Pax Input (Medevac) - Split from ORNGE thread

[bezerker]

No foot in my mouth skymedic. This whole thread is about flight safety (at least it was).

It appears that you have seen the light though and have changed your stance from previous posts that stated that high time pilots were killing your friends and needed oversight from the ground and back seat, to your current stance, that one time the airplane didn't get in, so after the flight you checked the wx, it backed up your theory (that pilots will f everything up), and now you believe that you now have the evidence required to include you as part of the flight crew or at least micromanage their decisions (like all good bosses do, right?).

Airplanes don't always get it. No one wants to miss ever, they would rather have not taken off or landed somewhere else nearby. You sound like the disgruntled airline passengers that whine and bitch on tv when a wx system hits a hub and their flight isn't going the way they would like. Unfortunately you are also a pilot and you are proving the saying that "a little knowledge is dangerous".

As a customer, if you had briefed the pilot before the flight and said if it is unlikely that we will land (you, as an experienced passenger, obviously know that airplanes are never guaranteed to land at their destinations right?), I would prefer to do X, and he tried to go to the original destination and missed, I suggest that you mention your issue to his Chief Pilot. You and the CP can then refine what wx would be considered a no go for you.

Unfortunately for you, charter Pilots discussing weather options with the passengers/paying customer before take off does not make them part of the flight crew. It is just the pilots doing their jobs. Like I said above, if they aren't, let their boss know about it.

Anyway, it seems like you are the last straggler left to convince that he is not crucial to the operation of the aircraft. I've had enough of others and myself trying to convince you. At this point I will follow my Dad's advice which was don't argue with an idiot, people watching may not be able to tell the difference.

Respectfully,

[bandaid]

I can't believe that this is still going on.
Pilots fly airplanes, paramedics treat patients. If the pilot is more interested in what is happening behind him then he is not doing his job. Similarily, if the paramedic is too busy watching the gauges or out the window, then he is not doing his job.
Sure, shit happens during a medevac from time to time, it pays to know where you alternate best outcome hospital is or more correctly where the airport for that city is. The time for that knowledge is long before any flight and any pilot that has been at the medevac business will already know as will the medics. If that is what this is all about then put it to rest, but if you are trying to say that all > 4000 hour pilots have the potential to put a big smoking hole in the ground then you are barking up the wrong tree, that can happen to anyone at any time, god forbid.
I liken this conversation to ones that I have had with "some" Occupational first aiders, just enough knowledge to make themselves a danger.
I get what you are trying to say Skymedic but question your reasoning in doing it the way you are. If you are trying to make us paramedics all look like a bunch of primadonnas, then you have achieved that. If you are trying to stir up the pot with your callous allegations, you have done that. If you are trying to impress all with your education and self importance, well lets just say, you're falling short.
Although I doubt that this will help soften the blow I'll try one of your tricks and end this little rant with....
respectfully,

[skymedic]

No foot in my mouth skymedic. This whole thread is about flight safety (at least it was).

It appears that you have seen the light though and have changed your stance from previous posts that stated that high time pilots were killing your friends and needed oversight from the ground and back seat, to your current stance, that one time the airplane didn't get in, so after the flight you checked the wx, it backed up your theory (that pilots will f everything up), and now you believe that you now have the evidence required to include you as part of the flight crew or at least micromanage their decisions (like all good bosses do, right?).

Airplanes don't always get it. No one wants to miss ever, they would rather have not taken off or landed somewhere else nearby. You sound like the disgruntled airline passengers that whine and bitch on tv when a wx system hits a hub and their flight isn't going the way they would like. Unfortunately you are also a pilot and you are proving the saying that "a little knowledge is dangerous".

As a customer, if you had briefed the pilot before the flight and said if it is unlikely that we will land (you, as an experienced passenger, obviously know that airplanes are never guaranteed to land at their destinations right?), I would prefer to do X, and he tried to go to the original destination and missed, I suggest that you mention your issue to his Chief Pilot. You and the CP can then refine what wx would be considered a no go for you.

Unfortunately for you, charter Pilots discussing weather options with the passengers/paying customer before take off does not make them part of the flight crew. It is just the pilots doing their jobs. Like I said above, if they aren't, let their boss know about it.

