pic

pic

Saturday, December 28, 2013

Inspire...

Jeanne just called. I am at home, sitting in front of a warm fire, watching two dogs watch me  for signs of a walk.  I am working up to it.
She has already done a flight this morning, taking a patient to St. Joe's in Savannah. Two nice things happened along her way.
First, she got to stop in and see our friend Laura. Laura is an older lady, mother of my friends Julius and Lawrence. She fell recently and broke her femur. This put her in-hospital for rehab - and we are keeping up with her progress. It is good to frequently visit people we care about who find themselves in the hospital. Much of institutional health-care is de-humanizing; it's important to provide a living, breathing, talking physical reminder to everyone involved that the patient is indeed a human, who is loved, and valued, and important. This matters, and improves the level of care, and the outcome.

So Jeanne was able to run up to the fourth floor and poke her head in the room for a quick hello. In uniform.
I asked Laura recently if she was being treated like the VIP that she is. She said, "oh yes - I graduated from here." I knew that Laura was a nurse, but I didn't know about her education at St. Joseph's when they taught nurses there. Laura spent her entire working life as a nurse, and was involved in the first-ever open-heart surgery in the city of Savannah. At the time this was cutting edge (pun intended). Laura has opened her home to me and my family for the last few years for each big holiday. She treats me like family. Her kindness and humility inspire me to be a better human. To do better at looking out for the people I work and play and live with.

in·spire
inˈspīr/
verb
  1. 1.
    fill (someone) with the urge or ability to do or feel something, esp. to do something creative.
    "his passion for romantic literature inspired him to begin writing"


  2. 2.
    breathe in (air); inhale.

Sometimes, when life get's sideways with us, it is good to consider the second meaning of that word - inspire. This is the meaning that paramedics, who own-the-airway, spend a lot of time focusing on - but it's good for us all to remember to breath - take a deep breath and relax - when things go wrong.

But I digress.
Winston Churchill said, "we make a living by what we get...but we make a life by what we give." People like Laura, and Jeanne give - freely, continuously, without reserve. And their lives are enriched for the giving.



As Jeanne was walking out of the hospital towards her helicopter, a huge man stood by. She wondered why until she got up close and recognized him from a decade and a half ago. He was at one time her medical-technician-assistant - her "tech." He went on to nursing school, then to Certified-Registered-Nurse-Anesthetist training. He lives near Atlanta now and is here for his dad who is also a patient at the Joe.

The giant thanked Jeanne for the way she treated him all those years ago. He told her, looking straight into her eyes, "I am the nurse I am today, because of you."





Wow.

Inspired.

Let us be...

(Please share with your friends and co-workers...)


Saturday, December 21, 2013

A Request for Feedback...





We enjoy blogging, and hope that some of what we blog about may entertain, inform, and even help prevent an accident. We can check the stats and see from whence the page-views come (Russia? really?), but we don't know much about who is checking in with us.

If you have a moment, please post a comment listing how you got here, what you do, where you live, and if you work with a HEMS program; the name of the program. We don't need to know your name, unless you care to share it. Also, if there is any topic you would like to discuss, let's hear it. If you are aware of any great businesses related to our business, we would like to hear about them too. We may just expose their greatness...

safe flights...

Helo Porn (or why I am a proponent of CRM)



                                Photo Credit:  Benjamin  Hunter. click on picture to enlarge...

The crew on this helicopter work well together. This is because they do everything as one. They eat together, they sleep together (in the same room, or in the cabin of the aircraft). They drive together, they drink together, they go to strip clubs together, they puke together. They are brothers from different mothers. They know each other as they know themselves. After every flight, they sit in a room and ask hard questions of themselves, in order to get better, stronger, faster, more capable...

 The bonds they forge are for life.

If you want to be part of a truly excellent HEMS program, set about building bonds like this where you work. Be a rain-maker!

Monday, December 16, 2013

An Essay on S-A...

I think the pilot was simply creeped out. 

He was the pilot flying, and was responsible for control inputs during the leg from from Brazil to France on the evening of June 1st, 2009. He would shortly be the proximate cause of his Airbus A-330 descending, under full power, into the Atlantic Ocean. All 216 passengers and 12 crew members would die because of a simple breakdown in crew communication, coodination, and situational awareness. This would not be the first time these human factors would lead to the loss of an aircraft - nor the last. If you are a HEMS crew member understand that I write this to prevent you from having to share their fate. I mean no disrespect to those who lost their lives, instead I would like use what we can learn to prevent future mishaps.

There are many reasons that crew members fail to communicate effectively in flight. In the case of the very recent crash of an Asiana Airlines Boeing 777, investigators point to culture, or power-distance, which is the amount of deference paid to superiors by subordinates. There is usually someone on board an aircraft that is about to crash who knows a problem exists, but they don't speak up.

The fail to assert led to the worst air crash in the history of the world; the destruction of two Boeing 747 aircraft, and the loss of 583 lives. Read about it by clicking here...

A crew member practicing:                                                          

Inquiry - the act of seeking information to create understanding

Advocacy - the act of pleading a cause or course of action

Assertiveness - the act of speaking up for what you think is right.

can prevent a crash, but because no one rings a bell when a crash is avoided, the larger HEMS community doesn't know.

The Air France pilot had the aircraft set up to fly automatically through an area of persistent bad weather known as the inter-tropical convergence zone. In flight, a pitot-tube was blocked by freezing rain, and the aircraft's computers lost the airspeed input and changed modes.

The fly-by-wire flight control system switched from "normal law" to "alternate law" affecting how much a given movement of a side-stick controller will move a control surface, but the pilot flying didn't know this. He lost situational-awareness. That aircraft is so complex, and can have so many things happening at once with systems, that the pilot doesn't understand what is happening or why.

This pilot got creeped out; he had just flown through a patch of rough weather and an atmospheric phenomenon that created an unfamiliar smell in the cockpit.

