Friday, August 1, 2014

He Who Cannot Remember the Past is Condemned to Repeat It...

It may be up to you...

How well do you think "see and avoid" works at preventing mid-air collisions? An investigator in charge of determining the cause of a mid-air between two planes flying over the Grand Canyon in 1956 came to the conclusion that see and avoid doesn't work. His findings led to positive air-traffic-control of commercial airliners. We in HEMS do not have the same level of control over our flights.

While HEMS hasn't suffered a mid-air collision between two helicopters since the collision in Flagstaff Arizona., there are more of us flying now than ever before - not to mention news-helicopters, law-enforcement, fire-fighting etc.  Competition and ever-rising reimbursements have led to different companies' helicopters frequently arriving and departing hospital helipads with scant notice of each other's intentions or actions...

Flagstaff Crash Scene photo by David Tedesco

Last evening, while approaching a hospital in Huntsville Alabama, I became aware of a competitor's aircraft occupying the single-spot helipad only after flying over the hospital for landing. About three hours later, our roles were reversed as I was loading a patient and  preparing to depart that same pad on another flight - and the other company's aircraft broke off his approach only after I flashed my landing lights. He had no idea that I was there...

Notwithstanding see-and-avoid and radio-calls in the blind, the relative freedom of  Visual-Flight-Rules (VFR)  to uncontrolled hospital helipads creates an increased risk of a mid-air collision, or a collision on landing. 

The Shands Hospital in Gainesville, Florida has instituted near-positive control of arrivals and departures from their helipads - perhaps such increased control is a good thing...

There is also a hazard associated with channelizing traffic across check-points or in corridors. Helicopter crashes at both the Fort Campbell Kentucky and Fort Stewart Georgia military reservations, involving air corridors and choke-points pointed out the need for procedural separation and increased control.

An example: In Huntsville Alabama, the main hospital is located between a mountain ridge-line and restricted airspace- forming a north-south channel that all HEMS aircraft use. At the south end of this channelizing phenomenon, there is a VFR checkpoint (bridge over river) depicted on the sectional map. It is entirely probable that multiple aircraft could be in this corridor heading in opposite directions. With multiple radios in use, a radio advisory could easily be missed. The lights on a low flying helicopter can easily get mixed in with ground lights...

A local area letter-of-agreement (LOA), endorsed by all area HEMS programs, agreeing to separate traffic along channelizing routes with choke points by procedure or altitude, ; for example... odd altitudes heading south and even altitudes heading north - flying west of the road heading south and east of the road heading north (fly right) - making an advisory radio call approaching choke-points; could present another layer of defense against the risk of a mid-air. Even if published, we must remember that everyone may not be aware of our LOA and procedures, but something is better than nothing. This agreement to cooperate should start with the senior leaders from all the companies involved - but they may be too busy. It may be up to you - to save your own life.

Another hazard-mitigation practice is the absolute dedication to professionalism and courtesy by all HEMS pilots (and crews) in an area. Yes, we work for different companies. Yes, we want our programs to do well. But that should never equate to a refusal to communicate or cooperate with another pilot or crew. As Dutch Martin used to say, "we are all just glad to have a job - and trying to do it." It is easy to fall into an "us-versus -them" mindset, and hesitate to communicate with each other.

But our lives may depend on us doing just that...

safe flights


  1. In many cases ( not all) the receiving hospital is aware of incoming aircraft and ETA. Personnel taking the radio report need to relay info regarding any other incoming aircraft. Its amazing but there have been several situations when the ED knew they had 2 aircraft arriving at approximately the same time yet didnt put 2 and 2 together ( or were never trained) and neglected to pass the info on

    MK Abernethy MD

    1. Sorry, didn't see the article first from Twitter. Guardian was my service; I lost two friends that day. When I think back on my career and the instances in which the stars and planets just didn't allign for me I know I'm not here today because I'm more savvy or safety conscious. --D Weber RN


Tell us what you think. If you are involved in helicopter emergency medical services / air ambulances, this is your community. Please refrain from posting profanity, or comments that might be considered libelous or slanderous.