managers who would question pilot judgment is don’t hire someone you don’t trust. Managers of HEMS pilots need to leave the decision-making to their trusted pilot employees. My advice to any HEMS pilot who may be faced with this situation is to please find a more supportive working environment where, in addition to your piloting skills, your analytical abilities will be appreciated and rewarded.

The Post piece also played on emotions a bit in the second article in the series by highlighting some of the 28 people who died in 2008. This part of the series wasn’t schmaltzy, however. It did a good job of making the people who lost their lives that year real. Those people included patients, doctors, nurses and pilots.

One experienced HEMS flight department manager and chief pilot told me, "Journalists and politicians tend to be negative toward the civilian EMS helicopter business until they realize a personal need for such a service, when nothing else will do." It is rumored that one state got its initial HEMS fleet quite a few years ago as a result of a political personality there having had a family member need a medical helicopter when none was available.

The bottom line is we need HEMS. But we need operators using all available information, equipment — whether regulated or not — and their good judgment to decide when and if they will take off into the dark of night, in challenging conditions to an unimproved landing site, to save a life.

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