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09/10/2010 - 03:18

9/11 Remembrance Ceremony set for Salem County Fairgrounds
Today's Sunbeam - NJ.com
A member of the flight crew representing EMS will be speaking at the ceremony, said Pierce. The fire department will either be represented by a Salem County ...

09/10/2010 - 02:10

EMS dispute gets a bit tense
Stockton Record
Before that date, paramedics with the Stockton Fire Department had been providing so-called "advanced life support" techniques instead of procedures of ...
SJ: Lives Not In Danger By EMS ChangesKCRA Sacramento

09/10/2010 - 02:05

Cooling treatment aids heart attack victims
Sarasota Herald-Tribune
Charlotte County Fire/EMS officials announced the new form of patient care Thursday. "It's almost like something out of a science fiction movie," said Dan ...
Body Cooling Treatment Saves Two Lives in Charlotte Co.Wink News

09/10/2010 - 00:19

Crash in Polk County leaves three injured
In-Forum
Nick Troutman, the driver of one of the cars, was transported to Sanford Medical Center in Fargo by Lifeflight. Hospital personnel said Troutman was in ...
Three Minnesotans injured in Polk County crashGrand Forks Herald

all 2 news articles »

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emsflightcrew.com

Landing on scene. Would you be comfortable as a crew member on this aircraft?

Crew Conflict

flyems's picture

How many times has anyone out there been talked into continuing on when they have expressed being uncomfortable? What were the circumstances and how was it handled?

Crew Resource

Anonymous's picture

In the military I fly in Special OPS 130s flying in very extreme conditions, low level mountains, at night, etc... Any crew member can speak up and call "knock it off” All the crew will reevaluate the situation. Even the least experienced have a say in the safety of the entire crew. There are many distracters, bandwagons, blinders, etc that can change the focus of the pilot.

Crew Conflict

Anonymous's picture

I am in the EMS, clearly there was no communication between pilot and flight crew prior to flight, if they were on the ground, perhaps the flight crew could have assisted the pilot in finding a suitable place to land.
Regardless wheather the pilot was a vet or a novice each operation is different, different LZ's obstructions and light, so instead of trying to blame each other and who has more experience on the job, lets assist and learn from each other.

IMC

FlightRN911's picture

Many years ago, I was on a patient flight, crossing over an area that is as flat as flat can be where you could normally see 100 miles or more.
On this flight, we had marginal wtx, which got worse, at dusk. We had a fairly new pilot with a lot of second seat hours in a blackhawk but not many in a single engine EMS heli.
As we flew our visual reference became the lights of the road we were following with significant fog (to the ground). After about 15 minutes of following lights with another 30 minutes or more to go, the pilot decided to turn away from the lights towards where he Knew a small town airport was and we immediately were inadvertent.
I had no idea where we were and I was pretty sure the pilot didn't either. My medic partner was scared silent. The pilot was refusing to land after putting us into a hover over what the pilot stated to be the ground. I could see the ground for brief seconds. He would get close then move saying I am gonna try to get us closer to a road which he thought was there, none of us could see. He landed twice and moved twice. After the second time I insisted he land and stay put after expressing my significant discomfort multiple times. On his third landing I called the lead pilot on my cell phone and put it up to the pilots ear so he could here the "DON'T MOVE IT AGAIN" and I opened my door telling him I was standing on the skids and not moving until he shut down. This time we could see a road (barely) about 20 yards away and he was going to move it again attempting to get closer to the road. I felt like we were on the ground, safe and had a ground truck in route to get us and the patient, so I didn't want to push the luck we already had.
In debrief, this was discussed extensively. (Unfortunately this pilot was later involved in a injury crash in that aircraft).
My partner didn't speak up out of inexperience and fear and I was beyond feeling scared and very pissed.
A bad situation with luck on our sides. SPEAK UP and understand the dynamics of all possible situations.
I learned a lot from this.

