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ON FINAL APPR O A CH

fields, were the FAA; the Helicopter As- sociation International (HAI); the Associ- ation of Air Medical Services; the Professional Helicopter Pilots Associa- tion; the National EMS Pilots Association; Air Methods; and CareFlite. A complete summary of the public hearing testimony, all of the exhibits, and the entire written transcript can be found on the NTSB’s web site.

As a result of the hearing, the NTSB identified the following safety issues: • Pilot Training • Collection of Flight Operations Data • Use of Flight Recording Devices and Data

• Safety Management Systems • Weather Information • Use of Autopilots or Dual Pilots • Night Vision Imaging Systems • Reimbursement Rate Structures • Federal Policy and Guidelines

Recommendations

The NTSB is issuing the following safety recommendations:

To the Federal Aviation Administration

1. Develop criteria for scenario-based helicopter emergency medical services (HEMS) pilot training that includes inad- vertent flight into instrument meteorolog- ical conditions and hazards unique to HEMS operations, and determine how fre- quently this training is required to ensure proficiency. 2. Once the actions recommended in Safety Recommendation (1) are com- pleted, require helicopter emergency med- ical services pilots to undergo periodic FAA-approved scenario-based simulator training, including training that makes use of simulators or flight training devices. 3. Require helicopter emergency med- ical services operators to implement a safety management system program that includes sound risk management prac- tices. 4. Require helicopter emergency med- ical services operators to install flight data recording devices and establish a structured flight data monitoring program that reviews all available data sources to identify deviations from established norms and procedures and other potential safety issues. 5. Require helicopter emergency med-

ical services operators to report activity on at least an annual basis to include total hours flown, revenue flight hours flown, revenue miles flown, patient transports completed, and number of departures. 6. Permit the helicopter emergency medical services Aviation Digital Data Service Weather Tool to be used by heli- copter emergency medical services opera- tors as an official weather product. 7. Conduct a systematic evaluation and issue a report on the requirements neces- sary for a viable low-altitude airspace in- frastructure that can accommodate safe helicopter emergency medical services (HEMS) operations. The evaluation should consider improved collection and dissemination of weather data, the role of automatic dependent surveillance-broad- cast, approaches to helipad and designated landing zones, and integration into the Na- tional Airspace System. Include in the evaluation process HEMS operators, re- lated industry associations, and hospitals, among others. 8. Once the evaluation and report as recommended in Safety Recommendation (7) are completed, initiate action to de- velop this infrastructure. 9. Require helicopter emergency med- ical services operators to install night vi- sion imaging systems and require pilots to be trained in their use during night op- erations. 10. Require helicopters that are used in emergency medical services trans- portation to be equipped with autopilots, and that the pilots be trained to use the au- topilot if a second pilot is not available.

To Public HEMS Operators

1. Conduct scenario-based training, in- cluding the use of simulators and flight training devices, for helicopter emergency medical services (HEMS) pilots, to in- clude inadvertent flight into instrument meteorological conditions and hazards unique to HEMS operations, and conduct this training frequently enough to ensure proficiency. 2. Implement a safety management system program that includes sound risk management practices. 3. Install flight data recording devices and establish a structured flight data mon- itoring program that incorporates routine reviews of all available sources of infor-

38 ROTORCRAFT PROFESSIONAL • August 2009

mation to identify deviations from estab- lished norms and procedures. 4. Install and require that pilots use night vision imaging systems for visual flight rules operations at night. 5. Equip helicopters that are used in emergency medical services transporta- tion with autopilots, and train pilots to use the autopilot if a second pilot is not available.

To the Federal Interagency Commit- tee on Emergency Medical Services

1. Develop national guidelines for the use and availability of helicopter emer- gency medical transport by regional, state, and local authorities during emergency medical response system planning. 2. Develop national guidelines for the

selection of appropriate emergency trans- portation modes for urgent care.

To the Department of Health and Hu- man Services’ Centers for Medicare & Medicaid Services

1. Evaluate your existing helicopter emergency medical services (HEMS) re- imbursement rate structure to determine if reimbursement rates should differ ac- cording to the level of HEMS transport safety provided. 2. If the findings from the evaluation conducted in response to Safety Recom- mendation 1 reveal that higher levels of reimbursement are required to increase the level of safety, establish a new reim- bursement rate structure that considers the level of helicopter emergency medical ser- vices transport safety that is required. ❚

NOTE: The Board approved additional recommendations regarding safety audit standards to CMS that are being drafted. Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52
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