How to save lives in EMS

[Gomer Pylot]

There is a major problem with H-TAWS and autopilots for light single-engine helicopters. They don't exist. Work is being done on getting manufacturers to offer them, but getting them developed and then STC'd takes time. A lot of time. I know that an autopilot has been under development for several years, but it won't be available for several more, and then it will take even more years to get the fleets equipped. IMO having an autopilot is one of the more pressing needs for HEMS, and it would save many of the lives lost to weather. But none of us can expel one from our anal orifice and have it magically working.

[Wally]

Rupert: Can you point me to some data regarding 2-pilot crew safety?

 

Gomer Pylot: "Autopilots" (at some level of capability) are available for the AS350, I was speaking with a fellow pilot the other day who'd flown one so equipped in my company's fleet.

 

Increasing capability through added technology almost always comes with more complexity or operator's accepting greater risk exposure. Twins crash with systems- even power- management issues; autopilots have put more than one aircraft in the dirt; even NVGs come with known issues. A previous employer allowed offshore XC in a VFR twin at 300 & 2 when a single was limited to 500 & 3, and A021 allows aided night XC at 1000 & 5 when unaided is 1500 & 5. Not knocking added tech capability, but it comes with training and proficiency issues while tempting one to extend your reach beyond your grasp. When you get to the limit of technology and you're still short of destination, you can be in a deep hole.

[helonorth]

There also has been an auto pilot available for the 407 for many years.

[Rupert]

Wally asked, "Can you point me to some data regarding 2-pilot crew safety?"

 

Unhappily, today I can't. I have retired the computer that has the data and references. I still have the computer in the garage and it works, but I don't have the time and energy to hook it up today. A lesson to me about transferring files to new computers.

 

In any event, I can share some things from memory and I can get the references from the person who collaborated with me on (hired me to do) a study dealing with single vs two-pilot operations.

 

 

Almost all of the data we have today, regarding two-pilot vs single-pilot operations, comes from the 1980's. Various authors continue to use this data without referencing the dates of the studies. The raw numbers from these studies still have usefulness; however, the structure and organization of the data tends to mislead. Definitely tends to mislead.

 

A casual reading of the data would reinforce the reader's preconceived beliefs in the superiority of two-pilot operations over single-pilot operations.

 

A deeper study, though, in which the reader compared similarly trained and certified pilots, who have similar recency of experience, and who engage in similar operations, all correlated to specific phases of flight, would reveal a dead heat between single-pilot and dual-pilot operations.

 

I apologize for not having the references and links at hand. If this conversation continues in this vein, I will find the data and post it here.

 

For the record, I presently begin my 44th year of flying helicopters. I have 28 years of continuous EMS experience, with the rest of my time spread out among the usual things helicopter pilots do. That said, I have spent most of my time in twin-engine single-pilot IFR operations. I presently work a DOD SAR two-pilot contract alternating between a 212 and a 412.

 

In my studies of two-pilot accidents, I have come away with the thought that the two pilots in almost every case did it to themselves. Mis-communication, dysfunctional relationships and mutual reinforcement of a bad idea have lead to accident after accident.

 

A single pilot with a good autopilot cannot mis-communicate with himself, cannot have a personality conflict with the autopilot, and cannot get permission from an autopilot to do a bad thing.

 

Back before they started locking cockpit doors on the airlines, I would sometimes identify myself to the regional pilots and they would give me a headset and let me hang out with them during the flight. I saw more than one dysfunctional relationship and more than one checklist read out loud for the Cockpit Voice Recorder, but out of sync with actual events.

 

In my present job, I often fly with younger pilots who have recently worked their way up out of the various off shore oil field jobs around the world. They report their previous two-pilot operations as single-pilot with a standby pilot in the cockpit. In my own experience, every pilot with whom I fly, whether PIC or SIC, creates a new dynamic. No two pilot pairs do the job the same as another pilot pair. For those who doubt this, I recommend "Fate is the Hunter" by Ernest K. Gann (a GREAT read).

 

I would also point out that the safest aircraft in the world, for many years, the Bell 206, has only one engine and one pilot. The Bell 206 does the most dangerous work imaginable under the most difficult conditions, with a single pilot.

 

As for safety statistics, so much depends on the structure and organization of the statistics as to make them largely useless; and any conclusions made from them accidental and arbitrary.

 

For example, when compared to bus, rail, van, car, foot, and water travel, air travel comes in a distant seventh in safety...when compared on the basis of NUMBERS OF JOURNEYS.

