EMS Survey Comments

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"The industry has a number of issues it must address in order to prevent and minimize the
number of accidents. First, ground EMS and transferring hospitals need to be educated on
the utilization of EMS helicopters. Second, safety equipment such as NVG and TCAS should
be mandated on all EMS aircraft. Third, specific aircraft type should be mandated for
night operations. Only duel engine aircraft should be able to complete missions during night
operations. It is time that all involved in this industry force providers to take responsibilty
for their actions and lack of. Over the last decade the industry has become consumed by providers
more concerned about the bottom line instead of about patient transport and care."

1

"Training, Better Equipment and safety culture should be emphasized in EMS."

2

"There is no single answer to any of the questions. Multiple issues need to be addressed seperately and concurrently."

3

"I am a member of the FAASafety Team. We are interested in working with EMS operators to develop voluntary solutions that will increase safety in the industry."

4

"I think communication is key to safety. CRM, air to air communication and mandated reporting of
'helicopter shopping' are all parts of this safety culture. NVGs for VFR night operations should be
mandatory as should TAWS."

5

"My greatest fear is complacency and inadequate number of flights during orientation. We cannot
be strict enough in regard to air medical safety programs."

6

"I believe the number of helicopter stand alone companies is one of the true issues at hand. They
are driven by profits and will sacrifice safety, training and operate with under power aircraft
all in the name of money. In addition, they drop a program when the profit margins start to slow
down. The other issue is arrogance, believing nothing bad will happen on my watch."

7

"I think that complacency on the part of all of the flight crews (medical and pilot) is the biggest
cause of the crashes."

8

"The usage for air medical helicopters needs to be looked at closely. Referring facilities calling for
transport of, room air, hep lock with abdominal pain, that has been in the emergency room for
12 hours,  is not a reason to call a helicopter. Some services are flying patients to appease
the 'customer', without looking at the big picture."

9

"I think we need to look at the common denominators of all the EMS helicopter crashes.
They appear to be single engine, private for profit, night flights, Bell aircraft, high
competition."

10

"I feel the root to many of the problems in HEMS today are reflective of the culture we
have. Most think the culture is one of safety, however when the bottom line drives the train,
it causes derailments. Competitive pressure, pressure to fly, and lack of emphasis from the
top level that is believable are definite problems that need to be taken care of."

11

"Situational awareness and crew resource management should be emphasized. I realize
that the Pilot is the last stop in taking the flight, but the Crew opinion should be valued and there
should not be any pressure to not speak up."

12

"The number one thing that companies can do for themselves is to implement an NVG program
for night EMS operations. This will increase thesafety level at night exponentially. There is
nothing safer than being able to see where you are flying and landing, especially in the
locations that EMS helicopters operate."

13

"Safety is often stated as a priority, but the operational disconnect between medical
managers, and the flight staff (pilots and medical) when it comes to prioritizing training,
critical decision making, and pressure to fly."

14

"There does not seem to be any new ways to have an accident. We as an industry keep
making the same mistakes that we did 15 and 20 years ago. Equipment can only do so
much if we dont change our safety philosophy and attitude across the board from
the CEOs on down we will never stop having accidents. There is an underlying pressure
throughout the industry, both internally and externally, to fly. We need to stop calling
each other heroes and get away from this mentality. We are pilots who transport
medical teams, period. Heroes end up getting remembered on tombstones.

I believe that night vision goggles are probably the one tool on the market that
can have the biggest impact on safety in our industry today. If only the FAA would
get their act together and stop bickering amongst themselves as to the proper
implementation of this tool and aircraft configuration. But as with any tool it is
only as good as the training that goes into its fielding. Inadequate training will
surely equate to additional accidents.

NVGs are not the silver bullet though but can be a significant factor in improving
the accident rate in our industry. Training pilots to say NO and empowering them with
the right safety attitudes and philosophies, then backing them up when they say no is
the only way that we as an industry will impact the accident rate for years to come.

