HEMS Or HAA-O... What's It Gonna Be?

Most medical crewmembers can extinguish a pilot's hero-light in short order...

Our pilots provide air ambulance services. Our crews provide emergency medical services. Neither HAA nor HEMS quite tells the whole story. Both terms are needed to represent the two domains that make up air medical transport services. Bill Winn - NEMSPA

From the advisory circular (AC) on helicopter air ambulance operations, 135-14B,

"The term Emergency Medical Service/Helicopter (EMS/H or HEMS) is obsolete. It is being replaced with HAA because, though a critical life and death medical emergency may exist, air ambulance flights are not operated as an emergency. Pilots and operator management personnel should not make flight decisions based on the condition of the patient, but rather upon the safety of the flight."

Several thoughts come to mind as I read this. First, history names things, like industries or aircraft, not officials.
It probably disappointed someone at Bell Helicopter that no one wanted to call their new turbine helicopter - the UH-1 (or HU1) - an "Iroquois." But no one did. It quickly became and will forever be the "Huey."

The next thing that comes to mind is how little the writer(s) of the AC understand of our business. But that's not surprising.  In almost 17 year of flying patients in helicopter ambulances, I have never once heard of an FAA inspector accompanying a crew on a patient transport.  Feds are paperwork guys, at least where we are concerned. They fly along on Delta, and they should probably ride along on some flights with us. We aren't all restricted to one skinny patient - yet.

The AC writer's assumption is that by removing the word "emergency" from our name for ourselves, we will remove some of the urgency that they think we feel when faced with a "mission." (Another word to be stricken from our lexicon). In other words, lets change our name and remove a source of pressure to complete flights.

Well, newsflash. Most medcrew can extinguish a pilot's hero-light in short order. And the smart ones do. We don't crash aircraft because we feel pressured to go get little Johnny from the accident scene. It's not that simple.

Mind you, our job will never be like flying an airliner with passengers or cargo on board. When someone is getting chest compressions 8 inches away from me, I can't ignore it. No matter what we call this, this is no taxi service.

People tend to act out of self-interest, and a desire to earn wealth. Understand that and you can drill down to the human (risk) factors.

What does make us crash, statistically speaking, is a lack of proficiency at our craft as pilots, and poor decision-making skills. To a large extent, those problems could be trained out of us. More line-oriented-flight-training (LOFT), more time in simulators, more scenario-based training, these are the things that could prevent crashes. And that LOFT and SBT should include medcrew! You can get the script for SBT from accident reports. Paint an entire team into a corner, and let them practice getting out of it. In military units, teams "train as they will fight." We should do this as well - we should train as we will work."

Yes, that would cost real money; In an era of hundred million dollar awards it will be a bargain.

Memorial flight line-up for Diana, Claxton, and Patrick. Conway SC. 2009

There is one form of pressure the FAA and the industry could revisit - the pressure for volume. In many companies, there is constant pressure from management to complete more flights. That pressure is at once understandable, and hazardous, and it has not one thing to do with worrying about a patient; or what our name is. If the crew at a community base doesn't fly enough sick people, the operator closes the base.

HAA is hard to say, and HAA-O(perations) doesn't sound right.

I'm sticking with HEMS.