Program Profile : Memorial Hermann Life Flight

We have come upstairs for a tour and I look out the window of the communications center and think how nice it is for the comspecs to be able to see the pad.

We walk out onto the rooftop helipad and find three beautiful red and black Airbus EC-145s sitting on their freshly-painted spots. The view, of both the three identical aircraft and the surrounding city of Houston is breathtaking. A person could like this place.

Christopher "Todd" Grubbs, Chief Pilot (L), and Mike Mock, Program Safety Officer

Todd Grubbs, Life Flight's Chief Pilot shows me some sights around the horizon, then points at a yellow building a short distance away. "Our GPS approach is going to guide us to a spot right over there."  The GPS approach he is referring to will be an LPV (localizer performance with vertical guidance) and will look and feel just like the ILS (instrument landing system) approaches that we have been performing for decades. Only the LPV won't require ground-based localizer and glide-slope transmitters typically found next to runways - it will use a wide-area augmentation system (WAAS)- a ground-based transmitter sending continuous position-correction data to the aircraft's on-board GPS. WAAS allows for precision-approaches anywhere!

Initially, the approach guidance will be usable down to 200 feet above the surface, with possible future upgrades allowing descents even lower. Todd is a man with a mission - to derive maximum operational benefits from the technology situated on his aircraft, on the ground, and in space. His enthusiasm for the job at hand and his deep understanding of what is possible are exciting and refreshing, like the cool spring day we are enjoying.

At 8;00 AM I had joined about fifty of Todd's co-workers as he presented an informative "state of the program" address.  He covered where they are as a CFR Part 135 air carrier - 5 bases, 6 identical aircraft with one serving as a spare, all aircraft and pilots IFR capable  - and where they are headed, and what will be required to get there. A vendor has been selected to "terp" (the process of creating terminal instrument approach procedures) GPS approaches at several hospitals that Life Flight visits. Once this is done a helicopter low-level instrument-flight-rules (IFR) route structure will be defined in and around the Houston area that will allow IFR trips underneath the heavily traveled routes used by the  passenger-jet air carriers flying into and out of Houston. They will even incorporate the  tower-enroute-control described in the Airman's Information Manual allowing IFR flights without needing to talk with approach-controllers.

What does all this mean?

It means Life Flight is able to transport ill and injured persons in worse weather conditions than they could before they became an IFR air carrier - and they are able to fly when other services are stuck at their bases for low ceilings and reduced visibilities. Their capabilities are going to improve even more with the addition of precision approaches to the hospitals they serve. A great program is getting even better.

I am visiting Life Flight thanks to fellow retired NightStalker Mike Mock. Mike is Life Flight's safety manager, and I had talked to him about presenting AMRM training. He arranged for me to have a two-hour block of time in which to spread the gospel of staying alive by working for and with each other instead of in spite of and against each other. The class went well and I had a great time meeting and bonding with the team.

Life Flight was started in 1976 by a Texas-sized personality named Dr. James"Red" Duke. They were the second air medical program in the United States. As Mike explained to me at dinner that evening, Dr. Duke treated President Kennedy and saved Governor Connally on a dark day in Dallas.

Dr. Duke is getting on in years now, but he is still the Medical Director, and is loved and respected by his team. The flight team went so far as to create their radio call sign in his honor, on the radio to ATC they are "RedDuke..."

How cool is that?

You can learn more about Dr. Duke by clicking here...

The Life Flight team are TV stars! Click here for more...

I think any man who loves what he does is lucky - and I love sharing the AMRM experience with flight teams. Visiting Life Flight was an honor and a privilege. 

Air Methods Enters Into Long-Term Agreement with Vanderbilt LifeFlight

Image courtesy JEMS

Denver, April 2, 2015 – Air Methods Corporation (NASDAQ: AIRM), the global leader in air medical transportation, announced today that it entered into a partnership with Vanderbilt University to acquire certain assets utilized in connection with the Vanderbilt LifeFlight Program, including medical equipment and three Airbus Helicopters EC-145 aircraft, as well as a 10-year agreement restructuring the program under Air Methods’ Alternative Delivery Service Model. Under the Alternative Delivery Service Model, Air Methods will provide aviation, fuel, maintenance, aircraft, dispatch, billing and EMS licensure. Vanderbilt will continue to provide all medical staffing, patient care and clinical services for Vanderbilt LifeFlight. The program will continue to operate under the Vanderbilt LifeFlight branding. Mike Allen, Air Methods’ president of domestic air medical services, stated “Air Methods and Vanderbilt LifeFlight have a strong partnership and track record of delivering high quality service to communities across Tennessee and the region. In this new service model, we will continue in our mission to give more tomorrows by providing the highest quality, around-the-clock service in partnership with Vanderbilt University and the exemplary patient care that has been their hallmark.” Vanderbilt LifeFlight currently provides hospital-based emergency air medical transport services throughout Tennessee and Southern Kentucky, with remote helicopter bases in Lebanon, Tullahoma, Clarksville, Smyrna and Mt. Pleasant, Tenn. Soon, a sixth base will open in Henry County, Tenn. LifeFlight also operates a fixed-wing aircraft (airplane) base at Nashville International Airport. “We look forward to continuing Vanderbilt LifeFlight’s commitment to excellence in patient care and patient safety with our longtime partner and industry leader,” said Stephan Russ, M.D., associate professor of Emergency Medicine at Vanderbilt University Medical Center and associate chief of staff for Vanderbilt University Hospital. “Vanderbilt LifeFlight has been delivering industry leading medical care as a community asset since 1984, and we trust that this opportunity will strengthen the access, reach and viability of the program for many more years to come.” Air Methods Corporation (www.airmethods.com) is the global leader in air medical transportation. The Air Medical Services Division is the largest provider of air medical transport services in the United States. The United Rotorcraft Division specializes in the design and manufacture of aeromedical and aerospace technology. The Tourism Division is comprised of Sundance Helicopters, Inc. and Blue Hawaiian Helicopters, which provides helicopter tours and charter flights in the Las Vegas/Grand Canyon region and Hawaii, respectively. Air Methods’ fleet of owned, leased or maintained aircraft features over 450 helicopters and fixed wing aircraft.

