Vanderbilt LifeFlight is applauding the new rules issued by the U.S. Department of Transportation’s Federal Aviation Administration (FAA) that will have a dramatic impact for all air ambulance operators and make the industry much safer.
Stricter flight rules and procedures, improved communications, enhanced training and additional on-board safety equipment are some of the newly added regulations, and represent the most significant improvements to helicopter safety in decades.
Effective this month, all medical helicopter operators will be required to use enhanced procedures for flights in adverse weather, at night, and when landing in remote locations. Within three years, helicopter air ambulances must use the latest on-board technology and equipment to avoid terrain and obstacles. Within four years, they must be equipped with flight data monitoring systems.
Vanderbilt LifeFlight is already 90 percent compliant with the new rules and will work with AirMethods, the corporation that provides Vanderbilt’s aircraft, to add Helicopter Terrain Awareness and Warning Systems (HTAWS) and flight data recording devices to its existing six aircraft.
Under the new rule, all helicopter operators are required to:
• Equip their helicopters with radio altimeters.
• Equip helicopters with a 406 MHz Emergency Locator Transmitter (ELT) and have occupants wear life preservers when a helicopter is operated beyond power-off glide distance from the shore.
• Use higher weather minimums when identifying an alternate airport in a flight plan.
• Require that pilots are tested to handle flat-light, whiteout, and brownout conditions and demonstrate competency in recovery from an inadvertent encounter with instrument meteorological conditions.
In addition, under the new rule, all air ambulance operators are required to:
• Equip with Helicopter Terrain Awareness and Warning Systems (HTAWS).
• Equip with a flight data monitoring system within four years.
• Establish operations control centers if they are certificate holders with 10 or more helicopter air ambulances.
• Institute pre-flight risk-analysis programs.
• Ensure their pilots in command hold an instrument rating.
• Ensure pilots identify and document the highest obstacle along the planned route before departure.
• Comply with Visual Flight Rules (VFR) weather minimums, Instrument Flight Rules (IFR) operations at airports/heliports without weather reporting, procedures for VFR approaches, and VFR flight planning.
• Conduct the flight using Part 135 weather requirements and flight crew time limitation and rest requirements when medical personnel are on board.
• Conduct safety briefings or training for medical personnel.
“This is a landmark rule for helicopter safety and a long time in the making,” said John A. Morris Jr., M.D., former medical director for LifeFlight, Associate Chief of Staff for the Vanderbilt Health System and Chief Medical Officer for the Vanderbilt Health Affiliated Network.
Morris, who is recognized for his expertise in air medical programs, was part of a seven member panel of experts that reviewed helicopter utilization and protocols after the Sept. 28, 2008, crash of a Maryland State Police helicopter that killed four people. That year proved to be the deadliest year on record with five helicopter accidents that claimed 21 lives. The FAA examined helicopter air ambulance accidents from 1991 through 2010 and determined 62 accidents that claimed 125 lives could have been mitigated by the new rule.
And while Morris applauded the FAA’s new oversight, he said the air medical industry could benefit from additional oversight.
“There is too much variability in the quality of care,” he said. “You have to save lives by reducing crashes, and you have to save lives by providing good medical care during transport,” Morris said. “You cannot look at just reducing crashes without looking at the quality of care that's delivered, because you can't justify the additional risk of any crashes if you don't provide better care than ground transportation.”
Jeanne Yeatman, MBA, RN, EMT, administrative director of Emergency Services for Vanderbilt, said the new rule will help provide safer air operations.
“LifeFlight applauds the move toward stronger federal regulatory oversight,” she said. “We strongly support anything that will enhance and promote safety. Safety is our No. 1 product. The new FAA rule will require operators to use stricter flying procedures in bad weather. This will provide a greater margin of safety by reducing the probability of collisions with terrain, obstacles or other aircraft.”
Vanderbilt LifeFlight has made more than 40,000 flights and has operated for 30 years with an accident-free record. It has been an industry leader in safety operations and a vocal proponent for greater safety in the air ambulance industry. The department went on record in 2010 supporting the proposed FAA helicopter safety rules.
In 1998 LifeFlight became one of the first air ambulance services in Tennessee to initiate single pilot instrument flight rules (IFR) capability, enhancing safety and increasing LifeFlight's availability during inclement weather. The system uses advanced pilot training, an electronic flight instrumentation system, a digital auto-pilot, and global positioning system. In 2009 LifeFlight added night vision goggles to its entire fleet. It was also the first air ambulance helicopter program in the United States to implement the American Eurocopter EC145, which has redundant systems to enhance the aircraft's safety.