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bered 1 and 7 in the Air Ambulance section of the table, above.


In an FAA legal letter dated 7 June 1990 it

stated that, "When an aircraft is owned by a hospital and all the people, which are carried aboard that aircraft during a particular flight (i.e., pilot and medical personnel), are employees of that hospital (a patient is not in the aircraft), a flight could be conducted under Part 91 of the FAR". But, the new proposal will require helicop-

ter EMS (HEMS) providers to conduct all flights under FAR Part 135 whenever medical personnel are on board, whether or not there is a patient on board and whether or not those medical per- sonnel are employees of the Part 135 certificate holder. This is especially problematic for (at least) two reasons.

The first reason is simply that the rule is

inconsistent with the parallel rule in FAR part 121 which allows airline pilots to operate under FAR Part 91 for a flight where only employees of the operator are on board. Even though many Part 121 operators may opt to demonstrate their com- mitment to safety by specifying in their Operations Specifications (OpSpecs) that they will operate under Part 121 rules at all times, the point is that they have a choice. That choice will not be extended to air medical provider services under the proposed changes to Part 135. But it is the second reason that causes the

biggest problems for air medical providers. The problem is caused by the effects of the require- ment to operate under Part 135 whenever med- ical personnel are on board, in combination with a recently announced (December 23, 2010) pro- posal by the FAA to impose a new legal inter- pretation on the crewmember duty rest require- ments of FAR 135.263 and 267. The rule estab- lishes a maximum duty day of 14 hours, without exception, for pilots flying under Part 135. It does this by requiring that a pilot be able to look back and see at least 10 consecutive hours of rest in the preceding 24 hours at any time during his duty period, including at the time projected for the completion of his final leg of flight. In heli- copter EMS operations, this strict interpretation of the language could lead to situations similar to the following scenarios.


"When an aircraft is owned by a hospital and all the people, which are carried aboard that aircraft during a particular flight (i.e., pilot and medical personnel), are employees of that hos- pital (a patient is not in the aircraft), a flight could be conducted under Part 91 of the FAR".

SCENARIO 1 A pilot is anxiously checking his watch at a

back-country ATV accident scene toward the end of his shift. Unanticipated and protracted extrication efforts are underway to free the vic- tim and then medically stabilize her before mov- ing her to the helicopter landing zone for the flight

scheduled duty period is 12 hours long, he has calculated that

to the hospital. Although his standard the end of his maximum legal

duty period will be at 9:00pm local time. He also figures that it will take 6 minutes to carry the patient to the aircraft and that once all are aboard it will require 2 minutes to be ready to take off and 35 minutes to fly to the receiving hospital. So, at 8:17pm (you do the math!), and after alien- ating everyone involved in the tense extrication process with his exhortations to speed up their efforts, he announces to his medical team that he is departing immediately and that they can either come with him now, or remain with the patient

and find some other way to get themselves and their patient off the side of the mountain. He knows that to do otherwise is to risk a violation of FAR 135.267(d) which could result in legal action against his pilot's certificate and hefty fines for his employer.

SCENARIO 2 A pilot and neonatal specialty team are

experiencing prolonged delays in preparing a critically ill newborn infant for transport from a rural hospital to a pediatric specialty hospital 130 miles away. (Anyone who routinely performs neonatal transports can attest to the frequent delays associated with preparing a critically ill newborn for flight.) As in the back-country ATV accident

scenario, this flight request came near

the end of the shift and it's beginning to look like the pilot will have to abandon the infant to a bumpy 3-hour ambulance ride to avoid a viola- tion of FAR 135.267(d). FAR 135.263(d) states that "A flight

crewmember is not considered to be assigned flight time in excess of flight time limitations if the flights to which he is assigned normal- ly terminate within the limitations, but due to circumstances beyond the control of the cer- tificate holder or flight crewmember (such as adverse weather conditions), are not at the time of departure expected to reach their destination within the planned flight time." To avoid scenarios like the two presented crews have

above, operators and flight two

options when they experience unforeseen patient delays on a transport late in the duty period and there is uncertainty whether the transport can be completed within the 14 hour limitation. Option 1: If the crew accepted the flight

believing that it could be completed within the time allowed, but unanticipated delays due to patient care would now extend the return leg of

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