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Will a Tragedy Spur Change?


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#1 Spike

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Posted 07 November 2014 - 09:21

I would appear the FEDs are beginning to identify the shortcomings of (some) public safety operators…… The question is; will it spur a change in the culture before the next tragedy?


http://alea.org/publ...ase.aspx?i=2266

 



#2 aeroscout

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Posted 08 November 2014 - 13:46

Risk assessments are nothing more than eyewash. I know it has been for the companies I have worked for that have them. 

Rescue helicopters are a double edged sword. Most often the rescue helicopter is the rescuee's last chance to survive. Sometimes the risk the rescue helicopter takes to rescue is one risk too much and that will never be legislated away.


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#3 Goldy

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Posted 08 November 2014 - 20:32

Most often the rescue helicopter is the rescuee's last chance to survive. Sometimes the risk the rescue helicopter takes to rescue is one risk too much and that will never be legislated away.

I would say, sometimes the rescue helicopter is definitely a life saving tool, but not many of the calls. Many times its just easier transport, or a way for the agency to log a call and show its importance to the budget makers. Many calls that I am on, I feel it would be a lot safer to do a ground rescue than an air rescue. (Lost hiker, no injury, at night, in the mountains, with goggles, high winds.....why risk it?)


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#4 Auto-Rotation-Nation

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Posted 11 November 2014 - 18:24

This has gotten me thinking since we have an almost 100% private helo fleet in the area of emergency response down here in Texas. Is the flight risk assesment something that really is only lacking in the public side right now or are the contractors such as those we use around here of the same mindset, rushing into situations where full consideration of loss vs. reward isn't made prior to launch. I know the mindeset of alot of the guys flying EMS privately around here lines up with the aviators behind the badge as well so is the difference in how private companies are training their pilots or are they really in the same boat and this investigation just isn't of a wide enough scope to include them? Just food for thought. I should also note that the majority of our EMS flight launches, even in poor weather, require somewhat less involved flying than the SAR type missions mentioned in the report.


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#5 SBuzzkill

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Posted 12 November 2014 - 09:24

I had a whole big thing written out but in the end most risk assessments are a paper drill and nothing more.

Edited by SBuzzkill, 12 November 2014 - 11:46.

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#6 Matt321

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Posted 12 November 2014 - 14:13

I'm with Goldy. I did a decent amount of hoist rescues while the Army's MAST program was still in effect (military assistance to safety and traffic) stateside. None of the civilian operators were willing to assume the risk of a hoist rescue. Unfortunately, as Goldy mentioned, most of the people we rescued were not at that life or death moment - most would have just taken a huge amount of time and manpower to safely get them out of the area they were in and we were the easy (and free) alternative. Fortunately we never had an incident (during a rescue anyways).



#7 Auto-Rotation-Nation

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Posted 12 November 2014 - 17:00

Matt, you bring up a really interesting point, the majority of the time I have heard or seen hoist resuces implemented it was to expedite the removal but without a level of injury which might justify the expedited nature. What public agencies are there that do hoist rescues?  LASO and Miami-Dade FR are the only public agencies that work in hoist out situations that I have ever known of.


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#8 Wally

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Posted 12 November 2014 - 17:46

Matt, you bring up a really interesting point, the majority of the time I have heard or seen hoist resuces implemented it was to expedite the removal but without a level of injury which might justify the expedited nature. What public agencies are there that do hoist rescues?  LASO and Miami-Dade FR are the only public agencies that work in hoist out situations that I have ever known of.

Georgia State Patrol does hoists as well. Not certain if they consider it 'rescues' or just in the best interest of those hoisted.

As a former working lifeguard (80 lbs and 45 years ago) I kinda consider "rescue" to be an 11 o'clock news term, along with "plummeting", "fiery", and idiot witness statements. Mostly,folks just doing the job as best they can.


Edited by Wally, 12 November 2014 - 17:49.

Just a pilot (retired, so I have a LOT of time)...


#9 helonorth

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Posted 12 November 2014 - 21:09

The thread seems to have lost its intent. It's not about the justification: it's that some of these rescue units are not adequately trained and do not have the right equipment to handle to mission. Am I right? If you don't have proper training and equipment, regardless of whether you think risk assessment is beneficial, it won't matter.



#10 ospreydriver

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Posted 12 November 2014 - 22:37

Partially true.

 

However, having good risk controls based on your unit's capabilities and readiness makes for better decision making.

 

A crisis is not a good time for human beings making decisions. Everyone always wants to be "can-do" and get the mission accomplished. Having rules or decision matrices worked in advance allows more rational decisions to be made.

 

Not every unit can be equipped and trained for everything. That's not ideal, but it's a fact that will always be there, government, military, or civil.