 

When compared on the basis of HOURS TRAVELED, air travel falls to third safest mode of travel; and, when compared on the basis of DISTANCE TRAVELED, air travel reveals itself as the safest mode of travel.

 

When we look at EMS accidents on the basis of accidents reported in the media, EMS helicopters don't look so good.

 

If we look at EMS accidents on the basis of HOURS FLOWN, they look better, but not as safe as we perceive General Aviation and the Airlines. Frustratingly, though, we don't know how many hours EMS helicopters fly. No one knows. Several organizations guess at how many hours EMS helicopters fly, but no one knows.

 

The comparison of EMS helicopters to General Aviation and the Airlines gets much better when we compare them on the basis of numbers of take offs and landings. EMS helicopters have many more take offs and landings (meaning flights) per hour than do their General Aviation and Airline counterparts. We don't know how many flights EMS helicopters have per year, but we do know that they have a greater number of flights per flight hour than do General Aviation aircraft and the Airlines.

 

If we knew the actual number of EMS helicopter flights per hour, we might see EMS helicopter operations in a more favorable light.

 

It remains, though, that EMS helicopters have many more events (take offs and landings) associated with flight than do General Aviation aircraft and the Airlines.

 

Well, enough. I someone indicates continued interest, I'll see if I can come up with the links and references.

 

 

 

 

 

 

 

 

 

 

[Wally]

One quibble: A poorly trained or confused pilot can mis-manage an autopilot into the dirt.

 

But, that post is gonna keep me thinking for a while.

Thank you, sir.

Edited December 19, 2012 by Wally

[Randy Mains]

Hi Rupert:

 

First of all, I wonder if we know each other? We’re the same vintage and you are one heck of an experienced HEMS pilot.

 

I actually thought I was finished posting on this tread but I noticed something that was written that I would like to comment on regarding two-crew operations.

 

First of all let me say straight out of the box that I have no illusions that the concept of using two crew will ever be adopted in HEMS for all the reasons mentioned in previous threads. Saying that, I do think it is a heck of a lot safer and from what I have seen and personally experienced I will not be conviced otherwise.

 

As I mentioned in a previous thread, the accident rate for the airlines where an element of human error figured into the cause of the accident hasn’t changed much since 1940 when records began to be kept. Seventy-five percent of the crashes have an element of human error. In HEMS it is around 82%.

 

When I first flew two-crew in the US Army in Vietnam we were essentially two pilots up in the front with no real delegation of duties, that is, there was no real idea of who did what except that the aircraft commander flew the aircraft and the co pilot (peter pilot) monitored his bootlaces.

 

The two crew flying I saw, experienced and eventually learned when I flew with the Brits 14 years later when I flew with the Royal Oman Police beginning in 1985 was so different from anything I had ever experienced in my aviation career. The British pilots I flew with were used to flying in the North Sea, hard IFR, and flying two crew in the military where they all received their initial training. They operated the helicopter like airline pilots each pilot knowing what his duties were as pilot and copilot.

 

The commuter crews you flew with and witnessed dysfunctional crew coordination may have been an anomaly or a sign of the times. Most airlines today, especially with the advent of CRM training mandated by the FAA back in 1998, with literally a thousand pilots in one company, can intermix any pilot with another and, through their training, each pilot is cut from the same cloth, that is, flying with Fred from Illinois would be no different than flying from John from Seattle. There are of course personality differences and with it there can be known traps which are studied and discussed in CRM classes and hopefully avoided, like the Tenerif airport disaster in March 1977 where the KLM captain of a 747 didn’t allow himself to be questioned by his second officer when he told the captain he didn’t think they were cleared to take off, the captain elected to take off anyway in the fog, ran in to another full 747 back taxiing on the runway becoming one of the worst airline disasters in history. The cockpit gradient, that is how approachable a captain is by the crew, was way too steep that day. That captain, a poster boy for KLM by the way, wasn’t going to be told anything and elected to take off even when questioned by his first officer. Had he listened to him and not tried to take off, 583 people would not have lost their lives.

 

Today, each crewmember knows what his duty is either as captain or first officer for any eventuality. Through CRM classes they have studied the traps and pitfalls and the human factors that can cause them, as a crew, to make a mistake. Two crew in helicopter flying these days has come a long long way since I flew in Vietnam I can assure you.

 

When I trained new pilots in the Bell 412 flight simulator in Dubai that Abu Dhabi Aviation hired for our Saudi HEMS contract, many of them had never before flown two crew operations. They were literally like deer in the headlights at first until, through training, they ‘got it’ learned what their job was when they flew in either seat.