Anyway, it seems like you are the last straggler left to convince that he is not crucial to the operation of the aircraft. I've had enough of others and myself trying to convince you. At this point I will follow my Dad's advice which was don't argue with an idiot, people watching may not be able to tell the difference.

Respectfully,

No, my stance is still the same.....Someone stated in this thread that 1000 hr pilots were having the most accidents, and others inferred high time pilots were the be all end all for aviation...Unfortunately, for you guys, this hypothesis is easily disproved with statistical facts from the NTSB website.... Disclaimer***** I am speaking about ROTOR WING HEMS in the USA here ******** The mean hours for pilots who have crashed a HEMS ship in the last 10 years have been > 4000 hr pilots, and >60 % were ATP rated. This is a FACT and cannot be disputed. The majority of these crashes were CFIT due to weather related issues...Again, statistical Fact......

I could care less about whether or not I am designated part of the flight crew...Honest, I have no such EGO. The only time I ever get involved with aviation stuff is BEFORE the flight, to determine whether or not I am even getting on the aircraft to begin with......

I fully understand FW flights dont always make it to their destination, this is not rocket science my friend....However, since the flight crew ( read: Pilots) decided to discount the forecasted weather in ABQ and categorically state we should have no problems making it in at minimums, this patient suffered as a direct result of their " EXPERTISE". All they had to do was say, look, weather in ABQ is at minimums, forecasted to get even worse, probably not a good idea.....I would have said, thank you very much, lets find a bed in phoenix or Flagstaff, and the discussion would have been over.....

This incident is directly responsible for me becoming a pilot.......Now, that I have the same ratings, I will no longer allow poor ( flight planning) decision making to have the potential to affect the life of any patient....Again, if one has never been on both sides of the coin, one cannot speak from a position of strength.....Once we take off, I expect you guys to be the experts which you are, and I will keep my nose in the back doing my thing with the patient......

Respectfully,

[skymedic]

I can't believe that this is still going on.
Pilots fly airplanes, paramedics treat patients. If the pilot is more interested in what is happening behind him then he is not doing his job. Similarily, if the paramedic is too busy watching the gauges or out the window, then he is not doing his job.
Sure, shit happens during a medevac from time to time, it pays to know where you alternate best outcome hospital is or more correctly where the airport for that city is. The time for that knowledge is long before any flight and any pilot that has been at the medevac business will already know as will the medics. If that is what this is all about then put it to rest, but if you are trying to say that all > 4000 hour pilots have the potential to put a big smoking hole in the ground then you are barking up the wrong tree, that can happen to anyone at any time, god forbid.
I liken this conversation to ones that I have had with "some" Occupational first aiders, just enough knowledge to make themselves a danger.
I get what you are trying to say Skymedic but question your reasoning in doing it the way you are. If you are trying to make us paramedics all look like a bunch of primadonnas, then you have achieved that. If you are trying to stir up the pot with your callous allegations, you have done that. If you are trying to impress all with your education and self importance, well lets just say, you're falling short.
Although I doubt that this will help soften the blow I'll try one of your tricks and end this little rant with....
respectfully,

Band,

Agreed, This should have been known before the flight even took off....However, it was NOT, and the patient suffered for 2.5 hrs longer than he needed to.....and ultimately passed away.

I am NOT stating all pilots with >4000hrs are dangerous...What I stated was statistical facts showing that the MEAN hours of pilots who have crashed RW HEMS ships in the last 10 years in the USA have been > 4000.......Only as a rebuttal to the inference that high time pilots are the be all end all for aviation.

These are not allegations, they are facts, easily verifiable...The truth hurts sometimes....Some people choose to bury their head in the sand, I do not!

Most Respectfully,

[sky's the limit]

I am NOT stating all pilots with >4000hrs are dangerous...What I stated was statistical facts showing that the MEAN hours of pilots who have crashed RW HEMS ships in the last 10 years in the USA have been > 4000.......Only as a rebuttal to the inference that high time pilots are the be all end all for aviation.

These are not allegations, they are facts, easily verifiable...The truth hurts sometimes....Some people choose to bury their head in the sand, I do not!

