Single Engine Safety

This is nothing new to the HEMS community, and is very much a "hot button" issue with some providers swearing that IFR rated twin engine programs are the only way to go allowing at least the reaction time to look for a safe landing (in theory) once you have an engine failure. His paramedic did ask a valid question, and it was neat he turned it into an article.

My program is a single engine VFR program, and this actually seems to be the trend with majority of most North American HEMS operations. Cost factors and flight plans are what I hear cited most often in regards to the practicality of a single engine VFR program vs. the costliness of an IFR program. I'm still pretty new to the flight aspect itself, but as time goes by more and more makes sense, or it doesn't...and we don't go.

Thanks for posting it. It definitely offers insight for anyone looking to jump blindly into HEMS (no pun intended). Maybe @CANMAN will make a cameo regarding the article, he's a well seasoned flight guy.
 
VentMonkey said:
This is nothing new to the HEMS community, and is very much a "hot button" issue with some providers swearing that IFR rated twin engine programs are the only way to go allowing at least the reaction time to look for a safe landing (in theory) once you have an engine failure. His paramedic did ask a valid question, and it was neat he turned it into an article.

My program is a single engine VFR program, and this actually seems to be the trend with majority of most North American HEMS operations. Cost factors and flight plans are what I hear cited most often in regards to the practicality of a single engine VFR program vs. the costliness of an IFR program. I'm still pretty new to the flight aspect itself, but as time goes by more and more makes sense, or it doesn't...and we don't go.

Thanks for posting it. It definitely offers insight for anyone looking to jump blindly into HEMS (no pun intended). Maybe @CANMAN will make a cameo regarding the article, he's a well seasoned flight guy.
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You guys are VFR? I figured the majority would be IFR (at least they are down here).
 
My main reason for posting was the A-star, which seems like the most common aircraft out there. I work two places, and one is a police helicopter with a secondary medical mission. I trust to pilots, and they know the response area intimately, but it looks like cost has led to single engine IFR, which I'm not thrilled about.
 
VentMonkey said:
Majority being all of REACH and Mercy Air's SoCal ops?
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Yeah haha. The ones that respond to our area (2-3 difference Mercy airs and 2-3 Reach) are all in the EC135 and have IFR.
 
The A Star is cheap, fast, reliable, and has a remarkably quick start up time, TMK.

A twin-engine aircraft certainly has its advantages, but nothing ever guarantees or offers absolutes in this industry. The majority of HEMS crashes seem to be caused by human error, though mechanical failures do happen obviously.

Things such as CRM, and the "3 to go, 1 to say no" rule can help augment safety culture at any program regardless if they're twin-engine, single-engine, VFR, or IFR rated.

Thee biggest thing we harp on is crew safety, if that comes into question regarding a particular mission we don't go; plain and simple.
 
VentMonkey said:
This is nothing new to the HEMS community, and is very much a "hot button" issue with some providers swearing that IFR rated twin engine programs are the only way to go allowing at least the reaction time to look for a safe landing (in theory) once you have an engine failure. His paramedic did ask a valid question, and it was neat he turned it into an article.

My program is a single engine VFR program, and this actually seems to be the trend with majority of most North American HEMS operations. Cost factors and flight plans are what I hear cited most often in regards to the practicality of a single engine VFR program vs. the costliness of an IFR program. I'm still pretty new to the flight aspect itself, but as time goes by more and more makes sense, or it doesn't...and we don't go.

Thanks for posting it. It definitely offers insight for anyone looking to jump blindly into HEMS (no pun intended). Maybe @CANMAN will make a cameo regarding the article, he's a well seasoned flight guy.
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I tend not to get into the twin vs. single debate a ton anymore, and merely just providing my opinion, which comes from only flying in twins. In just skimming through this article one of the things he talks about is maintaining a safe altitude that will allow for auto rotation if the need were ever to arise. That works great in perfect weather, but in marginal weather trying to maintain a higher level altitude because you're in a single, and always thinking about a single engine failure, can be just the situation that puts you IIMC, which in a single VFR program is much more panic inducing then in a twin IFR program.

Yes pilot error, poor CRM, and poor decision making makes up for about 90% of fatal HEMS crashes, but if you are part of the 10% which is saved because of redundancy then you likely don't care about the other 90% and you're still here to tell the story. If I had a choice I would take a twin and an IFR rated pilot anyday. My profile picture is of our base-site which sits on a pier in the inner harbor of Baltimore. About 10 years ago my base had an engine failure during short take off in the month of February. With pulling in 120% power out of the second engine they were able to get enough airspeed to climb out of it and safely fly onto a local airport, do a run on, and the crew walk away needing nothing other than a change of underpants. Had they been in a single they would have been in the drink and likely dead before help would have arrived. Thats the 10% scenario, and my friend is hear to tell the story because we work in an all twin program. Not an everyday scenario by any means but enough to sway my vote. People before profits is a huge factor in the industry.