Advisory circular for Helicopter Air Ambulance Operations Published...

From the FAA advisory circular...

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.

Does someone in government actually think that our accident rate can be reduced with a name change? While substantive changes are being made, you can call what we do whatever you want - it will not change the acuity of the bleeding and battered persons who lie on the cot next to us. 

This ain't no taxi ride pal...

While a new and inexperienced  HEMS pilot might worry about the condition of the patient, a much more likely scenario is a pilot and crew worrying about how many flights their base has performed - and if they are going to lose their jobs  It's too bad we've forgotten how dangerous it is to constantly harp on volume.

Click here to download the AC as a pdf.

On Machoism...

I have always thought of (and discussed) machoism from a certain perspective. But it has different personas. Here is a comment from a post I wrote on a facebook string.

One of our problems is that we are assumed to have the experience for all the different environments we operate in, or perhaps it's left to "tribal knowledge" (a check-airman's actual words during a message exchange on this topic a couple years back) to prepare us. Landing on, in, and among high-rise buildings is akin to mountain flying. No one in HEMS addresses wind or turbulence limits - it's up to the pilot. And if "all the other guys do it" then I should be able to do it too, right? I now realize that this attitude (I can do it if they can do it) is another form of the hazardous attitude "Machoism."

While attempting a landing at the Medical University of South Carolina's helipad on top of a parking garage, downwind of an airfoil shaped tower (The Ashley River Tower), I realized that the vortices off the building were putting me at the limits of aircraft control.

Image courtesy Vertical Magazine

The thought went through my mind...all the other guys would be able to do this...

I decided that what I was doing and thinking was stupid. It was self-induced pressure to live up to an image. I aborted the approach and went to an airport. The patient went by ground.

Sometimes old pilots try to be bold pilots...

Eagle Med helicopter crashes in Oklahoma

One person has died. The news report indicates four crashes within this company since 2010....

This is the second fatal HEMS crash in a week. Stand by for increased regulatory pressure and government oversight. Hopefully the survivors from last evenings mishap can offer insight into what happened.

Click here for more...

For a historical perspective on the problem, click here...

ARCH Preliminary report.

Cick here for NTSB prelim.

Reflecting on Loss of Power...

 Losing an engine at that point would result in a very rapid decrease in rotor rpm, and a rapid descent to who-knows-what kind of forced landing area. It would be a lot different than pushing the collective down from level slow-cruise at one thousand feet above the threshold of a big beautiful runway. An excerpt from a post on ready-thinking

Over the last few days, I have been doing some hard thinking about what it will mean to lose power from the single engine in the helicopter I fly. Notwithstanding the high reliability and statistically insignificant risk of failure, engines DO fail and when we only have one, it puts us in a bad situation. I have taken to slightly longer hover checks (to let it quit if it wants to while I am near the ground), and climb-outs at max-continuous power and best-climb speed. Altitude and speed are good when the whining stops.

I spoke with Alex Myers, a young pilot-friend about the failure he experienced in a 333 trainer in Saudi Arabia. He noticed a change in engine sound, took the controls, and said, "now what did you do?" to his student. The student didn't do it - a nut on a pressure line came loose. Alex says "everything slows down and time stretches" as he is doing his first-ever real-live no-crap auto to the surface. He had just cleared a built up area and was over flat open terrain. They were lucky. 

Not everyone is so lucky.

Fellow pilot Juan Terraza told me about his two engine failures. In both cases the problem was the same thing, a nut securing a pressure line vibrates loose, a pressure signal is lost, and the engine spools down. Juan said both problems occurred after making a power adjustment, and advised against moving the collective during climb-out until at a safe altitude for autorotation. So after my hover checks are complete, I make one smooth increase in power to the line and leave the collective still until level off. 

Bad fuel will ruin our day as well...

I continue to consider and announce forced-landing areas, for both arrivals and departures. But I know there will be some situations where a forced landing will be difficult if not deadly. It might be good to start looking at rooftop helipads on hospitals as higher-risk propositions, with some additional forethought on escape paths and forced landing areas. It might even be worth considering to begin an approach to a point in space adjacent to a rooftop pad, sliding over the pad as the approach terminates. If the engine burps, farts, or coughs - down-collective to maintain rotor rpm and fly clear...

I find myself reflecting on the amount of time I spend in the avoid-area of the height-velocity chart - that is the combination of altitude (low) and airspeed (slow) from which an autorotation will not end well. A wire strike is more likely than an engine failure, but there are some areas where a wire strike is unlikely - like on approach to a rooftop helipad. If we know that we are into the wind, and won't hit wires, perhaps a super-slow approach (200 feet per minute rate-of-descent) isn't the best way...

(One cannot land a single engine-helicopter on a rooftop hospital-helipad in the city of Boston. Recent events perhaps bear out the logic of this restriction).

When you read about someone perishing - someone of a similar age and with lots of experience - by all accounts a good and safe pilot - it brings on the hard thinking...

May it not happen to you.

Or me.

Please add your thoughts on this in a comment...