Then he  did two things wrong. First, he reflexively pulled his side-stick all the way back. When we get scared in an aircraft, one of our instinctive responses is to climb. His excessive control-input made the aircraft climb, and slow down. and then descend.

As he saw that the aircraft was descending, he kept this full-aft stick input applied. He wanted to go UP, not down.  His second and more important failure was that he failed to announce what he thought was happening and what he was doing about it.  This failure robbed the other pilot on the flight deck of situational-awareness. The second pilot didn't know that the stick was all the way back or nose-up, and they were stalling the wings. They fell into the ocean with engines screaming, in a level attitude. The designers never imagined that a pilot would hold the stick all the way back, all the way to the water, without anyone else noticing.

The take-away on S-A...

1. Anytime you sense anything "different" about your aircraft, sound the alarm! "Hey we have a new sound, shimmy, vibration, smell..." 

2. Then, announce what you think the problem might be. An electrical fire? Loss of oil pressure on engine number two? Loss of hydraulic-boost? A blocked fuel pump inlet or the strong odor of fuel? Take your best guess.

3. Announce what your are doing about this new sensation. If you are adjusting a flight control, switching a switch, turning a knob, speeding up, slowing down, climbing, descending, whatever... Announce your actions!

The other pilot could see that they were descending, but as that aircraft is fly-by-wire versus fly-by-cable, and there is no linkage between the two side-stick controllers.  The other pilot was denied the information that would have been provided by an old-fashioned between-the-legs control wheel being pulled backwards into his gut.

You can read about this crash by clicking here...

You can watch a video about this crash here...


                                         Photo courtesy Shawn Griffin, former USAF Combat
                                         Camaraman, current USAF and civilian flight nurse

Crew coordination is each of us knowing what the others are doing, when, and why. I was on a flight with a new crew member in a Bell 206.  He elected to get ahead of the game by placing a blood-pressure cuff on a patient's arm while still in the ambulance. They took the patient outside of the ambulance to move him from the EMS stretcher onto our aircraft stretcher. The other crew member observed a blood pressure cuff on the patient's arm and assumed it belonged to EMS. He took it off and handed it away. When we were all in the aircraft, the medic said to the nurse, "damn, I put a cuff on this guy, I wonder what happened to it."

Crew coordination depends on practice and communication - before, during, and after a flight. Rehearsals in the aircraft, full-crew simulator training, table-top scenarios, "rock-drills," and of course post-flight after-action-review all contribute to good crew-coordination.

Using periods of time when the work load is light to prepare for high work load times is part of Air Medical Resource Management.

Cross-training, or understanding what other members of the team do, and why, helps with maintaining situational-awareness. I practiced an instrument approach recently, with a relatively new flight nurse sitting directly behind me in our Astar. He was able to see over my shoulder. I explained everything I was doing. He asked what indications I was looking for on the instrument displays. I mentioned the common mistake of having the display set up to show GPS information when intending to use information from the Instrument Landing System (ILS), and handed him my approach plate to look at while we flew. Is he going to be responsible for how I fly approaches?  No. But the more he understands about what I am doing the better.

Sometimes we don't speak up because we are new, and don't want to say something dumb. In the name of every brand-new crew member who has been killed in a helicopter crash, you must set that thought behind you.  There is no such thing as a dumb question in an aircraft.

One of the Asiana pilots stated that he was preparing to speak up about his airplane's slow speed during descent for landing. The auto-throttles weren't set correctly, and the technology had gotten ahead of the pilots. That pilot decided that it would go against the cultural norm to question the command-pilot's actions. And they crashed.

Your organization's culture must be one that encourages frank, open, and honest discussion about things that concern your safety - or the safety of anyone in your organization. You speaking up may fix my misunderstanding about something that's happening to us in flight.  You may save our lives. You are not a passenger - you are a crew member.

As members of a crew, we coordinate our actions in the aircraft. We don't do anything without announcing it. We touch no switch without confirming which one we want, and announcing our actions. Failing to do this led to a crash of Marlin Air's jet carrying the University of Michigan's transplant team.

Read about this crash by clicking here...

Maintaining situational awareness requires managing the resources available to avoid demanding more from anyone on board or on the ground than they can provide. Separating and fixing responsibility goes a long way to preventing crashes like the loss of an Eastern Airlines jet in the Everglades in 1972 and an EC-145 in the water near Fort Myers FL in 2009. These crashes bear shocking similarities in the loss of situational-awareness while the person flying became distracted by attending to a duty not related to FLYING THE AIRCRAFT. In both crashes, the pilot thought the autopilot was flying the aircraft, and in both cases it wasn't doing what they thought it was.

Imagine if the flying pilot had said, "Hey guys, I am going to focus on flying the aircraft. Can you help my by working on..."

Our brains dislike being "adrift." We like to latch on to a sense of reality (right or wrong) and can easily get led down the wrong path by "expectation bias"  We can have everything all wrong, while thinking we have it all right. Complacency contributes to this, as does failing to use every resource available to confirm what is really happening.


In the helicopter, the one that went into the water, the pilot was trying to call EMS with no luck, and had the autopilot set. When she reduced power to descend to her selected altitude of 500 feet, she inadvertently set the collective too low to maintain the minimum autopilot speed. The helicopter descended to the water while the one person on board who could have been flying wasn't. The crew in back noticed water in the air outside and took it to be rain. It was sea spray. They didn't have situational awareness...




Thursday, December 12, 2013

Throwback Thursday... A day in the life.

A car bursts into flames on I-95. Four people are burned trying to remove a child from the vehicle. Colleton County EMS puts out a call for helicopters.



The former Meducare Air and the former CareForce helicopters (now LifeNet 7 and LifeNet 1, part of the LifeNet South Carolina statewide system) respond from Charleston and Columbia South Carolina, respectively. Not pictured, but also responding is the LifeStar 1 helicopter from Savannah GA. This program is also now part of  the LifeNet system, retaining the LifeStar name due to the associated history and goodwill.  


