Air Evac down E Ky

I know a guy who works at the small hospital where they were based. He said he personally knew all 3 onboard. Appears they just made a 20 mile or so transport to a neighboring hospital and were returning around 11pm. Witnesses on the ground reported heavy fog. The site was very close to their intended destination.
That area can get patchy valley fog in lower areas. Fog, night and aircraft is an unforgiving combination.
Very unfortunate for all.
 
These VFR operations are of course limited to VFR while transporting patients, I wonder whether they would be permitted (and capable) to fly IFR to a diversion airport if they encounter weather.
 
I am 82 nm NNE of Manchester, Ky. The weather all around the area last night was MVFR and IFR. Many are VFR only birds. Many fly with NVG's. They advertised looking to hire a pilot Mar 30. This was the second patient transfer for the flight nurse. Air Evac is the largest air medical transport in the U.S. operated under one name. They have also had fatal crashes in 2007, 2008 and 2010.

I was a helicopter crewchief from 88-93. When we ran into bad weather we slowed down and landed if necessary. Slept in the bird one snowy night after we thought we were awfully close to a tall obstacle. We woke to clear skies and a tv tower guy wire 500' in front of us.

They Bell 206 hit a power line near an elementary school last night 200 yards from the helipad. Get home itis. RIP.
 
Last edited:
Air Evac Lifeteam is one of the only air ambulance operators to require all of its pilots to demonstrate IFR emergency proficiency in a dedicated flight training device. Because of this requirement, the company makes use of its dedicated flight simulator as part of an on-going pilot training program.

They cannot accept transport requests in IFR conditions.

Every one of their helicopters are supposed to have a radar altimeter.
 
NVG's are very responsive to reflective ambient light; therefore, the light reflecting off of fog or heavy rain causes much more light to go toward the night vision unit and may degrade its performance.
 
Air Evac is the second largest operator. Air Methods is the largest. With over 300 bases they're over twice the size of Air Evac.

NVGs and radar altimeters are required on all Air Evac aircraft.

While the aircraft are not certified for IFR, they have the avionics / instrumentation to execute an IMC recovery.

Their pilots attend the IFR training in the sim semi-annually.

All companies get calls in bad weather. It's for the pilot to decide whether it meets their company mins and more importantly, personal mins. Some companies, including Air Evac, have pilots in the call center that must approve a flight in "yellow" weather. Of course all companies have the "3 to go, 1 to say no" policy. If someone in the crew turns it down, for weather, another company will be called.

These accidents in HEMS will continue to happen. It's the nature of the business. Nighttime accidents are disproportionately higher than daytime. You're sleeping, the phone rings and you have to make a quick, educated weather decision. Unfortunately you don't have a forecast or even current conditions for a road intersection. You can look at automated weather at airports around the area but you really don't know until you show up. Predicting wx in HEMS is an art form that only happens after getting to know local wx trends in your area. Even then, there are times wx bites you in the butt.

It's a common argument that is brought up by senior HEMS personnel a lot. That is we need dual pilot, dual eng, all NVG, all IFR fleet. I agree that would reduce accidents. Problem is no company can afford to equip their entire fleet like that. The little 206s and 407s cost far cheaper to purchase and operate than a dual EC-145. Unless these companies get some sort of supplement from the govt, they'll always have single eng, single pilot, VFR ships. Considering hundreds are saved annually over a ground ambulance, and it's a profitable business, HEMS will also always be around.
 
Last edited:
Velocity173 said:
It's a common argument that is brought up by senior HEMS personnel a lot. That is we need dual pilot, dual eng, all NVG, all IFR fleet. I agree that would reduce accidents.
Click to expand...

Intuitively, you would think that that is the case. Has the US hems experience confirmed that, do the IFR operators in fact have a better safety record ?

The small hospital I used to work for had to fly out any major trauma cases. As we didn't have a helipad, the flyouts would go from the local airport about a mile from the hospital. There were days when finding the airport access road was challenging due to the fog, but the IFR helo would still come down the ILS to pick up a patient. Pretty eerie when you stand on the ramp, can't see the runway lights and a helo would hover-taxi onto the ramp out of nowhere. For some reason, they seemed to have better weather at the other end of the trip for most flights.
For scene flights, it probably makes less of a difference. 'We dont have an approach to Rt5 and 236' is how a pilot for the local IFR operation put it.
 
weilke said:
Intuitively, you would think that that is the case. Has the US hems experience confirmed that, do the IFR operators in fact have a better safety record ?