 

At Abu Dhabi Aviation we fly with more than twenty nationalities of airline transport pilots, more than 160 pilots, and they have each been trained to know what to expect and what is expected of them when flying as pilot or copilot. Last week I had a Scotsman flying with an Egyptian and that’s a combination you don’t see every day. But they functioned well operationally and during emergencies because they were taught what to do and used good CRM practices.

 

A well oiled crew creates a synergy that is something larger than just two pilots. I have witnessed it for more than twenty-eight years. I have also witnessed two pilots flying together who are used to flying single pilot, taking on everything themselves, not delegating to the non-flying pilot because they have been used to doing everything themselves. That is actually a dangerous combination because if something happens the flying pilot usually becomes overwhelmed when a perfectly good asset is being underused in the left seat. That attitude can be more of a hindrance in a two-crew environment and create something less than two pilots. That is why good flight training and the elements of CRM must be taught and practiced because it is so important that they know where the pitfalls can lie.

 

When I was first exposed to two-crew operations in 1985 in Oman I was coming from a background where I was used to flying single pilot IFR in a Bell 222 in San Diego. It literally took me about six months to learn to delegate and relinquish some of that control that I was so used to holding on to myself. Now that I feel I ‘get it’ and from what I have witnessed in the two-crew cockpit over the years, I would fly two crew any day over single pilot, that is, if I have a similarly trained pilot to be my co-captain.

 

Randy Mains

Edited December 20, 2012 by Randy Mains

[Rupert]

If you find yourself slowing down, or going down (in altitude), then turn around.

 

=====

 

As I wrote earlier:

 

1. require night vision goggles for all night operations, no exceptions;

 

2. require out of ground effect hover capability during all phases of flight (makes the vertical EMS takeoff to 50' over obstacles and a steep climb to 500' agl on take off heading, possible);

3. require round trip fuel (allows the pilot to return to point of departure if weather starts getting bad, and precludes the need to push the weather to get to fuel);

4. require a simple autopilot capable of holding a heading and altitude (allows the pilot to review charts, tune radios, etc.);

5. raise the night cross country minimums to 3000' and five miles.

 

=====

 

Two pilots and two engines bring their own sets of problems, and, in the end, provide no statistical safety advantage.

 

Most of the accident statistics available to us appear to support two pilot operations, but, when one asks the right questions and looks at the data without preconceived ideas, the two pilot advantage disappears. The two engine advantage does not and never has existed.

 

And, two engines and two pilots require a LOT more training and money, with nothing in return.

 

Give the pilot a simple aircraft (one BIG engine, Pratt and Whitney preferred) and a simple heading-and-altitude-hold autopilot.

 

Give him enough fuel, always, to turn around. Many times we think the pilot pushed the weather for the patient, when, in actuality, he pushed the weather to get to fuel. Landing short, away from the hospital, worries many pilots more than what will happen to the patient.

 

For example, we had a back-up helicopter that could not make it round trip to a frequent destination on one fuel load. At about 3/4's of the way, the pilot had to make it to the destination hospital in order to get fuel, or, alternatively, land and have an ambulance and fuel truck meet him. So, at the 3/4's point (90 out of 120 miles), if the pilot encountered unforecast lowering ceilings, he had to either land, or take a chance that he could still get through that last pass in the hills surrounding the destination. If he landed, operations and other pilots and the nurses would second-guess his decision-making, and everyone would see the "obvious" in the weather forecast, and the pilot would become the goat. Or, given that the pilot knew the terrain like the back of his hand (strange phrase: who memorizes the back of his hand?), he could have relied on skill and luck to see him through to the hospital and FUEL. In other words, the pilot doesn't care about the patient and the hospital. He cares about the fuel and whether others see him as the goat or as the ace.

 

(Don't give me the argument that "professional" pilots with proper training don't play the "goat and ace" game. I've flown helicopters for 44 years, and I know helicopter pilots. They've all got remarkably small penises, except for the female pilots, and very sensitive egos. Keep it real, please.)

 

Give the pilot enough fuel for a turn around, at all phases of the flight, and he then has an honorable option to turn around and take the patient back to the hospital.

 

Give the pilot high enough night cross country minimums, and, as soon as he has to slow down, or go down, he can then turn around and go somewhere meaningfully better than an empty field or the side of the road.

 

Night cross country, when you can no longer maintain altitude (2500'), turn around. Period. And, any time you slow down, cross country or local, go home.

 

You have to have enough fuel to do that. Twin engines run at less than optimum power settings, and so you waste a lot of fuel just keeping those big compressors running. Get rid of one of the engines and put a legendary, powerful single in its place (Canadians and Europeans both make these kinds of engines), and get the safety that increased range gives you.