EMS prepares multiple patients for transport to the Dr. Joseph M. Still Burn Center in Augusta GA.



Paramedic Susan Lindemoen loads a patient into the Bell 230 with help from Colleton County Fire and Rescue personnel. Bell only made 38 model 230s, and soon transitioned to the 4 bladed rotor system on the Bell 430. 


The 230 departs, with her two massive blades thumping the atmosphere into submission. This is the rotor system that sets off car alarms on final approach.

This event is a precursor and rehearsal for the larger HEMS response to the sugar plant explosion and fire that will send every helicopter in the region to Savannah, and then on to the burn center...

All photos courtesy Barry McRoy, Chief, Colleton County Fire Rescue

Saturday, December 7, 2013

Another Fuelish Mistake... UPDATE 4/17/14



You gotta love humans. We never stop being creative. Or lazy.

I was enjoying a change-of-shift discussion this morning with my friend StuD, and I mentioned that I had looked over the entire list of pilots who work for our company. There are a bunch. I brought up a name from our past and he exclaimed - in the negative sense - his opinion of this fellow.

Stu told me a story that I had heard before, but forgotten. Life is like that,  when a mis-step happens to someone else it's not nearly as meaningful as when it happens to you. Perhaps that's why we are not so good at learning from other peoples mistakes - we prefer to make them ourselves and learn the hard way.

One morning, back-in-the-day, Stu was pre-flighting our old Bell 230 and checking out the base fuel system. His shift was following the other fellow in the story, who can remain Nameless. Nameless had developed a habit during refueling the aircraft, which seems kind of neat on the surface, but isn't. He would stick the fuel nozzle into the hole in the side of the helicopter


then use the grounding clamp for the fuel nozzle, which is supposed to be fastened to the airframe to prevent a static spark, to hold the valve lever in the open position. Aviation fueling systems do not have the "catch" on the lever like the one at your local gas station - for a reason.





Then Nameless would walk across the helipad to the fuel-system cabinet and switch on the pump. He would watch the counter for the correct number of gallons to be pumped into the aircraft, turn the pump off, then put everything away. Now this is an easy method of dispensing fuel, and saves much walking back and forth to check the fuel counter. It also eliminates the need to actually hold onto the lever while dispensing fuel.

Hey, we love automation; right?

There is no telling how many times Nameless performed his modified aircraft refueling, without incident, but one evening, he got distracted during the process. Maybe it was late and he was tired, or maybe he was talking to the new flight nurse - and something slipped his mind. Whatever - in any case Nameless forgot one little piece of his personal refueling-method before closing the fuel cabinet and heading back to bed.

The next morning, Stu opens the cabinet door and begins to check the system, checklist in hand. He needs to drain fuel from the filter vessel, to look for contaminants, so he switches on the pump, while standing directly in front of the wound up hose sitting on it's reel - nozzle pointed out.


Well, Nameless had forgotten to remove the clamp from the fuel lever, and it was stuck in the full flow position. Stu took a shower.

And never forgot.

Neither should we.

Safe Flights...

Friday, December 6, 2013

Maryland State Police Helicopter Program Costs Continue to Climb...




Updated: Thursday, December 5 2013, 02:22 PM EST On Wednesday Maryland State Police won approval of an emergency request for money to keep aging medevacs flying, despite a brand-new fleet of AW-139s. The State Board of Public Works approved roughly $500,000 to overhaul the engine of an older Dauphin Medevac helicopter which has been in service since 1990.  This is the third time this year that State Police have sought emergency funds to keep older choppers in service. State taxpayers paid roughly $130 million dollars to purchase ten new AW-139s - helicopters that preliminary plans indicated would be in service this year. However, several accidents and an unanticipated Federal Aviation Administration (FAA) ruling have delayed the rollout. One of the new AW-139s may have been damaged by a stray bullet on one if its rotor blades. Another AW-139 was waylaid when a technician broke a blade while trying to balance the rotor. In late September one of the state medevac helicopters hit the tarmac without its landing gear deployed. In September the state approved $600,000 to fund the hiring of ten additional pilots to fly the AW-139s after the state lost a behind-the-scenes battle with the FAA to fly with just one per aircraft. The decision to purchase 12 of the larger, more technologically advanced helicopters was controversial when it was made in 2008. The requisition forced the state to borrow $133 million instead of choosing cheaper alternatives such as privatizing the fleet or refurbishing existing helicopters. 

Read More at: http://foxbaltimore.com/news/features/top-stories/stories/price-tag-transition-new-medevac-helicopters-continues-grow-23816.shtml#.UqJCgNJDvTp

New 'Copter for Kids in Ohio

                                Photo Courtesy Nationwide Hospital


Transport at Nationwide Children's Hospital has expanded services to now include a fully-dedicated helicopter (named Monarch 1) to serve critically-ill patients. And fast. Their new helicopter, Monarch 1, will allow their neonatal and pediatric transport team to initiate critical care services more quickly.

The helicopter is an addition to the existing ground-based and air transport options offered by Nationwide Children's Hospital and MedFlight, their current partner for helicopter transport. The helicopter will be based at The Ohio State University Airport and is equipped with state-of-the-art critical care equipment. This includes IFR technology allowing the helicopter to fly in low visibility and a combination of nitric oxide therapies and High Frequency Ventilation (HFV) for patients in need of respiratory care.

Monarch 1 is the only Ohio transport helicopter that offers this kind of respiratory care for neonatal patients. And with Nationwide Children's Hospital being home to one of the largest neonatal networks in the U.S., with about 30 percent of all neonatal admissions requiring at least a one-hour drive, the helicopter will be a dedicated, specialized resource.

"Minutes count when it comes to transporting critically ill infants," said Edward Shepherd, MD, section chief of Neonatology at Nationwide Children's Hospital. "The addition of this EC145 helicopter allows them to better serve their patient families while increasing the access to the neonatal and pediatric specialty care."

