# HEMS crash on X-Mas. Sick of posting this news.



## SandpitMedic (Dec 26, 2019)

I mean... do military aviators crash this much? Commercial? Everyone wants to talk intubation being a hot issue and suicide prevention... 
Yeah, they’re issues, sure... BUT

Here is an in-your-face issue that get swept away after a few weeks. 
Why in the **** are EMS aircraft always crashing and our people dying?









						Pilot dies as air ambulance crashes on Christmas
					

A Survival Flight helicopter has apparently crashed at the Headland Airport and at least one is injured.




					www.wtvy.com


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## SandpitMedic (Dec 26, 2019)

RIP to the crewman lost.


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## PotatoMedic (Dec 26, 2019)

It always sucks.  Least this one wasn't pilot error


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## DesertMedic66 (Dec 26, 2019)

I don’t know if I would really include this incident into the normal why are we crashing talk. From the reports that I have read the pilot suffered a medical issue and was attempting to land when the crash happened. It is very likely that when he went unconscious or arrested is the exact time when the crash happened. This crash would have happened on any helicopter, airplane, vehicle with a single operator.

In this incident probably the only thing that would have been a dual pilot configuration. But that is the vast minority of configurations in the USA. If you want dual pilot then you have many of the most popular airframes for HEMS not fitting that role for either not having a copilot seat or having weight issues.

Sad and unfortunate that the pilot died but you have to give them credit for saving everyone else.


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## MetroMedic94 (Dec 26, 2019)

SandpitMedic said:


> I mean... do military aviators crash this much? Commercial? Everyone wants to talk intubation being a hot issue and suicide prevention...
> Yeah, they’re issues, sure... BUT
> 
> Here is an in-your-face issue that get swept away after a few weeks.
> ...


The one thing the military (and even commercial) does that air ambulances do not is have a co-pilot. Should the PIC (Pilot in Command) ever have issues and becomes unable to safely pilot the aircraft, the SIC (Second In Command) assumes PIC capabilities. I have yet to see an air ambulance to have a co-pilot, but I also attribute this to size of the helicopter. Then again, there are options out there that allow for two pilots, crew and a patient, it's just more expensive. 

Thats my opinion on the matter. I am still saddened every time I see these. A very sad and unfortunate situation.


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## Peak (Dec 26, 2019)

I think you still have to think about HEMS being dangerous in this case. In military and civil aviation there are strict limits on how long and how often you can fly. There is also a large amount of pressure to fly when you don't feel 100%. The exceptions to FAA regulations for emergencies are insanely overused by HEMS groups.

Could stress and fatigue contributed to the pilot having a medical emergency? Did the pilot feel pressured to fly even if he had not been feeling well, even if it was nausea or generally feeling unwell? When was his last FAA physical, was it presented with an accurate past medical history?

Given the already hazardous nature of HEMS flights I'm shocked that there isn't more strict safety restrictions. Why not require two pilots, two engines, and IFR capability?

Around here there have been a few flights that the military has had to take because the HEMS helicopters couldn't handle altitude, weight, and temperature. These are pretty routine summer conditions and in areas that often have a need for critical care providers and helicopter transport.


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## CCCSD (Dec 26, 2019)

Because cost cuts into profit.


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## CANMAN (Dec 26, 2019)

This is unfortunately the same program that just crashed last month and killed the entire crew as well. While this obviously was a medical issue, I agree with Peak that there may be more to the backstory leading up to the event given the program's SOP's that have been the hot topic on the last crash. People can tout old statistics all they want, but there is a reason I have said I will never fly in a single engine ship without an autopilot and the ability to access it in cruise altitude. Personally I believe in two is one, and one is none when it comes to this type of thing, and personally have friends that are still here today because of the air frame they were flying in. 