Most Respectfully,

I am not disputing your facts Skymedic, what I am saying is two-fold: One, the context for these accidents is being completely ignored by you when quoting them, and Two, your contention that the medic in the back having input would change these statistics. I do not believe for one second they would - nor does Congress. There is some fascinating reading on the HEMS hearings this past year and the issues with the structure of the RW system. I'm sure you are well aware of the issues facing the US RW HEMS system and its glaring flaws.

There is also an added issue of the air medical auditing system... but that is for another time.

Indeed, the truth may "hurt," but I would contend that your head may be partially buried as well given your assertions that largely ignore context and proposed 'fixes' you have put forward.

Anyway, I'm off flying for a few days, see ya'll at the end of the week.

stl

[bandaid]

I'm sorry Skymedic, I can not pretend to know that much about the operations south of the border but they sound like a nightmare. I am glad that we have a Provincial service that operates for the patient and not the profit. It sounds to me that you know little about Canada's operations. To be honest I know only a little about the country outside of B.C. myself, it is a big country with fewer "big cities" specially in the north. Our nearest tertiary care hospital for the north in B.C. is in Prince George, more central B.C. that northern. Our pilots and paramedics know full well that they are going to be one their own from time to time and the training that they recieve prepares them for this fact.
I have pretty much had it with this thread and your holier than thou attitude. Having said that I am glad that we have a different sysyem here in B.C.

[skymedic]

I am NOT stating all pilots with >4000hrs are dangerous...What I stated was statistical facts showing that the MEAN hours of pilots who have crashed RW HEMS ships in the last 10 years in the USA have been > 4000.......Only as a rebuttal to the inference that high time pilots are the be all end all for aviation.

These are not allegations, they are facts, easily verifiable...The truth hurts sometimes....Some people choose to bury their head in the sand, I do not!

Most Respectfully,

I am not disputing your facts Skymedic, what I am saying is two-fold: One, the context for these accidents is being completely ignored by you when quoting them, and Two, your contention that the medic in the back having input would change these statistics. I do not believe for one second they would - nor does Congress. There is some fascinating reading on the HEMS hearings this past year and the issues with the structure of the RW system. I'm sure you are well aware of the issues facing the US RW HEMS system and its glaring flaws.

There is also an added issue of the air medical auditing system... but that is for another time.

Indeed, the truth may "hurt," but I would contend that your head may be partially buried as well given your assertions that largely ignore context and proposed 'fixes' you have put forward.

Anyway, I'm off flying for a few days, see ya'll at the end of the week.

stl

Sky,
I am confused as to your meaning of " Context".

Second, I have NEVER stated medics having input post takeoff would change the statistics....NEVER....What I did state is that CRM should be a proactive technique used before every flight and especially when weather is marginal, thus allowing the medical crew to make an informed decision PRIOR to takeoff whether or not they want to get on the aircraft.....IF they choose NO, they alone bear the burden to explain their position to management. Based on my education and experience , I never have any issue explaining my rationale to mgt if questioned... I also never make it a pilot issue...NEVER.....

The fixes to the RW HEMS nightmare is complicated because there currently stands very little in the way of regulation...CAMTS is a complete joke with zero oversight above them...
What I would propose are the following,
1. NVG - Anvis 9 or no night scene flights

2. Terrain Awareness systems on all aircraft

3. Minimum of a passive collision avoidance system on board all aircraft. ( 7 people would be alive today if at least one of the helicopters in KFLG had one installed) ( Does it make sense to you that my Turbo 182 with the G1000 cockpit (450k) has more sophisticated avionics than a 3 million dollar helicopter?)

4. Regulate the industry, number of helicopters required in a certain geographic location, Certificate of needs, suspend medicare and other insurance reimbursement for non-medically neccessary flights.

5. Centralized State Dispatch Centers

6. In a perfect world i would say Multi-Engine Aircraft as well. ( And yes, I know the stats show no difference, however)

7. Eliminate helicopter shopping. ( Look to the PHI Texas crash as a good example)

8. Make all VFR helicopter pilots maintain proficiency in IFR flight. Pretty sad when I have more IFR time than a pilot who has been flying for 20 years and does the absolute minimum to stay current, which as you know, by no means makes one proficient in anything.