The helicopter also offers a large cabin with the potential to allow a parent or guardian to ride on-board during the transport of their child as well as additional staff to ensure patient safety while in flight. The helicopter will focus on transfers between hospitals and will not land at accident scenes.

Saturday, November 30, 2013

Another One Bites the Dust...




                                          Photo by Andrew Milligan

http://www.npr.org/2013/11/30/247906174/police-helicopter-smashes-into-roof-of-bar-in-scotland

EC135T2 Police Helicopter Crashes Through Roof of NightClub

Rescuers worked through the night and into Saturday morning to rescue an unknown number of people trapped inside a Scottish pub after a police helicopter crashed through its roof during a packed concert, causing numerous casualties.
Police said early Saturday 32 people were taken to hospitals across Glasgow after the incident at The Clutha pub in the city center. No fatalities had been reported.
"We are working hard to recover people still inside the building and we will make further details available when we have them," Dep. Chief Constable Rose Fitzpatrick said in a statement.
She said police and air-safety investigators have begun inquiries, but that it is too early to say why the Eurocopter EC135 T2 helicopter — carrying two police officers and a civilian pilot — came down.
Authorities said they had made contact with people still inside The Clutha, where a ska band was performing when the helicopter came down. Search and rescue dogs were on the scene, along with more than 100 firefighters.


Witnesses spoke of people streaming out of the building covered in blood, with gashes and other injuries.
"Given an incident of this scale we must all prepare ourselves for the likelihood of fatalities," Scotland's leader, Alex Salmond, said on his official Twitter account.
The crash Friday at around 10:30 p.m. local time sent dozens of patrons fleeing through a cloud of dust.
Asst. Chief Officer Lewis Ramsay with the Scottish Fire and Rescue Service said teams — including 125 firefighters on the scene — were working to stabilize the building and get people out.



As dawn broke, firefighters clambered on to the collapsed roof and pulled tarps over the wreckage of the helicopter. There was no word on the fate of those aboard.
Grace MacLean, who was inside the pub at the time, said she heard a "whoosh" noise and then saw smoke.
"The band were laughing, and we were all joking that the band had made the roof come down," she told the BBC. "They carried on playing, and then it started to come down more, and someone started screaming, and then the whole pub just filled with dust. You couldn't see anything, you couldn't breathe."
Retired firefighter Edward Waltham said he ran into the pub to help rescuers, and found on man covered in dust and apparently badly injured.
"My initial reaction for him from my experience was to try not to move him because he had been in a crush situation," Waltham told BBC News. "But as we were lying there other people were literally being pulled out of the pub and more or less thrown on top of us. "People formed a human chain to help pass unconscious people out of the pub so that "inch by inch, we could get the people out," said Labour Party spokesman Jim Murphy, who was in the area when the helicopter came down.
"The helicopter was inside the pub. It's a mess. I could only get a yard or two inside. I helped carry people out," Murphy told Sky News. "I saw a pile of people clambering out of the pub in the dust. No smoke, no fire, just a huge amount of dust."

The twin-engined Eurocopter is widely used by police and ambulance services.

In 2007, a Eurocopter EC135 T2 crashed in southern England. The pilot and his wife were unhurt, but the aircraft was badly damaged. Britain's Air Accidents Investigation Branch said there had been a failure of the autotrim system which maintains the aircraft's position. The agency recommended changes to correct the problem.

Reported by the Associated Press at NPR.org

Coincidentally, I was making an approach in a single engine helicopter recently (the one in the story was a twin-engine aircraft), and as I approached the over-water helipad I sized up the available forced-landing areas (if my one motor had quit - we would have been "forced to land" to an area - for all intents and purposes - between our feet. I asked the medic, "how strong do you think the ER roof is?" 

"It's pretty strong, I see people walking on it." 

"Do you think it would support this helicopter?"

"No."

Wednesday, November 27, 2013

Unsung Heroes...



Bobby Mordenti showed up at the hangar today, looking no worse for the wear. Amazing, considering what happened to him a few weeks ago. He was standing on a ladder, waxing the tail boom of  his aircraft, and fell. The ladder made a racket - thank-goodness - and the firefighter-medics here at the base went to see what was going on. One of them began treatment and the other came running inside to get more stuff and call for help. Bobby was out-cold on the concrete, with a plate-sized circle of blood coming from the split in his head.

Ouch.

Bobby has been a "wrench" for longer than some of his pilots have been alive. When speaking with him, a sense of camaraderie develops quickly. Hangar talking is good stuff - a pilot who asks questions and listens can learn something. Decades ago, Bobby sailed his boat to Charleston, South Carolina for a job as the mechanic for an EMS helicopter there; the Medical University of South Carolina's MeducareAir. When he was getting tied up at the dock, a kid working at the marina named Jess Perry helped him. They struck up a friendship, and Jess ended up going to Embry-Riddle and getting his Airframe and Powerplant certificate.

Jess was in Savannah maintaining a BK-117 when I showed up in 2000, after fleeing a Pennsylvania winter. We worked together four years. For years after I left, I would call and ask his advice about this or that happening with a helicopter, and he never complained or griped - he just kept giving up the gouge.  Jess spent twenty or so years himself as the LifeStar-Savannah mechanic, and did a wonderful job keeping a great ship in the air.



Jess now lives a "normal" life working for Gulfstream. I can't say that I blame him. A HEMS mechanic's life is grinding. They are on-call 24 hours a day, with perhaps one or two weekends off a month; by that I mean away from the base with the pager turned off. For the privilege of having a day off, they are usually responsible to cover another mechanic's base so that guy or gal can have a day off - it reminds me of the old HEMS pilot's "Chinese Vacation." If the helicopter god's are angry, and both ships break, there is hell to pay.

