|
|||||||||||
|
|
|||
National
Transportation Safety Board |
||||
September 1, 2009
- This is a synopsis from the Safety Board’s report and does not include
the Board’s rationale for the conclusions and safety recommendations.
Safety Board staff is currently making final revisions to the report from which the attached conclusions and safety recommendations have been extracted. The final report and pertinent safety recommendation letters will be distributed to recommendation recipients as soon as possible. The attached information is subject to further review and editing. SUMMARY AND CONCLUSIONS |
||||
|
||||
Helicopter
emergency medical services (HEMS) operations provide an important
service to the public by transporting seriously ill patients and donor
organs to emergency care facilities, often from remote areas not served
by adequate facilities. These operations comprise an estimated 750
helicopters, 70 commercial operators, 60 hospital-based programs, and 40
government-operated, or what is known as “public,” operations.
These operations
are unique and complex, mixing highly advanced medical care with the
technical challenge of safely operating helicopters 24 hours a day. Each
year, approximately 400,000 patients and transplant organs are safely
transported by helicopter. However,
the pressure to conduct these operations safely and quickly in various
environmental conditions (for example, in inclement weather, at night,
or at unfamiliar landing sites for helicopter operations) increases the
risk of accidents when compared to other types of commercial flight
operations.
The NTSB has had a
longstanding concern of HEMS safety. In 1988, the Board adopted a Safety
Study, Commercial Emergency Medical Service Helicopter Operations, which
reviewed 59 HEMS accidents that occurred from 1978 through 1986.
From that study, the Board issued 19 safety recommendations to
the FAA, the National Weather Service, and two associations.
These recommendations covered issues of training and guidance,
operating rules, onboard equipment, industry coordination, and workload
and fatigue. The majority
of these recommendations have been closed acceptable action.
The late 1990s and
early 2000s saw a rapid growth of HEMS operations and the number of
accidents began to rise.
Prompted by this rise, the NTSB completed a special investigation report
on Emergency Medical Services Operations in January 2006.
This report analyzed 55 EMS accidents (41 of which were HEMS
accidents and 14 airplane |
Immediately
following adoption of the 2006 special investigation report, the number
of HEMS accidents decreased.
In calendar year 2006, 3 fatal HEMS accidents occurred with a
total of 5 fatalities. The
following year, there were 2 fatal HEMS accidents with a total of 7
fatalities, but in calendar year 2008, there were 8 fatal HEMS
accidents, with a total of 29 fatalities.
This was deadliest year on record for HEMS operations.
Prompted by this
recent rise in the number of fatal HEMS accidents, the Safety Board held
a 4-day public hearing this past February to address the issues
associated with HEMS safety. The hearing called upon 41 expert
witnesses, representing 8 HEMS operators, 12 associations, 6
manufacturers, and 4 hospitals. Additionally, several organizations had
an opportunity to question the witnesses directly. These parties, who
were designated for their technical expertise in their respective
fields, were the FAA; the Helicopter Association International (HAI);
the Association of Air Medical Services; the Professional Helicopter
Pilots Association; the National EMS Pilots Association; Air Methods;
and CareFlite. A complete summary of the public hearing testimony, all
of the exhibits, and the entire written transcript can be found on the
NTSB’s web site.
As a result of the
hearing, the NTSB identified the following safety issues:
* Pilot Training
* Collection of
Flight Operations Data
* Use of Flight
Recording Devices and Data
* Safety
Management Systems
* Weather
Information
* Use of
Autopilots or Dual Pilots
* Night Vision
Imaging Systems
* Reimbursement
Rate Structures
* Federal Policy
and Guidelines
RECOMMENDATIONS
The NTSB is
issuing the following safety recommendations:
To the Federal
Aviation Administration
1. Develop
criteria for scenario-based helicopter emergency medical services (HEMS)
pilot training that includes inadvertent flight into instrument
meteorological conditions and hazards unique to HEMS operations, and
determine how frequently this training is required to ensure
proficiency. (A‑09-XX)
2. Once the
actions recommended in Safety Recommendation (1) are completed, require
helicopter emergency medical services pilots to undergo periodic
FAA-approved scenario-based simulator training, including training that
makes use of simulators or flight training devices. (A‑09-XX)
3. Require
helicopter emergency medical services operators to implement a safety
management system program that includes sound risk management practices.
(A-09-xx)
4. Require
helicopter emergency medical services operators to install flight data
recording devices and establish a structured flight data monitoring
program that reviews all available data sources to identify deviations
from established norms and procedures and other potential safety issues.
(A-09-xx)
5. Require
helicopter emergency medical services operators to report activity on at
least an annual basis to include total hours flown, revenue flight hours
flown, revenue miles flown, patient transports completed, and number of
departures. (A-09-xx)
6. Permit the
helicopter emergency medical services Aviation Digital Data Service
Weather Tool to be used by helicopter emergency medical services
operators as an official weather product. (A-09-xx)
7. Conduct a
systematic evaluation and issue a report on the requirements necessary
for a viable low-altitude airspace infrastructure that can accommodate
safe helicopter emergency medical services (HEMS) operations. The
evaluation should consider improved collection and dissemination of
weather data, the role of automatic dependent surveillance-broadcast,
approaches to helipad and designated landing zones, and integration into
the National Airspace System. Include in the evaluation process HEMS
operators, related industry associations, and hospitals, among others.
(A‑09‑xx)
8. Once the
evaluation and report as recommended in Safety Recommendation (7) are
completed, initiate action to develop this infrastructure. (A-09-xx)
9. Require
helicopter emergency medical services operators to install night vision
imaging systems and require pilots to be trained in their use during
night operations. (A-09-xx)
10. Require
helicopters that are used in emergency medical services transportation
to be equipped with autopilots, and that the pilots be trained to
use the autopilot if a second pilot is not available. (A-09-xx)
To Public HEMS
Operators
1. Conduct
scenario-based training, including the use of simulators and flight
training devices, for helicopter emergency medical services (HEMS)
pilots, to include inadvertent flight into instrument meteorological
conditions and hazards unique to HEMS operations, and conduct this
training frequently enough to ensure proficiency. (A‑09‑xx)
2. Implement a
safety management system program that includes sound risk management
practices. (A‑09‑xx)
3. Install flight
data recording devices and establish a structured flight data monitoring
program that incorporates routine reviews of all available sources of
information to identify deviations from established norms and
procedures. (A-09-xx)
4. Install and
require that pilots use night vision imaging systems for visual flight
rules operations at night. (A-09-xx)
5. Equip
helicopters that are used in emergency medical services transportation
with autopilots, and train pilots to use the autopilot if a second pilot
is not available. (A-09-xx)
To the Federal
Interagency Committee on Emergency Medical Services
1. Develop
national guidelines for the use and availability of helicopter emergency
medical transport by regional, state, and local authorities during
emergency medical response system planning. (A-09-XX)
2. Develop
national guidelines for the selection of appropriate emergency
transportation modes for urgent care. (A-09-XX)
To the Department
of Health and Human Services’ Centers for Medicare & Medicaid Services
1. Evaluate your
existing helicopter emergency medical services (HEMS) reimbursement rate
structure to determine if reimbursement rates should differ according to
the level of HEMS transport safety provided. (A-09-XX)
2. If the findings from the evaluation conducted in response to Safety Recommendation 1 reveal that higher levels of reimbursement are required to increase the level of safety, establish a new reimbursement rate structure that considers the level of helicopter emergency medical services transport safety that is required. (A‑09-XX) Medical Helicopter Goes Down Killing All On Board |
Other News Stories |
©AvStop Online Magazine Contact Us Return To News |
|