Look forward to your response. Enjoy your time off,
Most Respectfully,

[skymedic]

I'm sorry Skymedic, I can not pretend to know that much about the operations south of the border but they sound like a nightmare. I am glad that we have a Provincial service that operates for the patient and not the profit. It sounds to me that you know little about Canada's operations. To be honest I know only a little about the country outside of B.C. myself, it is a big country with fewer "big cities" specially in the north. Our nearest tertiary care hospital for the north in B.C. is in Prince George, more central B.C. that northern. Our pilots and paramedics know full well that they are going to be one their own from time to time and the training that they recieve prepares them for this fact.
I have pretty much had it with this thread and your holier than thou attitude. Having said that I am glad that we have a different sysyem here in B.C.

Band,
It was not my intention to present a holier than thou attitude, I just resent the fact that pilots make blanket statements inferring that medical people cant possibly know anything about aviation.....So, I put myself in a position of strength by attaining the same ratings as the majority of them have.

Also, be GLAD you don't work south of the border. It is a freaking nightmare here....I studied the canadian system during my MBA program, so I know more than one might think....I love your system, If I were king for a day, I would model the US system per the canadian system in a heartbeat........

Thank you for the insight. Fly Safe,
Respectfully,

[flyinNM]

FYI for the pilots who might want to contribute

A new working group of the air medical transport industry met to formulate a strategy to identify and mitigate the pressures that may be placed on air medical crew members to accept or continue a flight under conditions of elevated risk. The project is part of the No-Pressure Initiative sponsored by the National EMS Pilots Association (NEMSPA) and is funded, in part, by the $10,000 Vision Zero award sponsored by American Eurocopter and awarded to NEMPA at the annual Air Medical Transport Conference in San Jose, CA last October.

Representatives from what are known as the air medical “alphabet groups” are collaborating on the project. The principal acronyms represented were (in alphabetical order) AAMS (Association of Air Medical Services), AMOA (Air Medical Operators Association), ACCT (Association of Critical Care Transport), ASTNA (Air and Surface Transport Nurses Association), IAFP (International Association of Flight Paramedics), and NAACS (National Association of Air medical Communications Specialists. While a representative from AMPA (Air Medical Physicians Association) was unable to attend, that group has been very supportive of the project. Other interested parties present included a consultant from the FAA, and J. Heffernan, Director of Safety for the Helicopter Association International (HAI). Dr. Mark Rosekind, an internationally recognized expert on sleep and fatigue issues affecting workers who provide 24/7 services, attended the gathering and contributed an unbiased perspective to the discussions.

Facilitated by Dr. Frank Thomas, the group utilized a highly structured formal process to identify the universe of sources of adverse pressures on air medical flight crews. The results of that process will serve as the foundation to develop a survey to be presented to the nation-wide air medical transport community. The survey will gather data to clearly identify and quantify the factors that are most influential on air crews and are most likely to result in the kind of flawed decision making that could lead to a preventable aircraft accident. The results of the survey will be made available to air medical transport industry stakeholders nationwide. In the next phase of the project, the data will be used to guide the development and deployment of mitigations aimed at eliminating or counteracting the pressures that are identified.

Periodic updates on the progress of the project will be posted on the National EMS Pilots Association web site at http://www.nemspa.org.

[flyinNM]

As a customer, if you had briefed the pilot before the flight and said if it is unlikely that we will land (you, as an experienced passenger, obviously know that airplanes are never guaranteed to land at their destinations right?), I would prefer to do X, and he tried to go to the original destination and missed, I suggest that you mention your issue to his Chief Pilot.

Unfortunately for you, charter Pilots discussing weather options with the passengers/paying customer before take off does not make them part of the flight crew

What makes them crew - note not FLIGHT crew - is that they are designated as such by their employer in many systems, the same employers that the pilots report to. In those circumstances they are not charter passengers, but co-workers.

So, in that case, what is the issue with allowing them also to have the ability to terminate or turndown a flight. Not to OK a launch or say how it should be conducted minute by minute, but just the ability to say NO after the "go/nogo" decision has been announced as a GO by the PIC, and the "that's enough of this $#!+ lets call it off and go back" call at anytime during the flight (note not request, but activation of a policy that mandates return).

Please help me to understand why this, the original (way back near the start of the thread) concept being discussed, is such a threat or so disrespectful to the pilots here?