I don't know how they do it, these "knuckle-busting" trouble-shooting quiet-professionals. They have to get the aircraft exactly right every time or else, in the face of constant pressure for more in-service time. Now days scheduled-maintenance has to be performed during the hours when flight requests are least likely - this is when most humans are sleeping - and this mid-night labor often occurs out in the open on an exposed helipad; by flashlight. And guys still sign up to do it. When vendors had hospitals as customers, this wasn't how things were done. Maintenance was understood to be part of aviation, and it was done as required and when required - rarely in the middle of the night by a single mechanic out in the open. What kind of signal do we send to mechanics about their value to the organization when we treat them with so little regard? When we make a job so distasteful that the best and brightest, like Jess Perry, leave the workspace, what does that leave us with? How deep into the labor pool will we have to dip before we scrape the bottom?

With the advent of community-based operations, the aviation-services-vendors have become their own worst customers, demanding things that, in the past, would not have flown. And the mechanics have suffered.

I wonder why we don't make more of a fuss about the guys (and gals?) who keep our butts alive by providing us safe aircraft to fly. We have our professional organizations, and they recognize the Nurse or Medic or Pilot "of the year" but never have I seen a mechanic's face in a trade publication being honored for the huge part they play in a successful HEMS enterprise. Maybe it's time for AMMA. The Air Medical Mechanics Association... What the hell? All the other groups have their alphabet clubs.

They are kind of like bass players or drummers in a rock-star band. We couldn't do this business without them, but they toil in the background, unseen, unheard, and largely unappreciated. They receive polite applause, because it's obligatory. But they are never recognized for being the absolute rock-solid foundation upon which safe aviation operations stand. When Omniflight Helicopter's owners decided to do away with their own ability to fix helicopters - it spelled the end of the company.

Maybe times are changing.

There is a new breed of mechanic coming along now, and they are too smart and too cool to stay in the shadows. One is a young fellow named John Janiszewski. John decided to highlight the fact that "wrenches" are indeed "rock stars" and created a company selling Aircraft Mechanic Shirts (and other cool stuff).

                                         Photo from http://www.aircraftmechanicshirts.com/
                                         Property of John Janiszewski

He creates shirts and other items that make clear how much we need a good mechanic to fly sick people - indeed to fly at all. On top of this, John is a working HEMS mechanic, maintaining a helicopter on the line. When you go to Johns online "store" be sure and check out his blog post about using social media to enhance your business. I did, and it makes perfect sense. He is a real guy, with a bunch of real good products, and you can actually speak with him.

For a neat little video about John and his company, click here!

That young man's going places...

And maybe - thanks to people like John - and his products - we can bring  bring  mechanics out of the background - to the front of the stage. Like the rock stars they are!

                               Photo courtesy of Mike Harrington. Flight Engineer, Crew Chief,
                               Helicopter Mechanic!

safe flights...

Sunday, November 10, 2013

What if?

Dennis was excited.

This was going to be his first ever patient-loaded instrument flight in the beautiful helicopter he had recently been hired to fly. As his base had just stepped up to instrument-flight-rules (IFR) capability, everyone was still learning - but he felt confident in his ability to get the aircraft, crew, and patient to their destination under IFR as the sole pilot. He had just completed an IFR flight from his base in Charleston to this little hospital in Sumter, using the precision lateral and vertical guidance provided by the instrument-landing-system  (ILS) at Shaw Air Force Base, conveniently situated near the hospital. After breaking out of the clouds on the glide slope, he had cancelled his instrument clearance and proceeded under visual-flight-rules (VFR- able to see out the windows) the short distance to the hospital. With the only IFR helicopter in the region, Dennis understood that business was going to pick up when weather conditions went down and prevented the VFR helicopters in the area from flying.

The medical crew was down in the hospital picking up the patient, a 54 year old man who needed to go the heart hospital in Columbia to have his pipes cleaned. Years of a fat-rich southern diet had slathered deposits all over his heart's supply tubes; the ones that, in a healthy person allow a flow of blood to provide oxygen and energy to the heart's muscle tissues.

The flight-assignment was ready-made for an IFR-capable helicopter. While the ceiling was low at 800 feet above the ground;, underneath visibility was excellent at more than six miles. The temperature was sixty degrees Fahrenheit, so icing would not be a factor at the planned altitude of 4000 feet. The atmosphere was stable, with no convective activity observed or forecast. Winds aloft would not create turbulence, and none was forecast.

Dennis' training had been typical for his industry. His employer had a training program that met with Federal Aviation Administration (FAA) requirements, while not being extraordinarily expensive. The HEMS industry is relatively low-paying, and has high turnover, so a large part of any operator's budget is spent on initial training. Training first focuses on operating a "normal" aircraft in visual conditions both day and night, then deals with emergency situations and aircraft malfunctions. Once the new pilot has mastered the aircraft and can deal with malfunctions, he or she is given some time to gain operating experience and learn on-the-job. After six months or so; if the program operates under IFR, the new pilot's instrument-flight training takes place. Pilots are taught how to plan and prepare for flight under Instrument Meteorological Conditions (IMC) in a time-compressed situation. Steps that might take a few hours are distilled down to what can be accomplished in about fifteen minutes, allowing a launch within twenty-five or thirty.

The "E" in "HEMS" is for Emergency. The clock is ticking.

A laminated flow-chart is often used as a checklist to make sure that no planning-steps gets missed, like fuel required, primary and alternate destination-weather requirements versus current and forecast conditions; and notices-to-airmen about the condition of the departure, destination, and alternate airports and their instrument landing equipment. Plan complete, the pilot normally calls a flight service station and files the proposed flight plan. With the plan on file, the next step is determining how the actual clearance from Air Traffic Control will be obtained. If the location allows communication with ATC by radio, that method can be used. If not, a clearance to enter controlled airspace under IFR can be obtained over the phone, which means ATC saves the airspace around the departure location for the exclusive IFR use of  the departing aircraft until it can be picked up on radar, positively identified, and have any needed changes to routing or altitude transmitted and received. Because phone clearances tie up vast sections of airspace, their life is limited, with a "clearance-void" if not off (the departure airport or heliport) within ten minutes or so.