 

A unit that has the right equipment and training can do water rescues at night with less than 1000/3. Its risk matrix may be a "go" for that. One that doesn't have doppler hover might only be allowed to launch that same mission in day VMC. One without any of that might say no altogether.  That call can't be left to some poor duty pilot at 2am. If he's anything like most pilots, he'll find a way to make it happen.  That's not the right way.  It needs to be figured out ahead of time.

 

Risk management poorly done is administrivia and a paper drill.  Properly done, it save lives.


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#11 Spike

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Posted 13 November 2014 - 01:35

It would appear the point was missed altogether…..

 

Amongst the usual suggested improvements regarding safety systems mumbo-jumbo are a few glaring statements which point to management deficiencies contributing to the crash. If you’ve been in the public sector for a while this is nothing new, although new for the NTSB to identify these deficiencies as a contributing factor….. Such as….

 

The Board concluded that DPS had a “punitive culture that impeded the free flow of safety-related information and impaired the organization’s ability to address underlying safety deficiencies relevant to this accident.”

 

The recommendations also state to “hold senior state personnel accountable for the safety of state law enforcement aircraft”…. Again, for public safety operators, this is HUGE…….


Edited by Spike, 13 November 2014 - 01:36.

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#12 helonorth

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Posted 13 November 2014 - 07:17

 “hold senior state personnel accountable for the safety of state law enforcement aircraft”

 

That may make public operators (such as states and counties) get out of the SAR business. For most of them, that would probably be a good idea.



#13 Flying Pig

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Posted 13 November 2014 - 09:11

Matt, you bring up a really interesting point, the majority of the time I have heard or seen hoist resuces implemented it was to expedite the removal but without a level of injury which might justify the expedited nature. What public agencies are there that do hoist rescues?  LASO and Miami-Dade FR are the only public agencies that work in hoist out situations that I have ever known of.

LASO and Miami Dade are the only agencies you've seen who do Hoist rescues??? This isn't a business you are familair with is it?.

Edited by Flying Pig, 13 November 2014 - 09:13.


#14 Flying Pig

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Posted 13 November 2014 - 09:22

Just off the top of my head on agencies who do regular hoist work.....

CALFire, CHP, SD Sheriff, SDPD, Riverside SO, Orange County, LA County, San Bernardino SO, Ventura, Santa Barbara SO, Kern SO, Placer SO

NV: Washoe county and Vegas Metro

AZ you have Pima SO, Pheonix PD, Maricopa SO

WA you have Snohomish County SO

TX you have DPS, Austin Star Flight, San Antonio PD (I think has a hoist.)

FL : Seminole SO, Hillsboro SO, Miami Dade, Broward SO

VA has the VSP, I think VA Beach PD has one

MD has the MD state police and Baltimore County PD.

This list goes on and on. Those are just depts I typed out siting here over coffee. And that's really just LE agencies, not even fire depts.

Edited by Flying Pig, 13 November 2014 - 09:29.


#15 aeroscout

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Posted 13 November 2014 - 11:16

I had a whole big thing written out but in the end most risk assessments are a paper drill and nothing more.

You are right, but I would have loved to see the whole big thing you had written out.



#16 Spike

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Posted 13 November 2014 - 11:42

Nor was this thread about hoist ops, however, lots of LE agencies may have hoists but how many actually use them, and/or, use them properly…….
 
During hurricane Katrina, it was common for the TV news to show multiple helicopters hoisting stranded victims from rooftops. Soon thereafter, hoists began to flood into the LE sector…. How does that happen? My suspicion is; either the non-aviation upper managers saw the images on TV and implemented programs for their units in order to be the “big fish” on their blocks or, eager line personnel saw the opportunity and convinced (i.e. hoodwinked) the non-aviation upper managers to purchase hoists…. The glaring issue was; hoist operations during Katrina were done by medium and heavy twin-engine helicopters. From my understanding, light singles were prohibited from performing such operations during Katrina. Unfortunately for some, the non-aviation manager couldn’t tell the difference and jumped into the deep end….

Yes, SDPD has hoists. They’ve only been used for training and have sat on the hangar floor for years. At 250-300K per copy, someone should have to answer…….

As for Risk Assessments……..

If I conduct the same mission, in the same aircraft, with the same crew, in the same environment, day-in-and-day-out; does that constitute a “risk”….

Risk assessments produce a false sense of reality……

Edited by Spike, 13 November 2014 - 11:48.

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#17 Auto-Rotation-Nation

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Posted 13 November 2014 - 16:51

LASO and Miami Dade are the only agencies you've seen who do Hoist rescues??? This isn't a business you are familair with is it?.