The small hospital I used to work for had to fly out any major trauma cases. As we didn't have a helipad, the flyouts would go from the local airport about a mile from the hospital. There were days when finding the airport access road was challenging due to the fog, but the IFR helo would still come down the ILS to pick up a patient. Pretty eerie when you stand on the ramp, can't see the runway lights and a helo would hover-taxi onto the ramp out of nowhere. For some reason, they seemed to have better weather at the other end of the trip for most flights.
For scene flights, it probably makes less of a difference. 'We dont have an approach to Rt5 and 236' is how a pilot for the local IFR operation put it.
Click to expand...

I don't know of any data that suggests IFR programs are safer. If you look at almost all of the HEMS accidents that have occurred within the last year they were weather related and at night. The thing is you read about a lot of accidents that occur in bad weather but it isn't known whether they were actually in it. Sometimes it's just smacking into terrain or obstructions while trying to avoid it. Plus while they're legally VFR only, they are very capable of operating IMC. Problem is, you have some pilots that aren't as experienced and don't have the confidence in flying IMC.

In a perfect world we would all have S-76s with two pilots, two engines and fully IFR / NVG equipped. Economics just simply won't allow this. There just aren't enough IFR calls that would necessitate such an aircraft. The best we can do is equip our single engine stuff with all the available technology. I'm fortunate that I fly a 407 with NVGs and has Chelton EFIS, TAWS, TCAS, Garmin 530 and slated to get autopilot in the future. Although I'm not a big proponent of the autopilot in solving lack of instrument proficiency, it would be nice to have on long cross countries allowing me to be hands off a little.

So, IMO instrumentation isn't the issue it's judgment. That can be helped with having a another pilot giving a second set of eyes and decision making up front. Unfortunately that would require a bigger more expensive twin engine aircraft that most companies won't be able to afford. Not to mention the second pay check involved.
 
Velocity173 said:
So, IMO instrumentation isn't the issue it's judgment. That can be helped with having a another pilot giving a second set of eyes and decision making up front. Unfortunately that would require a bigger more expensive twin engine aircraft that most companies won't be able to afford. Not to mention the second pay check involved.
Click to expand...

Even when money is no object, like in the case of the Maryland state police, this is not easy to put together. One of the reasons given why they had to upgrade to AW139s was that it would allow them to go to two-pilot IFR operations. After a improper IFR crash some years back, this was the argument to lift some more money out of our pockets. Now that the new helos are coming on line, they are struggling with staffing the 24/7 two pilot service. Their existing pilots seem to have a hard time pasing the single pilot IFR checkride and there are not enough on the roster to double staff all locations. Now they are talking about flying single pilot, except when the weather is bad ;-) Sounds like a training nightmare to get everyone proficient in single and crew operations.
 
It seems to me synthetic vision would be a great help. Any of you guys considered propping an iPad mini up running wing x 7 just for increased situational awareness ?
 
I always feel great sorrow when an EMS flight goes down. These folks put their lives on the line to help those in need. I imagine some might feel great self induced pressure to launch a mission.

Prayers for the families and friends of those lost.
 
Hard to second guess from the sidelines, but since this was a repositioning flight after a transport it seems the only pressure they may have been under was either corporate or self-induced. I have talked to a couple of medflight helo drivers at my local drome and while impressed by their uniforms and swagger, when you begin to ask specific questions about qualifications and ability they get a little defensive. There is big money to be made in the market, no doubt, but to do it the companies apparently save expenses by shorting equipment and training.
If you are going to operate helos 24/7 on life-critical missions there is no excuse for having under trained crews and under equipped hardware. But then I may be biased by my past.
 
Velocity173 said:
Sometimes it's just smacking into terrain or obstructions while trying to avoid it.
Click to expand...

Possible just allowing IFR enroute would help? Yeah you need to be VMC at the LZ but it seems to me being able to pop into the clouds rather than scud run on the way would go a long way to preventing CFIT type accidents.
 