Dennis' crew walked up the ramp, and with the help of the hospital's security guard, they loaded the patient into the back of the aircraft. Dennis stood back and made sure that the doors were closed correctly, verified that no seat-belts or straps were hanging out, checked the latches all the way around the aircraft, he even dropped down and looked underneath for leaks or anything amiss. Then he strapped in, his mind miles ahead of the aircraft. He knew that, like marriage, IFR is easier to get into than out of. An aircraft departing visual conditions for flight in the clouds goes from being able to see out the window and what's coming to being "blind." Once in the clouds, a transition back to visual conditions often requires a descent, and places the aircraft near hard things like towers, buildings, terrain, and even other aircraft flying visually and not under air traffic control. While going into the clouds can occur almost anywhere, getting out of them safely is a different story.

Dennis started both engines of the aircraft, and performed the functional checks of the autopilot and other systems. He notified his communications center that he was preparing to depart, and would be talking to and flight-following with ATC;  and that for the duration of the flight the medical crew would handle com-center calls. Because Shaw is so close to the hospital, Dennis was able to call the tower directly and announce his intentions to take off. He asked for his clearance over the radio, holding his pencil over his knee-board upon which was a sheet of paper with the letters C R A F T printed down the left margin, as the mnemonic for "clearance limit, route of flight, altitude enroute, frequency for departure, and transponder squawk code."

"ATC clears Medevac helicopter November 12345 to Columbia Downtown airport via direct. Climb and maintain 2000 feet, expect 4000 feet 10 minutes after departure. Departure frequency will be 1 2 5 point 4. Squawk six five six two. On departure maintain heading 135 degrees to stay clear of the Shaw final approach course,   Shaw winds are 180 degrees at six knots, altimeter two nine eight six. Take-off will be pilot's own risk; area not visible from the tower.  Shaw using runway two two right..."

Dennis read back his clearance, once again verified that the aircraft's systems were normal, checked that the crew and patient were ready, and asked for help, "okay guys clear me all the way around and overhead and here we go."

Once airborne and turned to 135 degrees, Dennis pulled in power for a 1000 foot-per-minute climb at 100 knots airspeed. He had preset the heading and vertical-speed bugs, and when he coupled the autopilot to the flight controls he relaxed his grip but didn't let go completely until making sure that everything was going to work correctly. He felt a gentle movement through the aircraft as the system took over and then moved his hands away from the cyclic and collective, and set his feet on the floor. He had pre-selected 2000 feet as the level-off altitude, and knew that when the aircraft reached that altitude and stopped climbing,  it would accelerate to somewhere between 120 and 130 knots, which was just the speed he was looking for. They flew into the base of the clouds at 1000 feet on the pressure altimeter, so he made a mental note of the fact that the bases were around 800 feet above the ground, in case he had to come back, glancing at the radar altimeter to make sure all the numbers fit.

"Medevac copter 345 - Shaw tower - contact departure, good day sir."

"345, wilco."

Dennis had preset the departure frequency in the radio so all he had to do was press the flip-flop button and he was on the correct freq. He listened for a second to make sure the channel was clear, then transmitted,
"Shaw departure control, this is Medevac 'copter 12345, climbing through one thousand three hundred for two thousand. Heading 135 degrees."

"Medevac 345, Shaw departure; good morning. Climb and maintain four thousand, proceed on course direct Columbia Owens."

Dennis adjusted the target altitude to 4000 feet, and pressed the direct-to button on the Garmin, noted the new course to be flown, then considered whether to use the heading-bug to turn the aircraft or the NAV feature of the autopilot. It was at this instant that disaster struck.

Turbine engines produce incredible amounts of power from relatively small packages, by super-efficiently turning jet fuel into heat-energy. As part of this process, components rotate at extremely high rates, sometimes exceeding 60,000 revolutions per minute. A tremendous amount of heat, as much as nine times the boiling point of water, or  900 degrees centigrade, must be handled by lubrication systems and cooling airflow. As long as oil and air flow as designed, the engine screams contentedly and the rotors keep turning. Interrupt the flow of air or oil however, and a turbine won't go. It was ironic that the patient on this flight had a heart with small channels that were blocked; because the number two engine had the same sort of problem. Only the engine's blockage, caused by the repeated super-heating of lubrication oil and the residue left behind by a phenomenon called coking, wasn't starving a muscle of oxygen - it was starving a bearing of oil. As the lower oil line became more and more clogged over time, the amount of oil flowing to the bearing decreased. It was Dennis' bad luck that the instant when the lack of oil flow caused the bearing to overheat and seize - with a tremendous BANG - occurred when they were in the clouds.


An "occluded" oil line - coking, discovered prior to failure.


A coked bearing... discovered prior to failure.
Photo credit: http://www.bobistheoilguy.com/forums/ubbthreads.php?ubb=showflat&Number=2745290

While Dennis' training had prepared him to deal with an engine failure in visual conditions - when he could see the ground and where he needed to go, at no time had he been trained by his employer to deal with such an emergency while in the clouds. The terms "land as soon as possible" and "land immediately" take on a new flavor when one is in the clouds - and it tastes like copper on the tongue.

This is a shortcoming of the training provided to many EMS helicopter pilots flying under instrument flight rules in instrument conditions. Emergency procedures - like losing an engine (or both), or control of the fenestron, or a hydraulic boost system - are covered in class and practiced in a traffic pattern at an airport. This is part of the "VFR" training that all pilots receive. If we fly a helicopter IFR in IMC, we need to keep in mind that any of the malfunctions we prepare for in VFR conditions can happen to us while IMC. And we need to have a plan.

A simulator would be the best and safest way to prepare for this. Barring that, scenarios talked out while sitting in the aircraft, putting hands on the switches and knobs and controls that would actually be moved is better than ignoring the possibility that a problem might occur.