We are a SPIFR program, as was my previous program. At both places we routinely train with the use of the auto-pilot, GPS, and in-flight emergencies, and could get up front to the controls if stuff is really hitting the fan as a last ditch effort. You will never mitigate every single danger out of the profession, but you can certainly better your odds with good equipment and training. 

There has never been such a study, but I would love to see a study that compared crash statistics with for profit vs. non for profit programs to see if there is any increase in correlation.


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## VFlutter (Dec 26, 2019)

It may be an unpopular opinion but I think the industry allows pilots to fly way past their prime either due to shortage or culture. It is not uncommon to hear pilots joke about their "Flight Physicals" that can be obtained from an unscrupulous physician , despite health issues, with ease. HEMS is a challenging aviation environment and should have stricter evaluations. Just because a pilot can pass a check ride does not necessarily mean they are well suited for actual HEMS operations and potential emergencies.

I have flown many pilots in their 60s, mostly prior military, who are fantastic aviators whom I trust however I still think there is a point where this is a younger mans' profession.


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## SandpitMedic (Dec 26, 2019)

@CANMAN and @VFlutter 

Excellent posts, and I agree with every point each of you made.


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## EMDispatch (Dec 26, 2019)

I do have to say Maryland State Police Aviation, since 2008,seems to be on it from the safety aspect.  But perhaps a lot of that has to do with being a state entity, and a for profit entity.


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## CANMAN (Dec 26, 2019)

EMDispatch said:


> I do have to say Maryland State Police Aviation, since 2008,seems to be on it from the safety aspect.  But perhaps a lot of that has to do with being a state entity, and a for profit entity.



Don't get me started about MSP and safety. A lot of the changes they made weren’t their initial ideas (like two pilots) and they have cost the state taxpayers an astronomical amount of money to provide a sub-par service as far as medicine capabilities go. The same people who drool over a fleet of 139’s large enough to service Texas are also the same people who complain about taxes in MD. Instead of blaming the real issues that caused the Dauphin sized hole in the ground they decided to use that tragedy as a segway to get new overly expensive aircraft. I lost a good friend in that crash and the amount of ill-informed MSP bootlickers in the MD fire and EMS system is appalling. Even all the new people in the Aviation Command don’t know what they don’t know because they’re pumped up to think they’re the biggest and the best. That just isn’t so now a days, it isn’t the 70’s and 80’s anymore. MSP is a huge political machine with a seemingly unlimited budget. They also don’t operate under part 135 ops, so are completely different and not really relatable to this discussion in that aspect.


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## akflightmedic (Dec 26, 2019)

Medevac Alaska again...ugh. No fatalities thankfully









						3 people survive Christmas Eve crash involving Medevac Alaska
					

The crash near Koliganek follows deadly crash involving the air ambulance service Nov. 29 near Cooper Landing.




					www.ktva.com


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## SandpitMedic (Dec 27, 2019)

akflightmedic said:


> Medevac Alaska again...ugh. No fatalities thankfully
> 
> 
> 
> ...


Ugh! Shut them down.
Glad they survived, but that is either luck or pilot skill, probably more luck.

As I said initially... what gives with this being so frequent?! Enough is enough.


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## EMDispatch (Dec 27, 2019)

CANMAN said:


> Don't get me started about MSP and safety. A lot of the changes they made weren’t their initial ideas (like two pilots) and they have cost the state taxpayers an astronomical amount of money to provide a sub-par service as far as medicine capabilities go. The same people who drool over a fleet of 139’s large enough to service Texas are also the same people who complain about taxes in MD. Instead of blaming the real issues that caused the Dauphin sized hole in the ground they decided to use that tragedy as a segway to get new overly expensive aircraft. I lost a good friend in that crash and the amount of ill-informed MSP bootlickers in the MD fire and EMS system is appalling. Even all the new people in the Aviation Command don’t know what they don’t know because they’re pumped up to think they’re the biggest and the best. That just isn’t so now a days, it isn’t the 70’s and 80’s anymore. MSP is a huge political machine with a seemingly unlimited budget. They also don’t operate under part 135 ops, so are completely different and not really relatable to this discussion in that aspect.