[flyinNM]

I did years of Medevacs, and in the beginning I made all the mistakes many others did, trying to hard to keep what I percieved to be the right thing. These forums weren't available in those days. Communicating what we know to others is the best way to prevent future errors.
After the Air Ambulance system (in Ontario) got really going and everyone with a plane wanted to be in on it the pressure to go got pretty intense for pilots. If you didn't, someone else definitely would and medcom was happy to have it that way. After a few spectacular crashes things changed. Medcom would still send anyone that would go but they increased the standards. We realised to stay in the game we had to be the best at it. No errors, include everyone.
I was clear with everyone that going out in the middle of the night into less than perfect conditions was a team event, everyone has input, if the medics had something to say speak up. They never interfered with my decision making process, they offered what they had and if I could use it in my decision I would, same as I would from a mechanic or FSS, ATC or anywhere else I could get information that could help.
I spent a lot of days and nights flying around northern Ontario, sometimes landing, sometimes not. I always tried to give them some idea of what the chance of success would be, but I didn't put myself or anyone else at risk, I've even landed only to reject the patient because they were a risk to us. Not what the medic wanted but we are responsible for more than just the patient.
Our responsibility is to take into account all the information available, wherever it comes from, and make a decision.

BOLD items are items I thought worth emphasizing - not the author

MEDCOM (Ont), PFCC (AB), Central Dispatch etc etc have one primary job. To find ways to get pts moved. The last "check and balance" is the CREW at the pointy end of the stick. Trip REQUESTS can be canceled for any number of reasons, some flight, some medical. Occasionally a borderline situation will come up. One which on the face of it should be do-able.

But if all the variables are at their limits of acceptability the question becomes SHOULD we do this. Is this choice the prudent one. Or does the accumulated effect of all these factors add up to more than when they are looked at separately. Unfortunately, this most often concerns disagreements over flight profiles/weather than over patient condition.

Just as a medical crewmember might feel uncomfortable with weather the multi-thousand hour ex freight dog from the arctic KNOWS he can fly safely and legally the pilot might feel uncomfortable with the walkon but seemingly stable psych patient or the kid with all the funny colored red spots on his skin. After all, he doesn't want to bring measles or meningitis home to his own kids.

So some communication occurs, agreement is not forthcoming and two options exist. Someone feels pressured but goes anyway, or they don't and bitch up the chain of command. Crap rolls downhill and someone always wears it - hint, never the dispatchers or managers who set up the crew to fail in the first place.

A defined, automatic, no-further-questions asked cancellation policy with regular trend review and education as opposed to punishment reduces the number of times these situations occur/escalate.

And even dreaded "for profit" systems (I work in one) have adopted this concept. Despite the loss of revenue from those refused flights. Because they are still cheaper than the costs of a crash or a flight crew incapacitated or dying due to an acquired illness.

Apparently Ontario experienced rapid growth and for profit operations with some crashes. Same as the US. Same as what is starting to be visible in Manitoba.

Why do we, humans, always fail to learn from the mistakes of others?

[flyinNM]

I studied the canadian system during my MBA program, so I know more than one might think....I love your system, If I were king for a day, I would model the US system per the canadian system in a heartbeat........

Thank you for the insight. Fly Safe,
Respectfully,

Not to burst your bubble, but there isn't really a coherent Canadian "system". Rather several different models/systems in different regions, with different safety records to match...

That said, overall and ESPECIALLY in the RW world it is much safer. Personally I think because of more capable airframes and 2 pilots / better IFR proficiency.

The FW world is different. Sure, less crashes than in Canada than the US but also less flights per capita attempted in Canada. My suspicion is that it is MORE dangerous to be a patient on a FW in Canada than in the US. The exact opposite of the RW situation.

I'm not an MBA or statistical type or have any desire to be one - but I'd love to help in a funded study to examine and normalise the two however - just to find out what is really happening....

[skymedic]

I studied the canadian system during my MBA program, so I know more than one might think....I love your system, If I were king for a day, I would model the US system per the canadian system in a heartbeat........

Thank you for the insight. Fly Safe,
Respectfully,

Not to burst your bubble, but there isn't really a coherent Canadian "system". Rather several different models/systems in different regions, with different safety records to match...