I also fully believe there are some flights which can be completed safely with IFR capabilities where as VFR programs are likely to turn these down. If weather goes to crap or is not as reported, filing on the fly, climbing, confessing, and picking up a squawk in a twin IFR capable aircraft to either an airport or VFR conditions isn't a factor, punching into the crap in a single VFR is a huge factor. Around my way we have alot of water and weather conditions change pretty rapidly.

End of the day if money isn't a factor then why not have twins and IFR rated pilots? I don't ever foresee a time where I would be willing to fly for a "for profit" program but I also realize after being in this industry for a while that there are alot of solid programs that do the same mission but go about it completely different regarding airframes, budget, weather, training, etc and that is ok. I am just satisfied having the options I do in the area I live.
 
DesertMedic66 said:
You guys are VFR? I figured the majority would be IFR (at least they are down here).
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I think the two biggest deciding factors into VFR vs. IFR programs are cost and conditions (both topography and weather). Area saturated with a lot of hospital based programs then you're likely to see more twins. Area run by a lot of for profit companies then singles are the trend. Singles often do better in high altitude areas, while duals are better suited for extensive over water areas etc.
 
CANMAN said:
duals are better suited for extensive over water areas etc.
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I would love to do water ditching drills. One of the bigger regional programs back home has a base that frequently flies from their base to Catalina Island and back. I can only imagine they practice these drills periodically. I believe they're in 135's.
 
VentMonkey said:
I would love to do water ditching drills. One of the bigger regional programs back home has a base that frequently flies from their base to Catalina Island and back. I can only imagine they practice these drills periodically. I believe they're in 135's.
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You should check out WET. They are a program that does dunker and ditching training. They offer courses at AMTC if you ever go. Awesome class and I know a bunch of the instructors. All personnel assigned to my base (due to location) get the training, we drill routinely, and wear aviation PFD's for a large majority of our flights due to over water time. New HEMS rules that are going into effect soon specify that all crew members will be in PFD's if completing an over water leg and not in auto rotation distances of shoreline, and that will affect all programs nationwide eventually. We have just been practicing it for a while, and crew members can wear their vest anytime they wish. Anyway, if you ever have the chance the training is definately worth it!
 
We have a mix here where I am. We have several single engine Bell 407s... and a few dual engine A109s... I prefer the dual engine for safety and the configuration inside.

From a safety standpoint, dual engine IFR are safer programs- plain and simple.

We must remember, as Canman stated, that most tragic events in avaiation are human error related. Every event is never just the event itself. It is a chain of events that lead to tragic outcomes...

A spare aircraft, with a crew who didn't do a walk around who is stressed about recertification, and a pilot who should have taken a test flight, and a crew who should have turned down a flight, and a pilot who should have timed out and didn't eat dinner... etc etc etc. pick your storyline...

Most of the HEMS crashes are crews and pilots that are seasoned and unfortunately had an episode of complacency.. somewhere along the line, someone's complacency costs lives. "3 to go" and proper planning should be utilized with a fresh set of eyes every time. Pilot error is going to happen... there is not much a crew can do about that besides CRM and ensuring their pilot is good to go.

It is a risky business, and we all know that. We are very aware, and we accept the risks every time we show up to work.
 
Here's some safety questions for you guys in other programs I am curious about:

1. Does your program fly with dual controls (if able) installed at all other than if pilots are going out for check rides?

2. If available, are your medical crew members trained/proficient in getting the auto pilot coupled up in an altitude and heading mode?

3. Once there's a weather turn down, regardless of who turns it down, do you guys utilize this time to discuss why you were either safe/not safe to go? And if a pilot thinks they are able to complete the mission but someone has questions do they articulate why they feel ok taking the flight?

4. Does your base track numbers, and is there any pressure at all to fly? Can be direct or indirect...
 
CANMAN said:
Here's some safety questions for you guys in other programs I am curious about:

1. Does your program fly with dual controls (if able) installed at all other than if pilots are going out for check rides?
The dual controls are not an option in our 407. It might have been in the old triple deuce they had well before my time.
2. If available, are your medical crew members trained/proficient in getting the auto pilot coupled up in an altitude and heading mode?
We drill accordingly, but I'm sure drilling more is always warranted.
3. Once there's a weather turn down, regardless of who turns it down, do you guys utilize this time to discuss why you were either safe/not safe to go?
Yes, we have post-flight debriefings.
And if a pilot thinks they are able to complete the mission but someone has questions do they articulate why they feel ok taking the flight?
Yes, we discuss calls that have the potential for unforeseen or the potential for marginal weather.
4. Does your base track numbers, and is there any pressure at all to fly? Can be direct or indirect...
I am sure we do, our CBS/ assistant ops manager keeps tallies on the actual stats. No pressure, if one of us is uncomfortable we don't go. None of the pilots or other crew members have ever made me feel pressured in spite of still being fairly new.
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All in all I feel safe flying with the bunch I am with, and can confidently say I trust them with my life.
 