 Fair enough, I’m not their biggest fan by any means. The only positive they had is speed since they’re just medic staffed, but with their change in practices, it can take upwards of 20 minutes for us to get a helicopter from 10 miles down the road.


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## CANMAN (Dec 27, 2019)

EMDispatch said:


> Fair enough, I’m not their biggest fan by any means. The only positive they had is speed since they’re just medic staffed, but with their change in practices, it can take upwards of 20 minutes for us to get a helicopter from 10 miles down the road.



Yeah they’re start up sequence to pulling pitch is upwards of 11 minutes. My program is right next door to one of their ships.


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## Tigger (Dec 28, 2019)

SandpitMedic said:


> Ugh! Shut them down.
> Glad they survived, but that is either luck or pilot skill, probably more luck.
> 
> As I said initially... what gives with this being so frequent?! Enough is enough.


Sounds like this was a different aviation provider operating the aircraft this time? I've often wondered in arrangements like this where small aviation service companies are providing aircraft about how the dynamic between crew and pilot works, like does the crew have the same info about weather and aircraft that the pilot does?


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## SandpitMedic (Dec 28, 2019)

Tigger said:


> Sounds like this was a different aviation provider operating the aircraft this time? I've often wondered in arrangements like this where small aviation service companies are providing aircraft about how the dynamic between crew and pilot works, like does the crew have the same info about weather and aircraft that the pilot does?


Perhaps, but they wouldn't be flying if the company had not accepted the flight - the company shoulders the blame for these crashes. I understand there are more dynamics at play here, but I do not care. Perhaps my shutting them down comment is a knee-jerk reaction, but that seems like what needs to happen, at least a temporary safety stand down so the investigators can go in and do their thing.  
To me, two crashes in one month puts this company on the X list regardless of the cause. Anyone who would work for them is putting themselves in danger. Fool me once...


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## PotatoMedic (Dec 28, 2019)

Tigger said:


> Sounds like this was a different aviation provider operating the aircraft this time? I've often wondered in arrangements like this where small aviation service companies are providing aircraft about how the dynamic between crew and pilot works, like does the crew have the same info about weather and aircraft that the pilot does?


I can answer that sorta.  The answer is it depends.  My service I dispatch for contracts both fw and rw services.  When we dispatch a flight we keep the pilot blind to the call info outside of location and if it has been turned down by another service and why.  The pilot checks weather and we also check weatherturndown.com.  Our crews are able to stop the line if they don't like the weather.  I've even stopped a call because the pilot said he was willing to try and thinks he could do it but said it was 50/50 (at that point I said we will decline it without providing further info and we arranged another method).  We're all required to take annually a class on aviation weather.  But honestly for the most part we defer to the pilots to make the call about weather.  As far as relationship between the crews and pilots.  They more or less live together so they know each other quite well.


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## akflightmedic (Dec 29, 2019)

With my first outfit in Alaska, there were two main air vendors. To keep it fair, first half of month was x, second half of month was y. If y, was unavailable x was back up. For a small town it worked. 

As for the dynamics of pilots in AK flying these small AC, there are a couple things worth knowing. 

1. Bush pilot. Know what this means. Not saying it is right but AK people have a very “can do” attitude. If a bush pilot turns down a flight you better not step foot outside. Otherwise they can and do fly in harsh weather every single day. It is a fact of life there. Some of the crap I flew in would make you curl up and cry and that is not a boast. Weather changes at the drop of a hat there and if we waited for ideal conditions, well a lot of flights simply would never take place. 

2. With the above statement some may say fine then don’t fly. But here is the kicker. There are NO roads for many of these places and ones which have roads are impassable. Read that again...NO roads. 