That said, overall and ESPECIALLY in the RW world it is much safer. Personally I think because of more capable airframes and 2 pilots / better IFR proficiency.

The FW world is different. Sure, less crashes than in Canada than the US but also less flights per capita attempted in Canada. My suspicion is that it is MORE dangerous to be a patient on a FW in Canada than in the US. The exact opposite of the RW situation.

I'm not an MBA or statistical type or have any desire to be one - but I'd love to help in a funded study to examine and normalise the two however - just to find out what is really happening....

FlyinNM,

Agreed, It was my error that i did not qualify which parts of the canadian system i preferred versus an all encompassing " system" response.

I think the canadians have a much better idea as do the Germans of how to run HEMS.....of which the USA could learn from tremendously.

The study would not be all that difficult to do, I could put it together, the issue is with data collection, very time consuming process....

Respectfully,

[flyinNM]

Will PM you - collected a bunch of TSB reports when in Canada - but still many years to do and all the CADORS to locate... Not as easy to search as the NTSB database...

[Brewhouse]

The FW world is different. Sure, less crashes than in Canada than the US but also less flights per capita attempted in Canada. My suspicion is that it is MORE dangerous to be a patient on a FW in Canada than in the US. The exact opposite of the RW situation.

I find it hard to believe there are less FW medevac flights per capita attempted in Canada. However if the accident rate is higher in Canada you would have to take into account the facilities we are operating into and out of. ex. NDB approaches, 2500-3500 gravel strips some 50' wide on ocasion glow pots ect. ect.

[flyinNM]

I find it hard to believe there are less FW medevac flights per capita attempted in Canada. However if the accident rate is higher in Canada you would have to take into account the facilities we are operating into and out of. ex. NDB approaches, 2500-3500 gravel strips some 50' wide on occasion glow pots etc. etc.

Very true - the facilities and weather reporting are much more primitive - when even available (at least as far as the lower 48 are concerned - Alaska is pretty much the same). So once collected, the reports would have to be analysed by an experienced pilot to see if the navaids and facilities played a part (lack of reliable information to aid decision making), or if it was the decision making process or result itself (if it the decision would not materially be different if the NAVAIDS and facilities were to the US norm).

As to flight volume - simple geography - Canada has huge areas with no tertiary facilities within ambulance or helicopter range. So you do ground transfers that would go by rotor in the US, and FW for the rest. Outside southern Ontario there is nowhere near the density of RW. 800-ish for 300ish million in the US and 16 (dedicated) AFAIK for 30 million in all of Canada. PHX area has almost 20 RW for 4 or 5 million in an area smaller than that covered by STARS in YQU.

This is where it can get confusing - Canada would seem to fly less by FW than in the US, and more on a per capita basis. I'd totally have to agree with you on that. Rereading my earlier post I seem to have mixed up what I meant to say in that regard! Even more reason to do a proper study... my suspicion is that (lets see if I can phrase this right) there are more FW crashes in Canada per 1000 fixed wing MEDEVAC/LIFEGUARD flights than in the US, but that there are more FW flights per million population (as a result of geography and the relative size of the fleet).

What is open to discovery is if these cancel out. In other words, is it more dangerous to be a FW patient in Canada than in the US. I think it is (the starting hypothesis to be disproven) Just as it is demonstratedly and uncontestably safer to be a RW patient in Canada. Despite the far higher RW to million population figures in the US opposing the MUCH higher crash rate per 1000 RW flights in the US than in Canada. Canada has yet to have a fatal crash of a dedicated medical helicopter from my research.

[BoostedNihilist]

To: Skymedic

the > 4000 hour statistic without context could be skewed.. how many low time pilots are there flying these missions? Perhaps the reason the statistics reflect a higher rate of incidence in over 4000 hour piliots is simply because the mean experience level is above 4000 hours (which.. isn't all that much time in the grand scheme of a career, see various posters here with 10x that amount) BEing that the mean flight time of a medevac captain could be, oh who knows, 30k hours, perhaps 4000 hours represents the inexperienced within the demographic.. I mean, I am sure you have read this statistic somewhere, and I am sure it is correct within it's context.. but without knowing how this statistic was derived it bears little relevance in terms of this discussion. Basically, to make it simple for you, if all the helicopters have pilots with more than 4000 hours, the statistics will show that all of the accidents have happened to pilots with over 4000 hours.

