Autopilots and EMS safety

September 23, 2009 by Tim McAdams

The helicopter EMS industry has been suffering through the worst accident rate in its history. In fact, according to the NTSB, 2008 was the deadliest year on record with 12 accidents and a total of 29 fatalities. As a result, the NTSB has held hearings earlier this year and issued recommendations to the FAA. In a list of additional recommendations issued by the agency this month was the use of autopilots and improved pilot training.

I have flown an EMS helicopter both with an autopilot and without and I believe it is an excellent workload-reducing tool. It can also enhance safety, as many helicopter pilots are reluctant to climb into the clouds. When faced with deteriorating or unexpected bad weather, many helicopter pilots will descend to avoid entering IMC. Understandably, this comes from a lack of experience and confidence at controlling a minimally equipped helicopter on instruments, trying to contact ATC, and setting up for an approach. Moreover, adding to the urge to descend is the fact that helicopter pilots know if they can recover back to visual conditions they can always land. However in many cases it is much safer to climb.

In a 2006 report the NTSB said HTAWS (Helicopter Terrain Awareness and Warning Systems) might have helped pilots avoid terrain in 17 of the 55 accidents analyzed. However, when a pilot receives a terrain warning he or she needs to be comfortable climbing if necessary and an autopilot can be a big help.

The NTSB report also calls for improved pilot training. Training pilots to engage the autopilot, initiate a climb, contact ATC, and set up for an instrument approach will give them the confidence to use that option when appropriate. Autopilots, HTAWS, and other advanced technology tools for enhancing safety must be accompanied with the proper training to be truly effective. With the recent advances in computer technology, helicopter simulation has become realistic and less expensive.

I believe the NSTB has done a good job identifying some solutions that might truly help reduce the accident rate.


  • Ehud Gavron

    Tim, as always you bring great freshness to the perspectives on this profession. For those of us who do not have auto-pilots would you mind detailing what the auto-pilot does? Obviously ANYTHING that reduces pilot workload is good… but I’m curious as to what those things are.

    (Rotorcraft private pilot. Working on Instrument rating.)

  • Avi Weiss

    Hey Ehud;

    Since Tim hasn’t responded to your auto-pilot query, I’ll fill in with some info.

    An autopilot is an electromechanical system that enables the aircraft to “fly” itself, with little or not physical “control” input from a human pilot. Autopilots come in many flavors, from the very simple “wing-leveler”, which merely levels and maintains roll orientation of the aircraft, all the way up to fully-redundant six-axis (roll, pitch, yaw, altitude, navigation, vertical speed), with auto-throttle, and even auto-land (CAT IIIC), capable of taking the aircraft from taxi-out to landing with almost no pilot intervention.

    Conceptually, an autopilot is able to exercise aircraft control by receiving orientation information from pitch and roll instruments (mechanical or solid state), process that information, and manipulate flight control (and in some installations, power control) to maneuver the aircraft via servo driven cable that are connected to flight controls. Additionally, many autopilot are capable of accepting altitude information, as well as heading information from navigation equipment, and maneuvering the aircraft to fly a specific course and altitude.

    Implementation of autopilot in fixed wing and rotary wing aircraft differs significantly in the system details (and complexity in terms of being able to maintain orientation in a helicopter), but the principles described above are shared by all autopilot systems. There is a lot of great info on the web regarding autopilot functionality and systems.

    Hope that helped.

  • Avi Weiss

    Hey Tim;

    Concur on autopilot use for EMS. In fact a friend of mine who flew a lot of EMS and I had many discussions about how to lower the accident rate. Here are some of the things we came up with:

    The lack of a industry-sponsored “standardized” EMS certification program coupled with the wide range of mission types flown, and financial constraints and motivations, has undoubtedly led to the abysmal safety record we currently face. The tour industry suffered from this problem prior to creation of “TOPS”. What is needed is a industry-designed and driven EMS certification program (e.g. ESP – EMS Safety Program) that will bring a standardized “baseline” to each type of EMS operation, both in terms of aircraft capabilities and pilot/crew training.

    Pushing for the highest level of aircraft capabilities and pilot experience and training will meet resistance from the community who are trying to protect their financial interests, and could result in nothing being accomplished. So the certification program could be divided into levels, with each level predicated on mission type, starting from the “lower risk” operations and working up to the “high risk” operations, much in the same way ratings are used in aircraft and airman certification. Potential certification levels could be as follows: 1. Inter-facility transfers, airfield transfers only 2. Inter-facility transfers, one or more facility helipad stop 3. Scene call – day VFR only 4. Scene call – day/night VFR only 5. Scene call – day/night, IFR.

