The National Transportation Safety Board (NTSB) has issued 19 recommendations regarding Helicopter Emergency Medical Services (HEMS), according to an NTSB press release. These recommendations address various safety issues including pilot training; safety management systems to minimize risk; collection and analysis of flight, weather, and safety data; flight data monitoring; development of a low altitude airspace infrastructure; and the use of dual pilots, autopilots, and night vision imaging systems (NVIS).
HEMS operations include an estimated 750 helicopters, 20
operators, and 60 hospital-based programs. They transport
seriously ill patients and donor organs 24 hours a day in a
variety of environmental conditions.
"The pressure on HEMS
operators to conduct their flights quickly in all sorts of
environments makes these types of operations inherently more
risky than other types of commercial flight operations,"
said NTSB Chairman Deborah A. P. Hersman. "Operators need
every available safety tool to conduct these flights and
to determine when the risk of flying is just too great."For
the HEMS industry, 2008 was the deadliest year on record
with 12 accidents and 29 fatalities. In response to this
increase in fatal accidents, the NTSB placed the issue of
HEMS operations on its Most Wanted List of Transportation
Last February, the NTSB conducted a 4-day public hearing to
critically examine the safety issues concerning this
industry. The hearing, which included testimony by expert
witnesses representing HEMS operators, associations,
manufactures, and hospitals, explored the increasingly
competitive environment of the HEMS industry and provided a
more complete understanding of why this industry has grown
rapidly in recent years. As a result of recent accident
investigations and testimony presented at the hearing, the
NTSB made recommendations to the Federal Aviation
Administration (FAA), the Centers for Medicare & Medicaid
Services (CMS) at the Department of Health and Human
Services, Federal Interagency Committee on Emergency medical
Systems (FICEMS) and 40 government-operated or public HEMS
The 19 recommendations include 10
recommendations to the FAA to address the issues of improved
pilot training; collection and analysis of flight, weather,
and safety data; flight data monitoring; development of low
altitude airspace in infrastructure; and the use of dual
pilots, autopilots, and NVIS.
The two safety recommendations to the CMS are to evaluate
the current HEMS reimbursement rate structure and its
relationship to patient transport safety. Two
recommendations are to FICEMS to address coordination and
integration of helicopter emergency medical transport into
local and regional emergency medical systems and selection
of the most appropriate emergency transportation mode for
victims of trauma.
Finally, five recommendations are to public operators to
improve pilot training, flight data monitoring; and the use
of dual pilots, autopilots and NVIS.
In addition, the Board asked its staff to draft additional recommendations to
CMS regarding safety audit standards.
An abstract of today's Board actions can be found athttp://ntsb.gov/Publictn/2009/AB09-HEMS.htm.