MY 2 CENTS WORTH


WORDS HAVE CONSEQUENCES


I recently read a troubling story on the Facebook page titled When Seconds Count. It was written by a concerned air medical pilot who recounted something the lead pilot had said in their weekly safety meeting. In regard to newly arrived uniform ball caps embroidered with the words “FLIGHT CREW” on the back strap, the lead pilot said, “You may be the medical crew, but according to the FAA, because you are not directly involved with the operation or safety of flight, you are not considered part of the flight crew.”


The FAA shares a much different view. If the lead pilot read page 4 of the FAA’s Advisory Circular 00-64 on AMRM, under the heading “Background,” he would have seen that the FAA acknowledges the importance that the medical crew plays in ensuring the safety of every flight. The FAA writes: “Preventing accidents is the responsibility of everyone involved and takes the dedicated involvement of all of the aviation and medical professionals involved in the operation to provide the public the safest possible air ambulance service.”


The FAA is saying that the medical crew is directly involved with the safety of the flight, a fact I would think is self-evident and wouldn’t need to be said. I would argue that even a layman to aviation would acknowledge that those aboard an air medical helicopter play a vital role in the safe operation of that aircraft.


The pilot recalling the caps incident said the meeting was interrupted by an alert tone dispatching them on a flight. Once over the scene, the LZ commander motioned the pilot to descend vertically to the pavement


8 Nov/Dec 2019


below when the word “Stop!” came through his headset.


He stopped the descent responding, “What’ve you got?”


The paramedic said, “I see a state trooper looking a lot like he’s running away from an impending helicopter crash.”


The pilot asked, “Can you see any obstructions below?”


The flight paramedic and flight nurse reported seeing nothing. The pilot radioed to the LZ commander, “Is the area below us clear?” LZ command motioned him to move forward about 30 feet before setting down.


Once safely on the ground and shut down, the pilot walked to the rear of the helicopter and saw a cable running across the highway almost directly above the tail rotor.


This pilot’s story, as it relates to the lead pilot proclaiming the medical crew is not part of the flight crew, reminds me of the early history of CRM in the airlines when 60 airliners crashed from 1968 to 1976 – not due to stick-and-rudder skills but due to human factors, according to an NTSB task force formed to investigate that alarming rash of accidents. When crew resource management was first introduced, captains initially felt their captain’s authority was being eroded and they doggedly resisted CRM. These days all that’s changed, and CRM is treated like a religion in the airlines. Modern captains understand they are still the ultimate decision makers, however they must accept input from all team


By Randy Mains


members who may have vital information that can affect the safety of the flight. Statements like the lead pilot made in the pilot’s story serve to create a them-and-us mentality which, like a cancer, will destroy a cohesive team.


When I was asked to write the AMRM chapter for the Air Medical Physicians’ textbook, I wanted a one-sentence, high- concept definition of AMRM as a mental checklist for all team members. I call it my AMRM/CRM mantra, which is: AMRM is a team member’s awareness of how their action or inaction affects the safety of the flight, a team member being ANYONE who can have an influence on the safe operation of that flight.


Words have consequences. The lead pilot was technically correct in the definition of “Flight Crew” (as those he carries are termed “Medical Crew”). But from a safety standpoint we are talking semantics because the medical crew’s role is no less vital to the operation and safe outcome of the flight, as was so well illustrated in this pilot’s story. I personally have had my life saved several times by a flight nurse, paramedic or passenger who saw something I did not, or made a suggestion that helped my decision-making process.


This incident brings me to the way AMRM training is often practiced in America. Following the letter of the law and not the spirit of the law, the yearly AMRM requirement can, as you know, be satisfied simply by sitting at a computer and answering questions. The airlines learned early on that computer training alone does not change behavior, and that having a trained facilitator in the room does. It is


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