Typical

Anonymous's picture

This is very typical for a med-crewmember to throw the pilot under the bus...
I am a pilot, and I will be the first to tell you he should have landed and remained on the ground.

What is typical of this case is this, the med-crewmember has issues with this pilot and will use a situation like this to vindicate her/his issues with the pilot.

It also sounds like this program may not be practicing safety properly. Have they ever heard the "Three to Go, one to stay rule". this also applies in flight, "Three to continue, one to land / return.

This should be briefed daily and undrstood by all crewmembers that this will be practiced, I have turned around a few times at the request of a crewmember, I have turnded down a flight at the request of a crew member. I think this is a program problem and not a pilot problem

What is really learned

johnfjones3's picture

I appreciate your concern, but your post comes across as combative, judgmental, pilot bashing disguised as professional safety concerns.

1. "... fairly new pilot with a lot of second seat hours in a blackhawk but not many in a single engine EMS heli."

This doesn't need to be said since you really don't know all the details of a pilot's past experience and therefore, you don't determine if a pilot is qualified to fly the program any more than a pilot decides if a nurse is qualified to be in the program. This is irrelevant unless you are trying to set someone up.

2. "...After about 15 minutes of following lights with another 30 minutes or more to go, the pilot decided to turn away from the lights towards where he Knew a small town airport was and we immediately were inadvertent."

Now, unless you have personally debriefed the pilot and know what he or she was thinking, your presumption to know the reason for an inflight decision is merely speculative. This may have been a reasonable decision (You know, from a purely pragmatic position, everyone is alive so it couldn't be all bad).

Further, if a pilot in a VFR helicopter got you safely out of a truly inadvertent IMC situation, I think a thank-you might be in order. (As an aside, you could have been IMC but my experience has been that many crew members sitting in the back, or sometimes even in the front seat, cannot accurately tell if the aircraft is inadvertent IMC or not.)

3. "...I had no idea where we were and I was pretty sure the pilot didn't either." How is it that you were sure the pilot didn't know where they were? Since you said that there was an extensive debrief, the extent of pilot disorientation would have been a major topic so you wouldn't have to say, "I was pretty sure." Based on the extensive debrief, you should be able to unequivocally say, "the pilot didn't know." Why appear to default to the "pilot error" paradigm.

4. "... He would get close then move saying I am gonna try to get us closer to a road which he thought was there, none of us could see. He landed twice and moved twice. After the second time I insisted he land and stay put after expressing my significant discomfort multiple times. On his third landing I called the lead pilot on my cell phone and put it up to the pilots ear so he could here the "DON'T MOVE IT AGAIN" and I opened my door telling him I was standing on the skids and not moving until he shut down. This time we could see a road (barely) about 20 yards away and he was going to move it again attempting to get closer to the road."

You talk about a road "which he thought was there" (as if he was confused) and low and behold, you say that there was a road there that he wanted to hover toward; It turns out that he didn't "think" there was a road there, there was a road there and you were wrong. Is it possible that you could be wrong? You say that none of you could see the road which obviously, the pilot could see... then you expect your assessment of inadvertent IMC to be taken for fact?

You say you could see 60 feet to the road, which means that, by your assertion, there could have been more than enough visibility to hover at 3 feet closer to the road. You may not know this, but most pilots can hover a helicopter safely with only some ground clutter visible in the chin bubble and there was obviously a lot more visibility than that.

5. "...I didn't want to push the luck we already had."
Apparently, it never occurred to you for one second that perhaps the skill of the pilot got you that far; No, you say it had to be simply luck. Could it be that you were unwilling to recognize the skill of another team member? It sounds like you are trying to justify your position by standing on their shoulders.

6. "... Unfortunately this pilot was later involved in a injury crash in that aircraft." What does that have to do with this incident? That is completely irrelevant. Was it the same situation? Why do you even need to say that unless you are trying to bash the pilot?

Please hear what I'm saying.