    Each of these increasing levels would require specific aircraft and airman training requirements be met before the operator would be “certified” to operate under “ESP” for a particular mission type. The industry would come up with the levels, aircraft requirements (multi-engine, SVS, dual crew), and crew training programs, and the FAA could promote it as a “highly recommended” safety program, stopping short of issuing any regulatory material to see if self-certification works like it did for TOPS. Having a well-publicized program sanctioned by insurance companies, the FAA, and hospitals, would push operators to participate in the program, or lose business to those operators who do participate.

    Hopefully, some of these thoughts are shared by more folks and will gain traction with the community at large…

  • Ehud Gavron

    Avi, thank you! I’m extremely curious how a 3-axis auto-pilot works in a heli.

    Tim: s/NSTB/NTSB/…


  • Jon S

    I’d be interested to hear from some experienced EMS pilots who have been in a situation with deteriorating weather and decided to go IFR (Tim?). I’m not involved in HEMS, but my outside perspective is that regulations are a bigger deterrence to pilots wanting to climb into clouds than lack of autopilot. If a pilot did want to climb into clouds, but wasn’t already IFR, then it would technically be a violation. You don’t want to go into the clouds for fear of a violation; yet, if you’re so low that you’re worried about terrain, then you also don’t want to wait several minutes for a clearance. Plus, there’s always a risk of not being able to get that clearance. So do you declare an emergency and then climb into the clouds? Despite 91.3(b), the FAA has suspended pilots when poor decision making has created the emergency situation which led to the violation. It’s better than CFIT, but I’d be very hesitant to climb into the clouds, too.

    One solution would be to make all EMS operations IFR, but that would eliminate the flexibility and rapid point-to-point service that is HEMS’ sole advantage. Part of that problem is the lack of IAPs to hospital pads, so going into the clouds may mean that you wouldn’t be able to deliver the patient to the destination, and the mission would be a failure. IFR infrastructure is also nonexistent at a scene, so even if the hospital pad did have an approach to come in IFR, you still can’t go out IFR. Until regulations and infrastructure change to make IFR more attractive for HEMS operations, I think HEMS pilots won’t be climbing into the clouds no matter what equipment they have.

    So, are HEMS pilots generally able to obtain a pop-up clearance? When they do, are they still able to make it to the scene or hospital, or is that an automatic abort?

  • Tim McAdams


    Excellent point and some very good questions. In fact, I am going to make it the subject of my next blog (should post early next week) because I think it will generate some discussion and good comments with different perspectives. Please let me know what you think after you read it.


    Thanks for the really good autopilot explanation. I like it when others comment like that so readers are able to hear different perspectives. My company (Sagem) manufactures helicopter autopilots so I am preparing a more detailed description of how the servos work for a future blog. In the meantime to address Ehud’s question about the third axis: it would use a servo(electromechanical actuator) to control the tail rotor to maintain trim. Also, helicopters have a four axis system that controls the collective. There are systems that will auto-hover as well.

    Thanks to everyone for reading and commenting.

  • Avi Weiss


    Glad to help. Concur on “reader participation” adding flavor, especially in relatively smaller venues like helicopter blogs. Would be great to begin to start cross referencing your blog topically, so can begin to serve as a “working reference” manual.


    Concur on IFR, but as with most aviation operations, mission flexibility and safety concerns are inversely proportional. This is why I had mentioned having classifications of missions, and requiring specific training and equipment for the different classifications. I realize NO system of classification and training will protect crews and aircraft from poor decisions or judgment calls, but hopefully this will greatly reduce the variability in such decision making and enable crews to better determine whether flights can be made safely.

  • shock absorbing lanyards

    Safety is the number one concern at work, home, school and play. You should feel yourself comfortable in any weather and conditions!!!

  • Mike

    I fly an EMS helicopter with a great autopilot system. Above 500 feet all the pilots use the autopilot. It enhances safety and frees the pilot work load allowing him to scan for traffic, monitor radios, check weather, etc. The autopilot can couple up with an ILS and fly the approach to 65 feet and level itself off and fly the centerline of the runway. It enhances safety. We also have TAWS, TCAS, NVG’s, and airborne weather radar. All these items enhance safety when they are used. Some companies that fly single engine helicopters can not afford to install all these items. The added weight and cost would render the helicopter useless. It always comes back to the judgement of the pilot who should never be pressured into accepting a flight based on Medical crew pressure or money considerations. You have to change the mind set and culture of the EMS community. Safety first.

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