I'm a 20 year old aviation buff with a Fire-Rescue background so no, I'm not. I know of LASO and MDFR becuase I have seen their ops publisized, Here in texas there isn't much hoist work and I haven't had a reason to go looking for who does hoists. I also intended that as those who do it on a regular basis and train properly, not an all inclusive list by any means. Never intended this to digress the whole thread.


Edited by Auto-Rotation-Nation, 13 November 2014 - 16:52.

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#18 Mikemv

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Posted 14 November 2014 - 10:49

As a member of the USHST Safety & SMS committee, I am exposed to industry standard and best practices. 

 

Using a Flight Risk Assessment Tool (FRAT) is a best practice only if it is considered a hazard and risk identification exercise to be addressed by the PIC for sound decision making and not to accomplish getting a numerical value in a color coded zone. Different day/mission -same number/color and all could be different hazards or risks! PICs need to make sound decisions.

 

What most FRATs are missing is a Mitigation factor of the identified risks.

 

I have created a FRAMT, (Flight Risk Assessment/Mitigation tool) that is being tested/applied at the flight school level bringing this Best Practice to Pilots in Training. R&W mag has done an article that will appear in the Dec. or Jan. issue about the school and its SMS Safety Culture which includes a FRAMT.

 

Our USHST SMS committee has determined from data that upper echelon officials and managers in the law enforcement sector are far removed from daily flight operation and risks associated with them in the areas of knowledge and management. 

 

This is not the first time that the NTSB has concluded that State officials had a dangerous perspective on risky operations. New Mexico State Police were cited for their perspective on Can do/Must do flight operations. The A109 rescue/crash some a few years ago demonstrated this. 

 

Mike


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#19 Spike

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Posted 14 November 2014 - 16:33

Hi Mike!

The saying goes; the good news is; we haven’t found new ways to crash helicopters… The bad news is; we keep crashing helicopters in the same way…..

In my opinion, we (the industry) attempt to address the problem with a shotgun approach rather than a sniper rifle….. For example, I have completed approximately 250 FRATs (with mitigations) over the past year while conducting multi-mission operations (LE, Fire, EMS – day & night). During that time period, roughly 98% of the assessments ever reached beyond “low”. With that said, some would say, we’d need to adjust our values to better reflect the associated risk…. Those who I classify as “some” are the risk adverse and/or non-aviation bean-counters that posture themselves as subject “matter experts” and, represent my earlier comment about the “false reality”. Even so, perception cannot reduce risk and something that can’t be assessed by those who do not operate in the environment (environment meaning the total operation). This is where “Tacit Knowledge” comes into play and why a FRAT has no value when it’s applied to what is already expected of you as a professional pilot…… To wit, our (with emphasis on OUR as what my organization requires) has “IFR Qualified” as a mitigation factor…. NONE of our pilots are “IFR Qualified” (nor are our aircraft IFR certified). I also have a factor which states; “PIC less than 500 hours in type”. I have more than 500 hours in type so why am I required to have this factor on my assessment? The reply: “it’s the standard form”…. i.e. shotgun!!!! POW! Again, the reality is; non-applicable factors on the form which do not apply directly to ME, skew the overall total values making the FRAT useless……

Either way, I was hired and trained to do a particular job. As long as that job remains within the daily operational envelope, why would a FRAT be necessary? IF, I say again, IF an operation required me to go beyond and/or outside the “normal” envelope, then by all means, start assessing, with the understanding the assessing is for ME as PIC and based in tacit reality. Not perception, opinion, conjecture, fear or aversion……


Edited by Spike, 14 November 2014 - 16:37.

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#20 Mikemv

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Posted 15 November 2014 - 06:46

Spike,

 

Good post, and I agree. 

 

The check the boxes, get a number in a color zone is useless unless the PIC accepts their responsibility to perceive, process and perform. 

 

A PIC that has ingrained decision making skills and is dedicated to using them before and during the flight can be the greatest factor in accident avoidance.

 

USHST members realize that a FRAT or FRAMT is better than nothing for pilots that do not have the established Hazard and Risk ID habits if they realize its purpose.

 

One of the largest accident causal factors is the change in elements of the flight after launching where the PIC does not apply established decision making skills and experience. Changes after launching can negate a FRAT/FRAMT but the PIC may feel safe because of the FRAT.

 

USHST feels the value of a FRAT/FRAMT is not in checking the boxes but in developing pilot head working skills in Risk Management for the PIC to use with authority. Perception and recognition is the value, not the numerical value or color code.

 

We should all think and act as PICs, use the offered tools but always use our head working skills for the situation at hand. Management is not sitting in the aircraft and exposed to the hazards and risks, if they were, they would want you to make decisions to protect them. This is what we have been calling "Protecting the Sacred Trust". The trust that passengers place in the PIC to transport them safely is the PICs primary responsibility. 

 

Best wishes,

 

Mike


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