But what about Dennis?

He's cool.

The motor that seized blew up when it tried to stop turning from umptity-thousand RPMs all-at-once. The physics weren't right. Pieces of the motor flew off into the atmosphere, right through the engine-compartment cowlings and the rotor system.  Other pieces went right through the engine compartment fire-wall and fragged the good motor, which failed too. Dennis pushed down on the collective with gongs and bells and lights everywhere. And reverted back to his training.

"SHIT... HOLY SHIT!"  Both generators stopped making power, but the aircraft battery powered the panel and allowed him to keep flying by reference to his instruments. He checked the attitude, heading, airspeed -70 knots! 70 knots! -, and finally found the rotor RPM. It was above normal in the yellow range. "Screw it - leave it there," he thought, " I'd rather it be high than low."

The aircraft was making strange noises as it descended - quickly - but it was still flying - and he was still flying it.

"Shaw! 345! Mayday Mayday Mayday! We've lost both engines and are coming down - where's the airport?"

The voice of calm, "345 --- rrrroger,  I've got you sir - you are three quarters of a mile from the approach end of 4 left or 4 right - the airport is directly north of you now. Winds are 180 degrees at 4 knots, you are cleared to land."

"Okay guys, let's get the O's off, okay, the engines are not coming back;" his voice strained as he reached across to cut off fuel to each engine and blew the fire extinguisher bottles, "okay where are we? Okay 70 knots, rotors a little high, okay aircraft's in trim, somebody call the com-center for an ambulance (the medic had been talking to the com-center in one continuous stream of transmission since the first bang) - okay fly north, okay we can do this..."

The autorotation was different than Dennis was used to, he was on instruments instead of looking outside, and it occurred to him that this was a first-ever event. His brain was firing synaptic-contacts at light-speed, and he was thinking well ahead of the aircraft - as in "in a few seconds I am going to have to," as opposed to watching events happen to him."

They fell out of the belly of the clouds with the airport right where it was supposed to be. "YEAH BABY!" Dennis yelled. "Okay guys, seats, belts, doors, sterile cockpit!" When scared, we revert to our training. "We're ready in back!" Indeed the crew had never been so ready for a landing in their life.

Luck is a bitch. And then sometimes she isn't. Dennis rolled his eyes one last time across the instruments, thinking how strange it was to be flying with so many warning and caution lights lit up.

"Okay, we can do this, okay speed's good, okay we've got the runway, okay two hundred, okay one hundred, decel! fifty, okay here's some collective, hold her off, hold her off, level her up, okay cushion cushion cushion."

Dennis had no idea he was doing it, but he was speaking the exact same words that his instructor had spoken to him over and over during his flight training years before. And just as it had worked then, it worked now. The aircraft dropped smoothly onto the asphalt and slid down the runway, making a loud grinding sound that - truth be told - scared the new flight nurse worse than anything that had yet happened.

A fire truck pulled up alongside the right door - water cannon pointed right at them...

Our training should prepare us for real-world situations. Often it doesn't - it meets a requirement or checks a box. In the first Gulf War, I came under attack by missiles while flying from KKMC to Rafha at night under goggles. We fired flares in self-defense. The thought that went through my mind, as I waited for impact, was that I had never in my life seen a flare launched from an aircraft while wearing goggles. As a topic of discussion for your crew, consider how well  your training program prepares you for the different adverse situations you might encounter.

safe flights...

Update: to hear the audio record of a pilot having a dual engine failure click here




Saturday, November 9, 2013

Ice Ice Baby!

It's that time of year for ice on and in the aircraft. Last year, we in HEMS crashed a machine due to liquid water (rain) getting into the skyward facing engine air inlet - which was covered by a particulate (dirt) barrier.
As temps dropped throughout the night, the liquid turned to ice. The crew launched on a flight, and the ice underneath the filter broke loose and got sucked into the turbine a short time after takeoff. The ice destroyed the engine and the aircraft did not autorotate successfully.


A warm hangar would have helped...

A special notice about this is here...

While installing inlet covers is a pain, if a hangar is not available, and it is going to rain on your aircraft as the temperatures drop, it may be something to consider. We at this base are going to have to go out and run the aircraft each cold morning to defrost the blades, or suffer a delay upon activation for a ground run and visual check of the rotor blades. If there is frost on the cars in the parking lot, there is frost on the blades...

safe flights...

Friday, November 1, 2013

Fuelish Mistakes...

Complacency and Fuel Don't Mix...



Jet Fuel.

We use it everyday we work, take it largely for granted, and seldom consider how much trouble it has and will continue to cause. Every step of fuel's existence; production, distribution, dispensation, and consumption creates the chance for human factors or human failings to wreak havoc. Mayhem is waiting in the wings. Just when we think we have everything figured out, someone invents a new way to put bad fuel into a good aircraft, or put good fuel where it doesn't belong.  At best a flight is delayed or cancelled, at worst someone gets hurt or an aircraft gets destroyed.



I was doing some research a few years back, and stumbled across an account of a major fuel spill and accompanying lawsuit at a hospital - involving an aviation-services vendor, and the base mechanic. The fuel system at that location had an underground tank. The pump was situated so that people standing outside, especially with a running aircraft nearby, could not hear it. The mechanic fueled the aircraft and forgot to turn the pump off, so the hose remained pressurized, with only the valve in the nozzle to prevent fuel from flowing. Time passed, and the nozzle valve failed, and the pump did it's job and pumped about a thousand gallons of jet fuel all over the ground. The EPA fined the hospital hundreds of thousands of dollars, and the hospital... well, you can figure it out.

You can read about this event here...

Humans.