3. Regards to sterile cockpit....everyone knows everyone. Many times the pilots knew as much and sometimes knew before we did. They fly there every day for years on end. Lot of family ties too. Everyone knew everything where I flew. 

The way of life is hard for some to imagine. It was culture shock to me as well and this was nearly 15 years ago. Places like this exist.


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## FiremanMike (Dec 30, 2019)

CANMAN said:


> Don't get me started about MSP and safety. A lot of the changes they made weren’t their initial ideas (like two pilots) and they have cost the state taxpayers an astronomical amount of money to provide a sub-par service as far as medicine capabilities go. The same people who drool over a fleet of 139’s large enough to service Texas are also the same people who complain about taxes in MD. Instead of blaming the real issues that caused the Dauphin sized hole in the ground they decided to use that tragedy as a segway to get new overly expensive aircraft. I lost a good friend in that crash and the amount of ill-informed MSP bootlickers in the MD fire and EMS system is appalling. Even all the new people in the Aviation Command don’t know what they don’t know because they’re pumped up to think they’re the biggest and the best. That just isn’t so now a days, it isn’t the 70’s and 80’s anymore. MSP is a huge political machine with a seemingly unlimited budget. They also don’t operate under part 135 ops, so are completely different and not really relatable to this discussion in that aspect.



Do you still need to be a trooper with enough seniority to bid the next available open spot?  

I think working for a state based HEMS program would be nice, but not at the cost of falling asleep in the freeway turnaround for 10 years..


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## CANMAN (Dec 30, 2019)

FiremanMike said:


> Do you still need to be a trooper with enough seniority to bid the next available open spot?
> 
> I think working for a state based HEMS program would be nice, but not at the cost of falling asleep in the freeway turnaround for 10 years..



Still need to be a trooper yes, no wait list currently though. They're hurting for people and sucking people right off of field training into Aviation now, despite a lot of the providers not being super experienced.


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## PotatoMedic (Dec 30, 2019)

CANMAN said:


> Still need to be a trooper yes, no wait list currently though. They're hurting for people and sucking people right off of field training into Aviation now, despite a lot of the providers not being super experienced.


Wonder what would happen if they adequately paid their flight medics?


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## FiremanMike (Dec 30, 2019)

PotatoMedic said:


> Wonder what would happen if they adequately paid their flight medics?



Trooper pay range is 50k-91k, increasing all the way to 101k if you make "master trooper".. Not sure if there's a flight medic in the USA making more than that..


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## CANMAN (Dec 30, 2019)

PotatoMedic said:


> Wonder what would happen if they adequately paid their flight medics?



Their pay has increased and it's like 56K now once you make it to the flight line, plus the car which is worth something, but they have decreased their starting pay while in the academy to 35K for the first six months. I don't know many people (second income or not) that can make that work well and live in this state.

IMO they just aren't a premier service to work for anymore, and I think their safety culture is lacking. They provide standard MD protocol medicine with the addition of RSI. That is all. Private HEMS programs in the area do scene work into VA, have a much higher scope of practice and capabilities, and you can make double the salary. Thus why I work private HEMS. You really have to want to be a trooper, endure a 26 week live in academy, and be willing to work for fairly lower wages to work for them. With more and more people going to nursing school and an increasing paramedic shortage, especially paramedics that also WANT to be police officers and jump through a Marine style academy, it's fairly easy to see why they are becoming increasingly desperate for medics. They have taken people who have been medics for less then a year and put them on a Baltimore City medic units for some ride time, and then toss them onto the A/C. 

IMO the absolute best thing they could do for their program and their patient's is hire some civilian paramedics who have a critical care background to augment their clinical capabilities, and keep one Trooper on the aircraft for LE missions, but that will never happen. They have too much pride, think they're the greatest, look down on the field providers in the state, and in recent years my field interactions with them have been filled with nothing but cockiness and superior attitudes. They simply don't know what they don't know and I think they truly believe they are still a premier HEMS program.