 

Two engines will not take a helicopter weighing X pounds as far as a one big engine will.

 

For emphasis:

 

NVG's

 

Horsepower

 

Fuel

 

Simplicity of engine and autopilot

 

High Night Cross Country Minimums

 

=====

 

And, considering the mission, meaning night off-airport landings, night cross country, and high frequency of landings and takeoffs per flight hour, and EMS does not have that bad a safety record.

[Randy Mains]

Hello Rupert:

 

I agree with your five points. If instigated they would certainly help bring down the accident rate I think.

 

I was wondering, what single-engine aircraft with the power you're suggesting have you seen on the market these days? I can't think of one.

 

I'm in Sydney Australia at the moment speaking to HEMS crews here. I will be flying to Melbourne on the 28th to give two keynote addresses, one on how they can learn from our mistakes in the US and another on the importance of CRM/AMRM in HEMS. They have been kind enough to fly my wife and me over so that they can learn from our mistakes.

 

All I will say is that we can learn from the way the Australians do it . They have all the kit, NVGs or if the pilot is not current it is posted on the central dispatch board that the crew will not be flying with NVGs. They operate twin engine aircraft, two crew or if not a copilot a crewman trained to help in the left seat. No pressure on the crews. 30-minute response time at night. Etc.

 

Regarding the argument for two pilots, or like you say at very minimum an autopilot (amen) Randy Babbitt, the former head of the FAA said in a letter to the NTSB in 2009 that of the 123 HEMS accidents examined from 2000 - 2008 sixty could have been prevented had there been a second pilot or an autopilot. NTSB board member, Robert Sumwalt in May 2012 put on a presentation asking hospitals to go with vendors who supply aircraft with twin-engine and two pilots or the very minimum an autopilot.

 

Jim Hall the former head of the NTSB said in a newspaper article recently pilots flying at night should have an autopilot.

 

Pushing for an autopilot is my main thrust now. I will be banging on about it in the industry until every HEMS aircraft has one, or I get tired and give up.

 

By the way, I think we're the same vintage. I've been doing this for over 45 years now myself. From what I've seen here in Oz, Canada, Germany, Switzerland et al is the way we should be doing it back home. I am afraid I won't be dissuaded on that point.

 

As far as settling for the accident rate as it stands considering the job is in my mind an unacceptable stance. It's just me and I respect your right to disagree.

 

Best,

 

Randy

Edited August 19, 2013 by Randy Mains

[Mikemv]

Rupert & Randy,

 

Maybe this helo with two pilots and an autopilot?

 

 

Specifications (AW119Ke)[edit source | editbeta]

Data from AgustaWestland website^[15]

General characteristics

• Crew: 1 pilot
• Capacity: 6-7 passengers
• Length: 13.01 m (42 ft 8 in)
• Rotor diameter: 10.83 m (35 ft 6 in)
• Height: 3.77 m (12 ft 4 in)
• Disc area: 92.1 m² (991 ft²)
• Empty weight: 1,430 kg (3,152 lb)
• Loaded weight: kg (lb)
• Max. takeoff weight: 2,720 kg (6283 lb)
• Powerplant: 1 × Pratt & Whitney Canada PT6B-37A turboshaft, 747 kW (1,002 hp)

Performance

• Maximum speed: 267 km/h (166 mph, 152 knots)
• Ferry range: 991 km (618 miles, 535 nm)
• Service ceiling: 6,096 m (15,000 ft)

Or one pilot and auto-pilot?

 

Best Wishes,

 

Mike

[Velocity173]

http://search.yahoo.com/r/_ylt=A0oG7niQnxJSClkA9_BXNyoA;_ylu=X3oDMTEzaDRndDJlBHNlYwNzcgRwb3MDMQRjb2xvA2FjMgR2dGlkA1ZJUDI1MF8x/SIG=13265l9hm/EXP=1376981008/**http%3a//www.flyingmag.com/aircraft/helicopters/air-ambulance-safety-closer-look

 

Apparently our safety record isn't that bad.

[aeroscout]

http://search.yahoo.com/r/_ylt=A0oG7niQnxJSClkA9_BXNyoA;_ylu=X3oDMTEzaDRndDJlBHNlYwNzcgRwb3MDMQRjb2xvA2FjMgR2dGlkA1ZJUDI1MF8x/SIG=13265l9hm/EXP=1376981008/**http%3a//www.flyingmag.com/aircraft/helicopters/air-ambulance-safety-closer-look

 

Apparently our safety record isn't that bad.

I read that. We should be comparing apples to apples by accident rate per 100,000 flying hours.