I believe you were truly scared (been there, done that). Further, I believe that you needed to speak up, forcibly if necessary. In that regard, if the pilot was going to move the aircraft 20 yards and you were on the ground, you could have even told them that you were so uncomfortable, you were getting out which would have been a strong, and reasonable message.

No, you had to call the chief pilot on the phone. You had enough time to make a phone call. So how much time did you have to forcibly, but rationally and professionally make a case to the PIC who was obviously in a stressful aviation environment?

The pilot could have made some bad decisions and I hear that you learned something from this, but let me tell you what the pilots may have learned; "If there is a problem in flight, the medical crew members will be the first one to throw them under the bus."

jj

Epilogue?
Let me give you a story:
A pilot is flying a single engine VFR helicopter at night in marginal weather to an airport. The weather ahead really looks iffy. This aircraft has a lot better visibility than the twins he is used to flying so he is very comfortable with the situation but he believes that it could get worse ahead.

Rather than take a chance, he decides to be safe and since he has reasonable VFR now and has a clear place to land that is not far from a road, he makes a decision and turns. In the midst of this difficult decision and the stress of the operation, the flight nurse in the back is critiquing his decision and talking about their comfort level.

There is not much he can do about that now and just wishes that they would keep the aircraft a little more sterile so he can make his approach and landing to the middle of the clear area where he knows there are no obstructions. He knows it's far from the road, but he figures that if he needs to, after he lands, he might be able to reposition the aircraft.

After the emotional release, there is a nurse in the back who tells him again that they are really uncomfortable in this situation. In the realm of cosmic significance, the pilot hears the nurse but knows that there is nothing else he can do other than complete the landing.

He makes the landing and after all this stress, decides to reposition the helicopter closer to the road which is easy to see. It's not a big deal because the area is very clear but he figures that his fellow crew members, since he is just hovering, will help him with clearance. He might need to move it twice just to be safe.

Then he gets a door open light and a flight nurse while he is at the controls, the flight nurse is handing him a cell phone.

Now, this is purely a fictitious but can you see how things can be presented to present a egocentric position rather than an objective team-safety consensus.

I gotta call BS -

Anonymous's picture

Where do I start without this becoming a personal mudslinging contest...

I guess I must congratulate you on your pride in your profession and willingness to defend the pilot's perspective. And for putting the same set of presented circumstances in a different light. I also realize that all of us bring certain preconceptions and assumptions to the table when discussing anything like this - based on our training and experience. Just so the framework for our discussion is in the open - I am assuming the Vendor involved has a SOP that is commonly referred to as the "one to say no" rule, and that the Medical side of the house is not CAMTS certified. However I think you are missing the point here...

Regarding point 1: "This doesn't need to be said since you really don't know all the details of a pilot's past experience and therefore, you don't determine if a pilot is qualified to fly the program any more than a pilot decides if a nurse is qualified to be in the program."

Actually, there are a lot of RN's and Medics who who technically meet the minimum requirements for their positions and the same could be said of them. And when the show poor medical judgement, it very well may be - in court. The statement is a valuable part of the OP's story as it give a frame of reference. If the same pilot was a 10 year vet of that service with 5000 hours in-type and the same thing happened, it would be just as valuable a comment - as it points to a different underlying cause (complacency and overconfidence).

Regarding point 2: "Further, if a pilot in a VFR helicopter got you safely out of a truly inadvertent IMC situation, I think a thank-you might be in order."

To a point, true. But that is the crux of the matter. The CONTINUATION into what was then no longer an IIMC situation but actual IFR conditions IS TOTALLY DIFFERENT. If the pilot made the situation worse, repeatedly, even after being asked to land (and thus negating the "crew" concept totally and violating the "one to say no" SOP) and showed signs of wanting to do it again on the same flight - I think I'd seriously consider exiting the aircraft as soon as the ground was safely close (as you also suggested)!

Regarding point 3: Valid and good comment.