Art VanDelay said:
It seems to me synthetic vision would be a great help. Any of you guys considered propping an iPad mini up running wing x 7 just for increased situational awareness ?
Click to expand...

I fly Part 135 and our Certificate Holder hasn't approved (yet) iPads, that would be a no go. Since our aircraft has dual Cheltons with SV we're already set up pretty well. When we replace the Cheltons with Garmin 500s later this year, we'll even have a better set up. I like the TAWS but I like the TCAS / TIS better. TAWS just tells me what I already know, the traffic alerts have come in handy, especially for the MTRs that we fly over.
 
Skylane81E said:
Possible just allowing IFR enroute would help? Yeah you need to be VMC at the LZ but it seems to me being able to pop into the clouds rather than scud run on the way would go a long way to preventing CFIT type accidents.
Click to expand...

I agree, but like I said you'll still need an expensive IFR ship for that. At my base there are rumors replacing our VFR B407 with an IFR EC-135. They're analyzing all our turn downs for weather and wondering if giving us a 135 will help. At almost 2 million dollars more than a 407 and higher operating costs, it would have to bring in a significant increase in flights to pay for itself. They tell me it would be the first and only IFR HEMS aircraft in Georgia. It's not really important to me what they decide but I will say that it would be nice having a second engine.
 
Velocity173 said:
I fly Part 135 and our Certificate Holder hasn't approved (yet) iPads, that would be a no go. Since our aircraft has dual Cheltons with SV we're already set up pretty well. When we replace the Cheltons with Garmin 500s later this year, we'll even have a better set up. I like the TAWS but I like the TCAS / TIS better. TAWS just tells me what I already know, the traffic alerts have come in handy, especially for the MTRs that we fly over.
Click to expand...

Okay then, but just so you know your certificate holder does not need to approve personal use iPads. As long as you're not using it for any kind of primary device it doesn't matter.
 
Art VanDelay said:
Okay then, but just so you know your certificate holder does not need to approve personal use iPads. As long as you're not using it for any kind of primary device it doesn't matter.
Click to expand...

IAW Part 135.144 B (5) any portable device not listed must be approved by the certificate holder. As employees, myself and my fellow pilots are by definition, certificate holders. None of us has done the testing procedures as outlined in our GOM and listed an iPad on our Portable Electronic Interference Log. Therefore they are not approved by the "certificate holder" at this time. Since our current panel and our future panel (Garmin 500) meet our requirements quite well, I can't see any of us using an iPad or any other portable NAV device anytime soon. Now if we had a basic "steam" panel like most of the other VFR operators, then yes, I would invest in some sort of iPad setup.
 
Threefingeredjack said:
Hard to second guess from the sidelines, but since this was a repositioning flight after a transport it seems the only pressure they may have been under was either corporate or self-induced. I have talked to a couple of medflight helo drivers at my local drome and while impressed by their uniforms and swagger, when you begin to ask specific questions about qualifications and ability they get a little defensive. There is big money to be made in the market, no doubt, but to do it the companies apparently save expenses by shorting equipment and training.
If you are going to operate helos 24/7 on life-critical missions there is no excuse for having under trained crews and under equipped hardware. But then I may be biased by my past.
Click to expand...

There's no doubt EMS accidents have some of the same causes as other crashes, some pilot induced, others by management shortcomings.
 
Velocity173 said:
I agree, but like I said you'll still need an expensive IFR ship for that. At my base there are rumors replacing our VFR B407 with an IFR EC-135. They're analyzing all our turn downs for weather and wondering if giving us a 135 will help. At almost 2 million dollars more than a 407 and higher operating costs, it would have to bring in a significant increase in flights to pay for itself. They tell me it would be the first and only IFR HEMS aircraft in Georgia. It's not really important to me what they decide but I will say that it would be nice having a second engine.
Click to expand...

Children's Hospital in ATL was operating a BK-117 and a BO-105 and had plans to upgrade to a EC-135, but this was a while back.
 
RotorAndWing said:
Children's Hospital in ATL was operating a BK-117 and a BO-105 and had plans to upgrade to a EC-135, but this was a while back.
Click to expand...