A few years ago I oriented one of their guys to a part-time position at my old program. Nice guy and had been with them for years/disagreed with a lot of the changes over the years. One of the things he lead with when we started dipping into vent management was "we are getting vents on the aircraft at work" to which I replied "I think that is a horrible idea". He kinda balked at my reply, which was was based on the fact that 10 minutes earlier he could explain zero to me about minute ventilation. What it was, how to calculate, etc. But their "Maryland's Finest". I digress, I am going to go take my B/P now 😆.


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## FiremanMike (Dec 30, 2019)

CANMAN said:


> Their pay has increased and it's like 56K now once you make it to the flight line, plus the car which is worth something, but they have decreased their starting pay while in the academy to 35K for the first six months. I don't know many people (second income or not) that can make that work well and live in this state.



But it increases with the rest of the trooper pay scales, right?



> IMO they just aren't a premier service to work for anymore, and I think their safety culture is lacking. They provide standard MD protocol medicine with the addition of RSI. That is all. Private HEMS programs in the area do scene work into VA, have a much higher scope of practice and capabilities, and you can make double the salary. Thus why I work private HEMS. You really have to want to be a trooper, endure a 26 week live in academy, and be willing to work for fairly lower wages to work for them. With more and more people going to nursing school and an increasing paramedic shortage, especially paramedics that also WANT to be police officers and jump through a Marine style academy, it's fairly easy to see why they are becoming increasingly desperate for medics. They have taken people who have been medics for less then a year and put them on a Baltimore City medic units for some ride time, and then toss them onto the A/C.



Well that's silly about the lack of experience.. I'm reading on their website that they're alone in the back of the aircraft?  Thats.. hmm..




> A few years ago I oriented one of their guys to a part-time position at my old program. Nice guy and had been with them for years/disagreed with a lot of the changes over the years. One of the things he lead with when we started dipping into vent management was "we are getting vents on the aircraft at work" to which I replied "I think that is a horrible idea". He kinda balked at my reply, which was was based on the fact that 10 minutes earlier he could explain zero to me about minute ventilation. What it was, how to calculate, etc. But their "Maryland's Finest". I digress, I am going to go take my B/P now 😆.



I mean.. that's a bit nitpicky... Vents are something you need to be inside of every day.. I've only been out of critical care for 5 years and I can't remember how to do much beyond tidal volume based on IBW (which I'd need an app to remember), rate, and o2.. I was well trained when I got hired on how to use it and then monitored for several months to ensure I knew what I was doing.. I'd have to hope that a new piece of critical equipment like that would receive the same level of training..

But I don't work in Maryland, you know the system better than I.. I'm just sharing my "gut" on how things SHOULD be..


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## CANMAN (Dec 30, 2019)

FiremanMike said:


> Trooper pay range is 50k-91k, increasing all the way to 101k if you make "master trooper".. Not sure if there's a flight medic in the USA making more than that..



Sure there is. I know a flight medic in my program who’s been there since 1984 and easily does 120 without overtime. Hospital based program.


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## FiremanMike (Dec 30, 2019)

CANMAN said:


> Sure there is. I know a flight medic in my program who’s been there since 1984 and easily does 120 without overtime. Hospital based program.



Wow!  Flight medics in this area are about half of that on the top end..


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## CANMAN (Dec 30, 2019)

FiremanMike said:


> But it increases with the rest of the trooper pay scales, right?


It does, those steps are yearly, if funded by the state.


FiremanMike said:


> Well that's silly about the lack of experience.. I'm reading on their website that they're alone in the back of the aircraft? Thats.. hmm..


They now have two providers in the back, both who are troopers and sometimes both are medics, other times it’s a medic and an EMT/trooper who is in medic school for example. The primary person who is always a medic is their “Crew Chief” and the secondary provider is called the “Rescue Tech”.


