The FAA needs to do more to regulate helicopter emergency medical services, the NTSB said on Tuesday, and operators also need to improve their training and procedures. "The pressure on HEMS operators to conduct their flights quickly in all sorts of environments makes these types of operations inherently more risky than other types of commercial flight operations," said NTSB Chairman Deborah Hersman. "Operators need to use every available safety tool to conduct these flights and to determine when the risk of flying is just too great." The board said the FAA should mandate better pilot training, improve its data collection and monitoring, develop a low-altitude airspace infrastructure, and require crews to be trained to use night-vision systems. The agency should also require the use of autopilots during single-pilot HEMS operations. Operators should work to improve pilot training and upgrade their equipment, the NTSB said.
The NTSB also made recommendations to two other agencies that are involved with HEMS -- the Centers for Medicare & Medicaid Services at the Department of Health and Human Services and the Federal Interagency Committee on Emergency Medical Systems. CMMS should consider linking Medicare reimbursements to patient transport safety standards, the board said. And FICEMS should look for better ways to integrate HEMS into local and regional emergency medical systems and ensure that in each case, the most appropriate emergency transportation mode is selected for victims of trauma. HEMS operations include an estimated 750 helicopters, 20 operators, and 60 hospital-based programs. They transport seriously ill patients and donor organs 24 hours a day in a variety of environmental conditions. For the HEMS industry, 2008 was the deadliest year on record with 12 accidents and 29 fatalities. In response to this increase in fatal accidents, the NTSB placed the issue of HEMS operations on its "Most Wanted List" of aviation safety improvements. The FAA is working on a new rule proposal that is expected to be released early next year. Click here for more details about the board's recommendations.