Premium on Safety - Issue 38, 2020 - 1

PREMIUM ON SAFETY
ISSUE 38 FALL 2020

IN THIS ISSUE

Safety Spotlight: Helicopter Air Ambulance Safety 01
Tech Spot: Cabin Connectivity 04
Best Practices: In Case of Emergency 06
ASI Message: A Fly-By to Remember 07
Lessons Learned: False Economies 10
USAIG Performance Vector Spotlight 12

SAFETY SPOTLIGHT

Helicopter Air Ambulance Safety
A team of front-line risk managers

A MESSAGE FROM USAIG

The Power Of
Personal Examples
Oscar Wilde gets the nod for deeming imitation
the "sincerest form of flattery." But that implies
the imitated behavior is a positive one. Someone
co-opting a bad habit or emulating a personal
technique that you're not really proud of is not so
much flattering as it is annoying or depressing. Just
ask a parent. Maybe it's this year's abundance of
soul-shaking challenges that has me thinking a lot
about the power of personal examples and actively
seeking them. Being tested will do that to you.
Whether it's the trials of growing up, matriculating
in schools and training courses, or progressing
along a career path, we all draw heavily from the
examples of others.
I had a fresh pair of wings on my chest and
was halfway through my first qualification in an
operational helicopter. We'd completed all of the
flight's required syllabus items and my instructor
said "I'll fly home" and took the controls. For the
next few minutes, I rode along for an impromptu
air show involving a series of unbriefed
maneuvers that pressed many of the aircraft
limits I'd been working to memorize. All were
done within 200 feet of sea level, some very near
to boats in the area before we proceeded toward
the coastline for an ATC pickup. I'll admit that
youthful inexperience allowed my first thought

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1

BY SCOTT M. SPANGLER
Using helicopters for evacuation of injured individuals was born during the
Korean War. Vietnam defined its adolescence and introduced the golden hour,
the time to treatment that vastly increased the chances of survival. Going
to work as a civilian it became the helicopter emergency medical service
(HEMS), and the number of operators grew rapidly. So did their accident
rate, peaking early in the 21st century. To reverse the trend, the National
Transportation Safety Board issued safety recommendations, and the FAA
responded by issuing Part 135 Subpart L in 2014 and its companion Advisory
Circular 135-14B, Helicopter Air Ambulance (HAA) Operations.
The name change was part of its maturation (call it the mindset reboot
that many make when stepping up to adulthood). Helicopter air ambulance
operations have nothing to do with the medevacs that TV viewers see the U.S.
Coast Guard make during the crab-fishing documentary "Deadliest Catch."
Their primary purpose is rescue from gnarly situations. If the victims need
medical attention, Coast Guard rescue swimmers are trained emergency
medical technicians (EMTs), but they provide only basic medical assistance.
(Swimmers in Alaska are intermediate EMTs, which allow them to start IVs.)
Helicopter air ambulances, on the other hand, can be flying emergency rooms
with a medical crew of registered nurses and advanced EMTs certified to
provide critical care not only in a hospital ER but also as a trained member of
a helicopter crew. Given this difference, the AC discourages Part 135 operators
from describing their flights as "missions" in their "operator manuals,
training, and risk analysis programs.... The emphasis should be on providing
transportation rather than completing a mission."
From a fixed-wing point of view, given their foundation for aviation safety,
what seems to be missing from Part 135 Subpart L is the requirement for two
pilots. While not identical, military and civilian helicopter efforts are related,
so why not require two pilots for HAA? As M*A*S*H reruns reveal, the first

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