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## Peak (Dec 30, 2019)

FiremanMike said:


> I've only been out of critical care for 5 years and I can't remember how to do much beyond tidal volume based on IBW (which I'd need an app to remember), rate, and o2.. I was well trained when I got hired on how to use it and then monitored for several months to ensure I knew what I was doing.. I'd have to hope that a new piece of critical equipment like that would receive the same level of training..



So much this. I feel like ventilators are something that are massively underappreciated in how complex there management really is, especially for complex patients. I would say that I understood the theory of ventilation pretty well as a medic, a bit better as an ED nurse, but I never really appreciated how much of a impact seemingly subtle changes can make until I started working in the unit. 

I thought I was the hot s*** because we had a vent on our bus (and to my knowledge no other 911 bus in the county did), only later did I really understand how limited that vent was and how complex respiration and ventilation really is.


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## CANMAN (Dec 30, 2019)

FiremanMike said:


> Wow!  Flight medics in this area are about half of that on the top end..



100-120 doesn’t go far with MD/DC/NOVA cost of living man. I made more then that last year and ain’t driving the Porsche I want lol. You want a decent crib in a good school district you’re gonna pay.


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## FiremanMike (Dec 30, 2019)

CANMAN said:


> 100-120 doesn’t go far with MD/DC/NOVA cost of living man. I made more then that last year and ain’t driving the Porsche I want lol. You want a decent crib in a good school district you’re gonna pay.



My kids are about to graduate from high school, and I’d be ok with a rural home... 

Man you kinda got me thinking about this... I’m already a sworn officer with some experience there and a lot of EMS experience, I’d have to imagine I’d be a pretty solid candidate..


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## CANMAN (Dec 30, 2019)

FiremanMike said:


> My kids are about to graduate from high school, and I’d be ok with a rural home...
> 
> Man you kinda got me thinking about this... I’m already a sworn officer with some experience there and a lot of EMS experience, I’d have to imagine I’d be a pretty solid candidate..



PM me if you want to chat further, I went through their process and academy thinking it was what I wanted to do back in 05. You could def get hired if that’s what you want to do. There’s no laterals everyone does the academy regardless of previous LE experience but you would be a shoe in.


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## akflightmedic (Dec 30, 2019)

Yeh. I made 100k+ flying in Alaska and that was 20004-2006. 

Then flew for another outfit which provided my housing and paid over 65k+. 

The troopers don’t have the market locked up wage wise.


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## VFlutter (Dec 30, 2019)

We recently had a MSP Pilot troll on our base Facebook page commenting about how great their program is and giving us "constructive criticism" on how he felt we should do things. Entertaining


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## CCCSD (Dec 30, 2019)

Don’t you know Pilots know everything..?


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## FiremanMike (Dec 30, 2019)

CCCSD said:


> Don’t you know Pilots know everything..?



I'm reminded of it every time I check justhelicopters....


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## Tigger (Dec 30, 2019)

SandpitMedic said:


> Perhaps, but they wouldn't be flying if the company had not accepted the flight - the company shoulders the blame for these crashes. I understand there are more dynamics at play here, but I do not care. Perhaps my shutting them down comment is a knee-jerk reaction, but that seems like what needs to happen, at least a temporary safety stand down so the investigators can go in and do their thing.
> To me, two crashes in one month puts this company on the X list regardless of the cause. Anyone who would work for them is putting themselves in danger. Fool me once...


I don't disagree. I'm just more curious about how the operation actually works when you have what amounts utility aviation company flying the plane. Here we have nothing like that, the pilot and clinical staff are all together all the time it seems.


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## FiremanMike (Dec 31, 2019)

Man, I wish flight pay was like that around here.. 

Although, as I think I've mentioned before, I'm stuck in my pension system for 6 years and 7 days..


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## GMCmedic (Dec 31, 2019)

I didnt make 100, but I made 75 in my first full year flying. Thats a pretty comfortable wage in Indiana.


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