Calls For All EMS Ops Under Part 135, Use Of TAWS
Aero-News has learned that in a special report adopted
Wednesday, the National Transportation Safety Board is calling on
the Federal Aviation Administration to impose stricter requirements
on all emergency medical services flights.
The NTSB undertook the special report after investigating 55 EMS
accidents in the three-year span between January 2002 and January
2005.
"The very essence of the EMS mission is saving lives. Operating
an EMS flight in an unsafe environment just makes no sense,"
commented NTSB Acting Chairman Mark Rosenker.
During the study the Board found that while carrying patients or
organs, EMS flights are required to operate in accordance with 14
CFR Part 135 regulations. However, when positioning flights are
conducted without patients on board, they are permitted to operate
under the much less stringent provisions of 14 CFR Part 91.
The Board noted that thirty-five of the fifty-five accidents
occurred on positioning flights with medical crewmembers, but no
patients, on board.
Part 135 and Part 91 requirements differ significantly regarding
weather minimums and crew rest requirements -- two key factors
found in the EMS accidents investigated by the Board. The Board
concluded that the safety of EMS operations would be improved if
the entire EMS flight plan operated under Part 135 regulations and
recommended that the FAA require all emergency medical services to
comply with Part 135 regulations during the conduct of all flights
with medical personnel on board.
The Board's investigation also examined the decision-making
process of EMS operators when evaluating the potential risks of a
flight. Weather, nighttime flight, spatial disorientation from the
lack of visual clues, pilot training and experience, and pressure
to take the flight are all risks associated with the EMS mission.
Safely operating in this high-risk environment calls for the
systematic evaluation and management of the risks. However the
Board found that none of the operators involved in the highlighted
accidents had an established aviation risk evaluation program at
the time of the accident. Therefore the Board recommended that the
FAA require EMS operators to develop and implement flight risk
evaluation programs.
In conjunction with the
lack of risk evaluation programs, the Board's investigation
revealed that many EMS operators lack a consistent, comprehensive
flight dispatch procedure to assist pilots in determining the
safety of a mission. Currently most EMS operators are notified of
an assignment by the local 911-dispatch system or emergency
hospital staff. Because most hospital staff and 911 dispatchers do
not have aviation expertise, they are not aware of flight
requirements, particularly requirements for nighttime flight or
adverse conditions. This information is critical and can help avoid
accidents. The Board asked the FAA to require EMS operators to use
formalized dispatch and flight following procedures that include a
dispatcher with aviation experience, up-to-date weather
information, and assistance in flight risk assessment
decisions.
Finally the report reviewed several technologies that can assist
in flight operations -- terrain awareness warning systems (TAWS)
and night vision imaging systems (NVIS). Controlled flight into
terrain is a common factor in helicopter EMS accidents that could
be alleviated by the use of TAWS. The investigations of 17 of the
55 accidents determined that TAWS might have helped pilots avoid
terrain. The Board recommended that the FAA require the
installation of terrain warning systems on all EMS aircraft.
In addition to TAWS, the Safety Board found that some EMS
operators were using NVIS to enhance a pilot's ability to avoid
terrain. The Board determined that if used properly, NVIS could
help EMS pilots identify and avoid hazards during nighttime
operations. However, because NVIS are not feasible in some
situations such as populated areas with ambient light or numerous
streetlights, the Board did not make a recommendation on this
subject.
In its action Wednesday, the Board also adopted final reports
for seven EMS accidents highlighted in the safety study. A synopsis
of the report that includes the conclusions, and recommendations
can be found on the Board's website.
Briefs of the individual accidents cited, including probable
cause statements, will be available on the website Friday, January
27.