Useful References and Tools for Safety Management

Here are some useful references and tools for aviation safety in general and Safety Management Systems. 

http://www.ntsb.gov/recs/mostwanted/aviation_issues.htm

http://www.flightweb.com/filemgmt/datafiles/AMPA_Safety_Report.pdf

http://www.faa.gov/documentLibrary/media/Advisory_Circular/AC%20120-92A.pdf

http://www.faa.gov/library/manuals/aviation/media/FAA-H-8083-2.pdf

NTSB Most Wanted

The National Transportation Safety Board has recognized where safety improvements need to be made in the Helicopter Emergency Medical Services (HEMS) industry, and has placed four areas for improvement on its "Most Wanted" list. These are:

• Conduct all flights with medical personnel on board in accordance with stricter commuter aircraft regulations.
• Develop and implement flight risk evaluation programs for EMS operators.
• Require formalized dispatch and flight-following procedures including up-to-date weather information.
• Install terrain awareness and warning systems (TAWS) on aircraft used for EMS operations.

Many HEMS operators have already taken voluntary steps to implement some or all of these recommendations, but further steps are needed to advance the cause of safety in HEMS.  A significant number of HEMS accidents could be prevented with these and other modest improvements. 

Safety Management Systems in Helicopter Emergency Medical Services

Safety programs within aviation and the Helicopter Emergency Medical Services continue to evolve.  Many HEMS operators are now adopting a systems approach to safety, beginning with changes in management's philosophy toward safety, and adopting a more safety-based culture in their organizations.  The industry has adopted both managerial and engineering improvements to their programs which continue to impact safety in HEMS.   Many operators are emphasizing more risk management and training in their operations.  Additionally, there are growing numbers of operators equipping their fleets with twin-engine aircraft, better IFR capabilities, Night Vision Goggles, and instrumentation for alerting crews of terrain or obstacles.  The environment in which the HEMS industry operates is a demanding one; one in which risk cannot be completely eliminated.  However, the HEMS industry is among a growing sector of the aviation industry adopting Safety Management Systems to improve their operations. 

Safety Record of Helicopter Emergency Medical Services (HEMS)

The use of helicopters in the Emergency Medical Services role expanded exponentially during the 1970s and 1980s.  In 1980 there were 32 companies or public use agencies providing aeromedical evacuation services in the United States; by 1990 there were 172 such programs.  The drastic expansion brought with it dramatic increases in the accident rate of Helicopter Emergency Medical Services.  Accidents among HEMS operators tripled during the mid-1980s, prompting more attention to safety programs.  The accident rate increased again in the late-1990s, once again bringing industry and governmental attention to the safety issues within HEMS.  Like many aviation sectors, most safety issues within the HEMS industry are related to a combination of weather and human factors.  The aviation industry and the Federal government have worked to improve HEMS safety in the last decade, resulting in a HEMS accident rate consistently below that of the general aviation community and the helicopter industry as a whole for the last decade.

History of Helicopter Emergency Medical Services (HEMS)

The first use of aircraft for evacuating wounded soldiers from battlefields occured during the Second World War with fixed-wing aircraft.  The first rescue performed by a helicopter occured in the Pacific Theater when a prototype R4 helicopter was used to rescue a downed pilot from the jungle.  During the Korean conflict a crude system of helicopter evacuation was used to evacuate wounded soldiers to field hospitals.  The Vietnam war brought major advances in aeromedical evacuation with the first use of dedicated MEDEVAC aircraft and a doctrine for using helicopters to evacuate sick and wounded.  A system was formed for evacuating patients via aircraft in stages from near the point of injury back to hospitals for long-term and recuperative care.  During the war the first concept for using helicopters to provide medical transport of civilians began to emerge.  As the civilian Helicopter Emergency Medical Service (HEMS) system took shape and grew, the industry began experiencing many safety issues and painful accident rates.