Always liked the BK. Gotta friend who flys one in SAV but they aren't up NVGs yet. Can't imagine doing a scene site in the mountains with no NVGs. Sometimes I wonder how the guys did it in the old days without all the bells and whistles we have today.
 
3393RP said:
There's no doubt EMS accidents have some of the same causes as other crashes, some pilot induced, others by management shortcomings.
Click to expand...

I guess it all depends on your point of view. IMHO tasking under trained and ill-equipped pilots to fly these kinds of missions borders on criminal. I know it falls on the PIC to make the call to abort, but the pressure to perform is a real factor. I know the feeling well, but I was fortunate to have to have the best equipment and training the nation could afford on my side. When you put yourself in a launch on demand position you'd better bring all the toys and training you can to the party.
 
Velocity173 said:
Always liked the BK. Gotta friend who flys one in SAV but they aren't up NVGs yet. Can't imagine doing a scene site in the mountains with no NVGs. Sometimes I wonder how the guys did it in the old days without all the bells and whistles we have today.
Click to expand...

The program at Children's Hospital is NVG. Their operator (Metro) is all NVG.

BK is a good ship, I liked the EC-135's and 145's.
 
Threefingeredjack said:
I guess it all depends on your point of view. IMHO tasking under trained and ill-equipped pilots to fly these kinds of missions borders on criminal. I know it falls on the PIC to make the call to abort, but the pressure to perform is a real factor. I know the feeling well, but I was fortunate to have to have the best equipment and training the nation could afford on my side. When you put yourself in a launch on demand position you'd better bring all the toys and training you can to the party.
Click to expand...

I don't agree with lumping all HEMS pilots into the "under trained and ill-equipped" category. When I first entered the FAA I was placed into a FAA HEMS Unit that oversaw a couple of large operators. The one certificate I was assigned used EC-135's and EC-145's, a few BK-117's and a few BO-105's. They were all NVG equipped and operated as well as several IFR programs. The pilots were extremely well trained and proficient with their jobs.
 
Velocity173 said:
Always liked the BK. Gotta friend who flys one in SAV but they aren't up NVGs yet. Can't imagine doing a scene site in the mountains with no NVGs. Sometimes I wonder how the guys did it in the old days without all the bells and whistles we have today.
Click to expand...

We were tougher than the kids today......:D Seriously, hovering close to a vertical slope in heavy rain while illuminating with a searchlight is a real bi**h. The optical illusion caused by the rain falling through the searchlight beam makes you think you are rising. That is why we had eyes in the back calling our position and using reference points on the ground to talk us through the maneuver. It ain't easy, but then we didn't know any better. :dunno:
 
Velocity173 said:
I agree, but like I said you'll still need an expensive IFR ship for that. At my base there are rumors replacing our VFR B407 with an IFR EC-135. They're analyzing all our turn downs for weather and wondering if giving us a 135 will help. At almost 2 million dollars more than a 407 and higher operating costs, it would have to bring in a significant increase in flights to pay for itself. They tell me it would be the first and only IFR HEMS aircraft in Georgia. It's not really important to me what they decide but I will say that it would be nice having a second engine.
Click to expand...

Our locals run the EC-135s
 
Threefingeredjack said:
We were tougher than the kids today......:D Seriously, hovering close to a vertical slope in heavy rain while illuminating with a searchlight is a real bi**h. The optical illusion caused by the rain falling through the searchlight beam makes you think you are rising. That is why we had eyes in the back calling our position and using reference points on the ground to talk us through the maneuver. It ain't easy, but then we didn't know any better. :dunno:
Click to expand...

Oh I can bet. I could never do the CG missions. Not because of the demanding flying but the over water stuff. I could fly through crap to save somebody over land but over shark infested waters, no way! Plus even with the better technology today it's still the most demanding flying. My friend flys HH-60s. The stories he tells are amazing. High seas under NVG, no hover hold, disoriented, basket swaying, cable rips through the FLIR. Nuts!

Also about qualifications and pressure. EVERYONE is complaining that our 2,000 hr requirement is too high. That's why we have opens everywhere. We can't find enough qualified pilots. Plus Air Evac has like a 5,000 hr average pilot experience. Pressure? None from company. If anything I'll get in trouble for pushing weather. Now internal get home itis because you want to get home and sleep, yeah that's possible.
 