A couple of weeks ago, I was fueling an aircraft in South Carolina. The base there has a small "portable" fuel tank sitting near their T-hangar at the nearby airport. This system has a smaller-than-normal nozzle, without the rubber-cap that is commonly used to prevent foreign objects from getting inside. As it was the first time using the system that day, I was required by company policy to both sump the tank - draining a small amount of fuel from the bottom of the tank into a bucket - and also to sample the flow from the nozzle. With my medic and nurse watching (we were talking about something important like women, or beer, or fishing) I dutifully pointed the little nozzle into the bucket and squeezed the handle.

Something "foreign" spat out along with the flow of fuel, and each of us blurted, "what's THAT?"  I let the foam clear and watched a tree-frog climb disgustedly from the fuel bucket and hop off to the showers, or where ever tree frogs go after swimming in jet fuel. If it hadn't been the first fueling of the day, and I hadn't checked the fuel into the bucket, that frog would have gone into our fuel tank...

Another incident similar to this happened to a friend of mine. They were flying from Columbia to Charleston South Carolina in a twin-engine BK-117, with two supply tanks being fed by transfer pumps in main tanks. As they rode along, the pilot noticed that the level in one of the supply tanks was dropping. What-the-hell?

There happened to be nurse sitting up front for this flight, instead of a medic, as it was an empty leg home and the nurses seldom had the chance. She watched with growing dismay as the emergency-procedure checklist was consulted, circuit-breakers were checked, and the main tank level was verified. The pump was "working," but the level in the tank was going down, and at empty an engine was going to quit. They were over a big swamp, and headed to the closest airport with a runway for a single-engine run-on landing. Most twins won't hover on one motor...

Inexplicably, just as they neared the Orangeburg airport, the level began to rise, and soon indicated topped-off.  "Let's go home," they said and flew on to their base. It wasn't until later that the zip-lock bag that someone had dropped into the fuel-tank and missed during final inspections was discovered floating around inside the main tank. When it sloshed up against the inlet hole for the pump, fuel stopped moving. This happened twice to this particular base which is why they knew what to look for.

Negative habit transfer: Many aircraft have airframe mounted (in addition to the filter built into the engine) fuel filters, and on some aircraft these filters are designed to be drained or purged each day, to allow water out. But not all filters are so designed. In one recent case, a pilot who had  transitioned from a Bell 206 and was used to draining his filter elected to drain the filter on his "new" aircraft. This allowed air to get into a space it shouldn't have, and resulted in an engine flame-out at a high-hover, and significant damage.

Speaking of the Bell 206 and it's filter, there is a sequence of steps used for this purging. I knew a pilot once who decided that the way the steps were written was dumb, because he routinely got fuel all over himself from the pressurized spray hitting the engine compartment deck and splashing up. He decided to change things up, and open the drain valve and then turn on the pump and let it flow. Only he got distracted one day and forgot to close the drain after turning off the pump. On his next flight, he flew from one platform in the Gulf of Mexico to another - thankfully very close - platform, at which an oilfield worker who was waiting for a ride commented on the steady stream of fuel draining from the aircraft as it came in to land...

Dumb. Dumb. Dumb. If the fuel boost-pumps mounted down in the fuel tank hadn't been putting more fuel into the filter housing than the engine was taking out, the engine would have sucked air and quit. Never deviate from an established procedure.

I did some work at a hospital in the mid-west once. I asked the guys there about sumping and sampling the fuel from the hospital's tanks, which were located well away from the dispensation point. "The mechanic takes care of that." I wonder how many times a pilot has taken it for granted that someone else is making sure the fuel going into the aircraft that he or she will soon climb into is actually clean and safe for use.

Day after day, when we take a sample and it comes out clean and bright, we are gradually reassured that our fuel procedures are okay, and if we miss a sample now and then, it won't matter. This is complacency trying to kill you. Perhaps the best scenario is when the base mechanic drives a diesel powered car or truck. Then we know darn well that fuel is regularly being sumped and sampled...



Sumping the aircraft tanks is a pain in the back and knees. Maybe the aircraft didn't fly since yesterday, when you took a sample. All you have to do is rub the mark off the sample jar and change the date... But wait, are you absolutely sure no one tampered with the aircraft? Are you positive no suspended water (in the fuel) has settled to the bottom of the tank? Want to be your life on it?

My current employer requires a letter from anyone we buy fuel from verifying that they comply with established fuel handling procedures. Unfortunately, letter-not-withstanding we don't really know if they have checked the fuel in the truck or tank we are getting fuel from unless we watch them do it, which isn't practical. If they don't have a letter on file, we are required to perform a quality-check on the spot before allowing the fuel into our aircraft. I wonder if anyone has actually done this at an airport - asked for a white bucket and sumped the airport's truck and sampled the hose? Again, it's not really practical in the middle of a patient transport with the crew waiting at the hospital. One thing I always do, letter on file or not, is look the guy in the eye and ask him if HE checked the fuel that day. I want to hear it from his mouth. Draining some fuel from the aircraft after fueling is complete is another option for checking the quality. I have cut a plastic water-bottle in half, wiped it out, and checked the fuel after buying it from a place I deemed sketchy.



We use fuel every day we work, and it's always ok - but there was that time in Savannah when I pumped a mayo jar full of water and mud from the base's filter-vessel. Now that got my attention. I picked up the radio and called us out-of-service. Then I went underneath the BK with another jar.

Once, while flying in Pennsylvania, I slid underneath a backup BK that Keystone (the old Keystone - gone now) had issued us. I went to push up on the little belly-drain plunger. It resisted, because the aircraft had recently been painted, and over-spray got on the plunger. I pushed harder and up the plunger went, and fuel flowed into my coke bottle. Then I relaxed upward pressure on the plunger, and it stayed "in". And fuel continued to flow. There I was laying underneath a helicopter with my finger on the hole in the drain hollering for one of my crew members. The mechanic had to come in and drain the tank and rebuild the drain. It turned out that not one person had sumped the belly of that aircraft since it left the paint shop - and that had been a while.

Complacency and fuel don't mix.

safe flights