I'm not a rotorhead, but want to throw something else out there about the A-Star airframe. Following the FFL crash in July 2015, there were a few articles that came out regarding the crashworthiness of the A-Star's fuel tank(s). Apparently, from what I gathered, this aircraft has a reputation for turning survivable incidents into fatal incidents due to fuel tank failure and post-crash fire. Hopefully, there can be a safety retrofit in the near future.
 
My replies are in bold. Expand below, brother.
CANMAN said:
Here's some safety questions for you guys in other programs I am curious about:

1. Does your program fly with dual controls (if able) installed at all other than if pilots are going out for check rides?
Dual controls are out except for check rides. Pedals obviously do not come out. Even in the 109 the controls are out. The 407 must have the litter removed for check rides.

2. If available, are your medical crew members trained/proficient in getting the auto pilot coupled up in an altitude and heading mode?
Negative, we are trained on emergency shut down once we meet the Earth, emergency comms, and engine fire procedures. We do not fly any autopilot capable aircraft at this time.

3. Once there's a weather turn down, regardless of who turns it down, do you guys utilize this time to discuss why you were either safe/not safe to go? And if a pilot thinks they are able to complete the mission but someone has questions do they articulate why they feel ok taking the flight?
We have a brief and a debrief on every flight and every turn down. Pilots are people and people have varied attitudes. I am fortunate to work at a place where we all get along, and we all communicate openly without fear.

4. Does your base track numbers, and is there any pressure at all to fly? Can be direct or indirect...
Yes, yes, yes. The system is designed to be a no pressure system. If you have a legitimate articulate reason not to go... you don't go. However, corporate tracking of the numbers, competing (unofficially) with other bases, or otherwise other tracking does imply pressure. There is a fear of one day you come to work and boom! Your base is closed down, which in my particular region is ridiculous because between 4 bases within a 100 mile radius we collectively fly about 140-160 missions a month. (Which are good numbers for the bean counters). It does imply pressure to fly, but to me... I don't care about the numbers... this job is not worth my life. The moment I feel as though the company is putting my life in danger for profit I will be back on the ground ambulance full time before you can blink your eyes.[\quote]
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CANMAN said:
Here's some safety questions for you guys in other programs I am curious about:

1. Does your program fly with dual controls (if able) installed at all other than if pilots are going out for check rides?
No.

2. If available, are your medical crew members trained/proficient in getting the auto pilot coupled up in an altitude and heading mode?
We have auto pilot but it's very difficult to obtain access to the pilot (impossible with a patient), we'd likely be on the ground before we could.

3. Once there's a weather turn down, regardless of who turns it down, do you guys utilize this time to discuss why you were either safe/not safe to go? And if a pilot thinks they are able to complete the mission but someone has questions do they articulate why they feel ok taking the flight?
Yes, though we all usually know and agree to no go anyways. We always communicate if a disagreement, but at the end of the day it's 3 to go, 1 for no.

4. Does your base track numbers, and is there any pressure at all to fly? Can be direct or indirect...
Officially we don't track numbers, though we all have an idea of how much we've been flying. I've have absolutely no pressure to fly. Other people apparently have but corporate doesn't play around with that and it has always been addressed quickly!
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SandpitMedic said:
My replies are in bold. Expand below, brother.
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It's great you're keenly aware of the implied pressure of having other services around puts on your program, and that you don't let it affect you/your crews decision making. I think a good majority of pushing weather scenarios are based off that simple fact. If you can't do it some other program might. That mindset is what gets people killed and the fact there are still places that helicopter shop, and programs which don't share weather turn downs with other programs blows my mind.
 
CrispyCCTNurse said:
I'm not a rotorhead, but want to throw something else out there about the A-Star airframe. Following the FFL crash in July 2015, there were a few articles that came out regarding the crashworthiness of the A-Star's fuel tank(s). Apparently, from what I gathered, this aircraft has a reputation for turning survivable incidents into fatal incidents due to fuel tank failure and post-crash fire. Hopefully, there can be a safety retrofit in the near future.
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Same with EC130s
 
CrispyCCTNurse said:
I'm not a rotorhead, but want to throw something else out there about the A-Star airframe. Following the FFL crash in July 2015, there were a few articles that came out regarding the crashworthiness of the A-Star's fuel tank(s). Apparently, from what I gathered, this aircraft has a reputation for turning survivable incidents into fatal incidents due to fuel tank failure and post-crash fire. Hopefully, there can be a safety retrofit in the near future.
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They've had crash resistant fuel tanks for the A-star for a bit now. It's just expensive to do the retrofit so many services aren't doing it.

You'd think paying out death benefits would be more expensive, never mind the safety of your personnel but hey, I'm just a lowly Paramedic not a numbers guy.


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