EMS Helicopter Crashes

A study published in the Annals of Emergency Medicine (on line) in January 2006 reports a "disproportionate increase" in the number of EMS helicopter accidents and deaths.

Without a membership, we are limited to reading only the abstract and, consequently, are not privy to the more detailed statistics. Therefore, the numbers cited in the report have little meaning.

For example, we could reasonably expect the total number of accidents to increase over time, but has the accident rate increased? If so, by what measure (per 1000 flight hours, per 1000 sorties, etc.). And what is it that makes the increase "disproportionate?" Disproportionate to what?

These folks sometimes have a funny way (to me, anyhow) of stating the obvious, like when they say "Multivariate logistic regression revealed that controlling for other factors, the odds of fatal outcome was increased by postcrash fire ..."

What the heck is "multivariate logistic regression," and just why was it needed to "reveal" that postcrash fires increase the odds of a fatality? Common sense will "reveal" the same obvious result of postcrash fires.

The conclusion to the study (at least that part included in the abstract) offers nothing more than what has been known for many years:

"Fatalities after helicopter EMS crashes are associated especially with
postcrash fire and with crashes that occur in darkness or bad weather..."

Yes, postcrash fires add to the number of fatalities. Crashes that occur in darkness or bad weather (low visibility) usually involve high-speed impacts with obstructions or terrain and, therefore, increased trauma to the aircraft's occupants.

"...and can be addressed with improved crashworthiness..."

Believe me, helicopters are already about as crashworthy as they can be made to be and still be practical for their intended uses.

"...and measures to reduce flights in hazardous conditions."

This problem was addressed very well in a 1986 NTSB Safety Study of EMS helicopter accidents - mainly, apply strict weather minimums (ceiling and visibility) and don't pressure the pilots to fly in any weather conditions that the pilots determine are too dangerous. The highest percentage of fatalities (61%) in the 59 accidents included in this study resulted from "continued VFR flight into IMC."

"Further studies will be necessary to determine which changes will decrease the fatal crash rate and which are cost effective."

Again this is already known, but the lessons learned from previous studies are soon forgotten.

Recurrent flight training in flight simulators (not in the actual aircraft), in my opinion, will yield the most positive results in accident reduction. Yes, simulators are usually more expensive per hour of flight than the aircraft, but simulators offer the pilot the opportunity to fly in the kinds of situations and conditions that most often result in accidents. One hour in a simulator can provide the pilot with several hours more training benefit than one hour in the aircraft.

EMS pilots are often required to fly when the weather is at, and possibly below, their VFR minimums - at least at some unknown point along their flight route. That's why pilots sometimes (especially at night) find themselves in unforeseen IMC through no fault of their own.

Flight scenarios in the simulator can include all the elements involved in an actual aircraft accident and prepare the pilot to better handle the same or similar situation.

Those pilots who have experienced this type of simulator training know of its benefits. Unfortunately, the people who determine how much money will be spent on pilot training and how it will be spent are often not pilots and unaware of the value of simulators.

I have over 30 years experience conducting all levels of training for pilots in both aircraft and simulators, so take my word for it.

In all fairness to the authors of the study, I have access only to the abstract. The full study may actually have some useful information in it.