04 February 2009

Most Dangerous Nursing Job?

Emily claims she has it.
I think there can be little argument.

Some of you remember at the time I started flying EMS in 1986 I had been flying helicopters for 18 years. Looking around at my peers at the time, I was surrounded mostly by Viet Nam Veterans. The Helicopter EMS business was exploding and competition for flights was fierce.
Some operations pressured their pilots to "just go out and give it a try", meaning go ahead and take off and see what the real weather conditions are.
And the accident statistics reflected how stupid that was...
1987 was a terrible, record-breaking year.

Now I've been flying the air ambulance going on 23 years. I've been flying helicopters longer than most of my fellow workers have been alive and I have the gray hair to prove it.

Emily's post gives you the recent numbers... the past year has been horrible and as an industry we've once again drawn negative attention to ourselves.
As always, many of those accidents happened either at night, in bad weather, or at night in bad weather. And therein lies the answer to the problem so far as I'm concerned.
To make our industry safer we need to remember Nancy Reagan's exhortation...

The flying business has lots of valuable cliches-
There's an old cliche I frequently repeat to our new pilots:
"It's better to be on the ground wishing you were in the air than to be in the air wishing you were on the ground."
And those of us with lots of hours in our logbook know just how true that is. When that flight request comes in, those of us with fat logbooks know to listen to our gut-
...Night time?
...Weather iffy? (What's the trend?)
...Are ya tired?
...Just woke up and runnin' mostly on instinct?

Government agencies are now gonna review last year's accidents and try to come up with resolutions to our problems. When their review is done they will issue recommendations, some of those in the form of new regulations. I'm sure some of those will be valid and necessary. But some of them will cost a ton of money and will run small operators out of business, to the detriment of the small markets they serve. Therefore, some patients will suffer too.

I truly believe most of our safety issues could be resolved if we could, as a group, put peer pressure on one another...
"You want to fly in that? What in the world are you thinking?"

Turning down a flight, for whatever reason, may cost a little money in lost revenue.
Crashing a multi-million dollar machine and killing all aboard costs a ton of money right now, and results in more industry-wide regulation that costs EVERYONE more money in the long run.
And it seems to me such an easy problem to fix:



emily said...

Culture, culture, culture.

Unfortunately until that changes, and there isn't more regional cooperation between companies, blah blah.....


We need to say no. WE AS A CREW!

Maybe you and I should go testify.

Yeah. Then I will buy the beer. ;)

The Duke said...

I just found your blog, and I'm always happy to see another Army Aviator spreading the good word.

The current Army approach to go/no go decisions is almost entirely taken out of the hands of the aircrew. As I'm sure you know, you fill out a risk assessment worksheet, which assigns values for things like crew rest, planning time, weather, etc. It then has to be signed off by progressively higher levels of authority based on the point value.

Does the civilian Medevac community have anything comparable?

If you want to read more about suffering through reams of paperwork in order to fly Blackhawks in Afghanistan, you can wander over to my blog at:

Greybeard said...

No "industry-wide" standard, Duke. But that may be something that comes out of the hearings Emily blogged about.
My company has a "risk assessment" matrix we use to help with the "go-no go" decision for a flight. But as you are more than aware, the "best laid plans" of men are based on vagaries, weather forecasting being top of that list.
Personal story to illustrate:
We were called to an accident scene. Weather checked... OK.
Halfway there we ran into really bad visibilities and I aborted the flight. My dispatch called and asked "can you make it to such-and-such LZ? The ground ambulance will meet you there."
So I landed at the LZ, where the weather was fine.
And waited.
And waited.
An hour later we were engulfed in low ceilings and bad viz when the ambulance finally showed up...
(They stopped to "stabilize" the patient at a local hospital before bringing him to us!) I took off, patient on board, with a 400 foot ceiling and the worst visibility I've EVER flown in! The only thing that saved me was my knowledge of the area...
There was an electric powerline just North of the LZ that I knew terminated just Southeast of the receiving hospital. I flew with those big wires literally outside my door... 75 feet AGL and at maybe 60 knots... for about 15 minutes until POOF!... I got to the clear blue and 22 I knew was ahead of me.
Should I have continued with that flight? My crew trusted me and left the decision to me. They told me later that had I landed, the patient would have died. (He went straight to the OR when we landed.)

These decisions aren't easy.
I hate to make hard and fast rules, because what is right for the Midwest is certainly not right for mountainous areas.
But the way we're operating now is killing far too many people. My fear is that we'll kill the industry while trying to fix the problem.

cary said...

I said it over on Emily's, and I will repeat it here - you guys do a job that would leave most people looking for a good dry cleaner.

Continue to be safe. Go and testify if you can. Take up her offer on the beer, too.