Last edited:
I believe we took a huge step back when we went to single engine aircraft. Pilot experience is down from what it was 15 years ago when many had 5000 TT requirements. Unfortunately the pilots with those kinds of number and experience are diminishing. Not to take away from many of today's pilots as I'm sure many are very good. A couple I worked with with exemplary qualifications still fly and do so for Airevac.

I was fortunate to work as a medic from 1992-1998. At that time we flew the 365 n1 dauphin and later the first Sikorsky C+. Many services across the nation had multiengine heli's and receiving a fax that an accident occurred was not a common occurrence. The service I worked for also flew 2 pilots at night initially but later transitioned the medic to front at night for extra set of eyes.

I don't think I would fly now. The idea of night flight, questionable terrain and single engine just don't sit we'll with me now. I sure wouldn't fly same stuff in my 182.

As a physician now I would personally like to see some form of necessity for flying patients. In many instances the risks associated with flying don't benefit the patient. I know there are times when it is needed but many time its overkill. I can't tell you how many flights I've seen where a patient was flown with minimal injuries only to be discharged from ED a short time later.

My heart goes out to the families and it strikes a cord with me when anything like this occurs. I strongly think they should re-evaluate some methods behind their madness. Economics changed the way things were done when I was flying and it continues to affect the aeromedical industry in a negative manner!
 
Jthamilton said:
As a physician now I would personally like to see some form of necessity for flying patients. In many instances the risks associated with flying don't benefit the patient. I know there are times when it is needed but many time its overkill. I can't tell you how many flights I've seen where a patient was flown with minimal injuries only to be discharged from ED a short time later.
Click to expand...

Reducing the number of unneccesary hems flights would probably do the most to reduce the number of accidents. In some systems, 40% of primary flight patients get discharged within 24hrs. I dont know where the correct number is, but 40 is too high.

There are lots of factors that play into this, one of them liability. Small rural hospitals dont want to get involved in trauma care. Rather than evaluating a patient in a local ER before transferring them out, anything 'trauma' gets loaded in the helo and shipped 1/2 way across the state. While there are certainly patients where this makes sense, in many cases it doesn't.

The other factor of course is money. As long as everyone gets paid, the turbines will turn.

And then of course, there are the bigger hospitals that try to vacuum up the lucrative cardiac work. 'chest pain center' 'stroke center' 'senior citizens not feeling well center'...... All to feed the cath-lab and the cardiac rehab hospital. Of course, the large hospitals make things easy on the local volunteer ambulance company: 'One-call' and we'll take care of it.

Lots of reasons why we are seeing what we are seeing.
 
In this case, it was a repositioning flight so the pressure shouldn't be as high if that were the case.

I do wonder if it's the nature of the decision tree that sometimes comes before they are called. where I used to live, I heard several people say that there were two trauma centers in the city, both with helos. One would get a call. The pilot would decide whether capacity or conditions allowed him to take it. If he said he wouldn't do the flight, they called the other trauma center. If the other trauma center declined as well, AirEvac was called. IF that is true, it would seem more risky condition flights are going to AirEvac as sometimes at least one other experienced pilot has already declined to take the flight for whatever the reason.

Any thoughts on this? Or is that not an accurate depiction of how they are dispatched?
 
CalSTAR requires something like 3,000 PIC helo, 1500 PIC turbine helo, a couple hundred unaided night, instrument helo rated and ATP within a year of hire. They are switching from MD Explorers to EC-135 s and keeping the Bo-105 at a mountain base. As far as I know, they have never had an accident. They will decline a flight when weather is below minimums.

I briefly thought about getting a helo add-on and working up to flying for Calstar. Decided it would cost $50,000+ along with taking a 50-75% pay cut for a few years just to be qualified to turn in an app.
 
weilke said:
Thank You for the lengthy post, nothing like a first person perspective.
Click to expand...

:thumbsup:

Agreed, no need to be sorry for the length. It was nice to get a more full understanding from the inside. I very much appreciated the articulation.
 
You must log in or register to reply here.
Back
Top