As is the separation and delineation between maintenance and operations under
part 135 so should it be between the medical the industry and operations. Too many times
important aviation decisions are being made by non-aviators with little or no input in
Washington from those that fly. This is becoming detrimental to pilots and seriously
impacting how aviation decisions are being made."

15

"Some HEMS pilots fly less than 10 hours per month. This is not enough flight time to maintain proficiency. Mandate that unless a pilot flies at least 30 per quarter, that he accomplishes a 1 hour
night currency/proficiency flight with his crew. The flight should include at least 3 off airport takeoffs and landings to simulate the typical HEMS flight profile."

16
"While I feel our program puts safety in the forefront, there are still times we feel pressured to try and make flights, or don't take the time to check if there have been other programs that have
turned flights down for weather,etc."

17

"When PHI had their mishap in Anderson IN, the crewmembers were brought to Meth hosp in Indianapolis. One of our medics was down in the room talking to the PHI medic when the PHI "staff" came in. They said "we (PHI) have to fly in wx LifeLine won't if we are to make our nitch in IN". In the past 5 years I have seen these guys do this kind of thing here in IN at least 5 other times. We can have all the rules and gizmos we want. If the rules have no teeth they are just words on paper."

18

"We need to sustainable economic model, a culture of safety & an effective SMS. We should look more closely at what the big European offshore operators havve done e.g.:
http://www.flightsafety.org/asw/may08/asw_may08_p12-17.pdf where they do control commercial pressure from their customers."

19

"Mandate NVGs! Benchmark HEMS programs with zero/low accident rates. Stop helicopter shopping once and for all! Improve low altitude & rural weather reporting."

20

"NVGs for any HEMS night flight. This is a mature and proven technology and the lack of NVGs in this industry is approaching criminal. I'm not buying the excuse that the military demand is causing a shortage. Where are they all going? There were certainly no shortages in my units.   Maybe foreign sales but not the US military.

Streamline the FAA's approval process for new technologies. Get them helping us rather than building empires and setting up more barriers.   We need more NVG Check Airmen in the field.

The perceived threat of local competition is at the root of just about every poor decision made in this business. From the CEO/Mgmt choosing equipment, training, compensation, and base locations, right
on down to the line pilot making go-nogo weather decisions.

Something must be done to stem this rabid competition in HEMS. It is not healthy in this particular sector. It hasn't improved the product, it has simply reduced the business to a "cheapest is best"
mentality and resulted in competing bases practically on top of each other. The quality of our aircraft, our training, and our hiring standards, have gone down over time. Not up. I realize that
"Certificates of Need" have their own problems but something similar really needs to be developed.

Serious pet peeve. Requiring additional paperwork/forms/matrices/notes from Mom will provide window dressing but will not help the pilots one bit. I guess it shows that we are "doing something" without cost to the operator, but additional, worthless tasks simply burden an already time burdened pilot more. One more thing to do before takeoff....while the Program Manager is standing there with her stopwatch."

21

"We need IFR training and the equipment to go with it. Simulator training at lease once a year.
Higher standard of pilots not just high hours."

22

"Feeling pressured or rushed to accept a mission is unacceptable. Especially from your own dispatch center. It is OK to take a deep breath or maybe referring the flight to your competitor. After all our business is all about doing whats right for the patient, not for personal gain."

23

"Lack of training - new people to EMS need some training in Landing Zones, how to evauluate best areas to land and how not to become rushed due to the nature of the business. The military is
very good at this. Many new pilots are civilian trained now and are not familiar with the different types of enviroments the EMS flying takes them. Suggest a specific card like the guys that do long lines to certify that they have been throgh a course that bridges this gap.   Anyone can learn to fly an a/c, but not everyone can do what EMS pilots are supposed to do, obviously."

24

"My company thinks safety is great as long as it doesn't cost money. Also, it would be nice not having someone looking over your shoulder every time you turn a flight down due to weather. We do not
have people that habitually turn flights down if the weather is good (or even fair). Babysitting is not necessary."

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