Again and again we see headlines air medical crashes. Every time I hear of another one, it brings back bad memories and guilt. These memories began June 21, 2002. I had just gotten off shift and given my report to the oncoming shift. By the time I made it home, my phone was ringing. The first flight of the day for the oncoming shift had crashed, eventually killing all on board.
Guilt crosses my mind every time I hear of another crash, because the solution seems so obvious to me that it’s like having an elephant in the room. I continue to read expert opinions and thoughts on air medical crashes, things like mechanical troubles, weather, and night vision seem to be recurring themes.
So what isn’t being discussed? The elephant in the room is the pilot training.
American vs. French Helicopters
I recall as a flight medic the pilot I respected most once explained that cross winds are challenging because the pilot needs to counteract the wind. Throw in a crosswind and that maneuver becomes much more difficult. Add to it that American-made helicopter rotors, such as the Huey and Black Hawk, spin counterclockwise, while such French-made helicopters as the Eurocopter AS350 Ecureuil, called the Astar, spin clockwise.(1) Therefore, every movement a pilot makes in one feels unnatural in the other, especially if it’s the exact opposite of what they’re used to doing.
When Mechanisms Fail
When a mechanical failure happens in a helicopter, the pilot has only a fraction of a second to react. There’s no time to ponder. The response has to be a reflexive reaction; you just react the way you were trained. Unfortunately, most of the training many pilots get is in the military and on U.S. helicopters but many American EMS aeromedical systems use French helicopters. Thus the pilot’s instinct may very be the exact opposite of what they should do in the critical event.
As a medic, I can thoughtlessly insert a laryngoscope blade with my left hand. Ask me to do it in a split second with my right hand, and my movements will be clumsy and uncomfortable.
Every time I here of an air medical accident, I look to see what type of aircraft has crashed. Was it made in France? Which way did the rotors spin? Helicopters have many moving parts and there will always be mechanical failures, regardless of where an aircraft is made, but how the pilot reacts to those failures will be the difference between life and death.(2) The following are examples of this:
According to the National Transportation Safety Board’s 2005 Annual Review of Aircraft Accident Safety, 92% of helicopter accidents are attributed to personnel or human performance.(6) Although these data are only anecdotal and suggestive of a possible factor, it’s possible that there were maneuvers the pilot could’ve done to prevent each accident or reduce their severity.
Between 2002 and 2008, there was an average of 15 air medical crashes a year.(7) Job advertisements for new air medical helicopter pilots typically describe requirements for total hours of flight or minimum number of turbine hours. One of the largest air medical organizations in the country actually boasts on its web site that their pilots are trained six to 12 hours per aircraft type. If someone has been flying for thousands of hours over many years with the rotors turning in one direction and then trains six to 12 hours with their rotors turning the opposite direction, will their reaction time in an extreme crisis be as fast and precise as it needs to be?
Air medical helicopter crashes and correlated deaths are happening at an alarming rate, and safety is on everybody’s mind. Of course, night vision goggles and wire cutters on helicopters are great. But air medical services might also be able to improve safety by first recruiting pilots who have initial training in the type of aircraft they would be flying with the service. Alaska serves as a good model, where many private helicopter pilots receive their initial training on Astars. Second, a substantially increased number of flying hours on the type of aircraft the service uses could be required.
1. Aerospace Web. www.aerospaceweb.org/question/helicopters/q0212b.shtml.
2. Flightweb. www.flightweb.com/index.php?page=3.
3. Associated Press. EagleMed Releases Statement on Fatal Chopper Crash. www.kake.com/home/headlines/99072784.html .
4. Sims A. Air Evac Chopper Makes Emergency Landing in Field. www.newson6.com/Global/story.asp?S=12894669 .
5. Peterson B. Officials ID 3 Killed in Tucson Copter Crash. http://azstarnet.com/news/local/crime/article_93b991e6-7e25-58d0-912a-4d6a50487e54.html.
6. National Transportation Safety Board Annual Review of Aircraft Accident Data U.S. General Aviation www.ntsb.gov/publictn/2009/ARG0901.pdf .
7. Blumen, Ira (February 2009): An Analysis of HEMS Accidents and Accident Rates. Obtained September 10, 2010 from http://www.ntsb.gov/Events/Hearing-HEMS/NTSB-2009-8a-Blumen-revised-final-version.pdf.