Over the past year 28 people have died in EMS (emergency medical services) aircraft crashes. The industry is experiencing one of the worst accident rates in its history. Solving this problem is a complicated issue for sure, however I have some very basic thoughts on how this problem can be fixed.
Flying an EMS helicopter was some of the most demanding flying I have done. Flying at night and landing on streets or other confined areas, having to make quick weather decisions sometimes with little information available, and having to block out the pressure to fly. Yet many EMS helicopter pilots receive the minimum amount of required training.
Conversely, when I flew a corporate helicopter it was normally airport to airport or heliport. The occasional off-airport landing was performed, however it was planned and I had plenty of time to assess the area. This was far less demanding and risky than flying an EMS helicopter. Yet, it was also where I received the best and most consistent training. We had the time and resources available to practice our skills and FlightSafety training every six months.
Corporate helicopters are not expected to make money and the person who has the authority to cut training expenses normally rides in the back. That’s a strong motivator to ensure that the pilots know what they’re doing. EMS helicopter operations by contrast need to make money and that means keeping a close eye on costs. Also, because of the competitive bid process hospitals use when selecting vendors, margins are thin. Training costs come right off the bottom line. If a vendor increases its training costs and the others do not, then that vendor is at a competitive disadvantage. Hospital-owned programs are also in business to get patients to their hospital and make money.
To level the playing field, I think two requirements are needed. The first is more frequent and comprehensive training. Not just training in maneuvers but scenario-based training that addresses issues such as crew coordination, judgment, and accident chains to name a few. Additionally, more IFR and inadvertent IMC training, even for VFR-only programs, is needed. Pilots need to be very comfortable initiating a climb and not descending if they get caught in bad weather.
This type of training can be done in simulators. Simulators are not only good for showing pilots how to do things correctly, but can also show how quickly a bad decision can degenerate into a serious problem. That’s a powerful learning tool.
Second is better equipment, such as terrain avoidance and warning systems and night vision goggles. In addition, important in adding new equipment is providing the appropriate level of training on how to use it effectively.
Another issue that should be addressed by the industry is pilot salaries. I have known many very good pilots that have left EMS for better paying jobs. This has made EMS a steppingstone for pilots to get to something better. EMS flying requires a very specific skill set and experience level. It should be the job that pilots aspire to get. Higher salaries will keep turnover down and keep experienced pilots in the industry.
I realize that all of my solutions cost money and that some operators will claim they cannot afford these programs. That is why training and equipment should be mandated for everyone who wants to operate an EMS helicopter. The difficult part is figuring out how the industry will get there.
The FAA has tried the quick and inexpensive solutions and they do not work. Case in point is the risk assessment matrix. Three years ago EMS pilots began filling out a questionnaire before each flight to determine a score that related to a risk level. The accident rate has gotten worse in the last three years.
As with most things in life, to get the best results one needs to spend the effort and money required. Cheap solutions are just that.
Tags: Tim McAdams