Regarding point 4: Yes the pilot has a better point of view but from the same text you quoted, nowhere did it say the pilot was, in ANY of the THREE landings, on a road. Just that he landed and took off again. Now you are interpolating data (a road in sight) not present. The nurse gave the pilot the benefit of doubt and only communicated with the pilot AFTER the first landing - at which time the pilot had already violated company policy by initiating a flight into known IMC!

While hover-taxiing at 1'AGL at a walking pace in fog may be legal under FAR 91 as the pilot can see the ground and objects in time to ignore them it is FAR from SAFE or WISE (especially in non airport areas with all kinds of ground debries that rotorwash can disturb and guywires/thin grey metal sign posts etc that are almost invisible from 30' away in fog) and I can pretty much predict the NTSB/FAA's comments if an investigation were conducted after an incident/crash with those circumstances.

Regarding point 5: "Could it be that you were unwilling to recognize the skill of another team member? It sounds like you are trying to justify your position by standing on their shoulders"

Skill may have allowed the first landing under IIMC conditions - but no matter how skilled, all of us who have been in this game for a while also know of highly skilled individuals who, for lack of a better term, simply ran out of luck. Once that first event was over, both skill and luck were involved - skill to prevent an incident and luck that nothing in the area but beyond the horizontal visual range intersected their flight path.

Regarding point 6: "Unfortunately this pilot was later involved in a injury crash in that aircraft. What does that have to do with this incident?"

Are you serious? How about it being predictable - or put another way, that pilot had already showed poor judgement in an IMC situation? And did you just miss the fact that the pilot IGNORED repeated requests from the medical crew to LAND? That it took the CHIEF PILOT giving direct orders via cellphone to get him to follow company SOP instead of his own pride (thinking he could still carry on...)?

"So how much time did you have to forcibly, but rationally and professionally make a case to the PIC who was obviously in a stressful aviation environment?"

That is the crux of the matter - the pilot was so task focused he had lost partial situational awareness. The cellphone was what it took to break through that tunnel vision so that communication could begin. Remember that whole thing in CRM about being simple, factual, direct and forceful as a technique to interrupt the thought process of the PIC and allow him to reorient to the current situation?

"but let me tell you what the pilots may have learned; If there is a problem in flight, the medical crew members will be the first one to throw them under the bus."

OK - fair comment even if I think the lesson learned is the wrong one. But here is what the medical crew learned - that pilot is overconfident, does not work as a team member, possibly is easily task saturated and ignores SOP's.

The take home message to all new medical flight crew members might well be - Nurses and Paramedics do not kill pilots (by forcing them to fly), but pilots are CONTINUOUSLY killing medical crews. Makes being a TEAM even more critical.

(My background: I'm NOT a pilot, but a medical crew member for 16 years who has survived over 3600 hours of flight time and numerous CONCERN eligible events and other incidents - and lost 6 close friends and another 18 aquaintances to human errors in the cockpit)

Old Pilot

Anonymous's picture

Well said

Happy Holidays everyone. I've

admin's picture

Happy Holidays everyone. I've been reading the posts here and appreciate each of you; first for the work that you do in this very challenging field and second for your willingness to take the time to put your experiences out there for others to read. That being said, please try and refraim from inflamatory comment or rebuttle in your writings. If you disagree, say "I disagree because X". If you find insulting or offensive a post try and look at it from another perspective and if you still find fault just say "I disagree". There is nothing to be gained by anyone berating anyone else. Lets focus on what we can do to build up this profession (besides that which we are all currently doing) and not attack one another. I think we can all agree that if any one crew member becomes uncomfortable then we abort the mission in the safest manner possible and live to fly another day. Effective, early communication is key (and that is not always easy for med crew or pilot when people are new to a program).

This is a challenging potentially dangerous job and we all must work together for a positive outcome.

training

ATP's picture

To me there should be CRM training with the med crew and the pilot. Even though the med crew in many companies is not considered "crew", they may very well save your life one day calling out an impending collision. Why wont companies step up and train more? Money of course.

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