In another context.. if I never hammer a nail, I will never hit my thumb with the hammer. My grandpas car insurance increased because he did not have an accident within a timeframe which matched up with their curve... they seem to think that if you do something for long time, versus a short time, if you have not had an accident you have a higher chance in having an accident. this is not to say that the density of incidence will increase, just the chance of incidence will. Is this logic correct? I see an argument both ways, it's a glass half full argument.

Do you have any statistics on hotshot doctors with money and pilots licenses smoking holes into the earth? Hell, someone once told me that the bonanza's moniker was the v-tail doctor killer... With this in mind, I would be less likely to take your advice if you checked both the doctor and pilot boxes on your preflight declaration.

Furthermore, the contention that you are as qualified to command an aircraft as the contracted pic.. well, that's just ignorant and you know it. Experience is everything in every sector of employment. I doubt many here would argue a fresh journeyman is as qualified as a journeyman with subsequent years of experience.. yet, this is your aim? If I'm going to court, do I want Joe Scheistypants fresh off the BAR or johnny cochrane?

To your root point, if a patient is being loaded onto the medevac and destabilizes, or for some other reason becomes unairworthy.. should the pilot be able to tell you he thinks the patient will make it and to load him on the plane? You say you don't have an ego.. this situation would test it and reading your posts (Im an unabashed a-hole too so I know one when I see one) given your pompous arrogance I can imagine how the challenge to your authority by a lowly pilot would go over..I can tell that you would probably share the reciprocal opinion of the pilots you come here to antagonize.

[flyinNM]

OK, so here's some comments from a predominantly medical board. I don't know if it's in the US or Canada but it doesn't really matter. Not being a pilot I can't really answer to the heart of the posters questions but I am sure someone here can. I am sure that one of you would be able to explain things in a more informed manner than the medical types answering.

A chance to educate those in the back... Thread title is "Safety Question Was this safe??"

http://www.flightweb.com/forums/index.p ... entry20779

[flyinNM]

I can't believe that this is still going on.
Pilots fly airplanes, paramedics treat patients. If the pilot is more interested in what is happening behind him then he is not doing his job. Similarily, if the paramedic is too busy watching the gauges or out the window, then he is not doing his job.
Sure, shit happens during a medevac from time to time, it pays to know where you alternate best outcome hospital is or more correctly where the airport for that city is. The time for that knowledge is long before any flight and any pilot that has been at the medevac business will already know as will the medics. If that is what this is all about then put it to rest, but if you are trying to say that all > 4000 hour pilots have the potential to put a big smoking hole in the ground then you are barking up the wrong tree, that can happen to anyone at any time, god forbid.
I liken this conversation to ones that I have had with "some" Occupational first aiders, just enough knowledge to make themselves a danger.
I get what you are trying to say Skymedic but question your reasoning in doing it the way you are. If you are trying to make us paramedics all look like a bunch of primadonnas, then you have achieved that. If you are trying to stir up the pot with your callous allegations, you have done that. If you are trying to impress all with your education and self importance, well lets just say, you're falling short.
Although I doubt that this will help soften the blow I'll try one of your tricks and end this little rant with....
respectfully,

Some info from the US that from the sounds of it (at least the feelings expressed on this thread) many here should review and consider.

http://rgl.faa.gov/REGULATORY_AND_GUIDA ... C00-64.pdf

A moderator on Flightweb posted the following

Canada is a different environment.
It's basically you vs them; Get in, sit down, and shut up

Definitely NO CRM/AMRM or team work.

I really hope he is wrong....

[Indanao]

[quote="skymedic" "a little knowledge is dangerous".

The mean hours for pilots who have crashed a HEMS ship in the last 10 years have been > 4000 hr pilots, and >60 % were ATP rated. This is a FACT and cannot be disputed. The majority of these crashes were CFIT due to weather related issues...Again, statistical Fact......

Well, as an afterthought - Sorry to be Rude Skymedic, but you really don't know what your talking about here. As such, you have proven your former quote, about your little knowledge.

As per the second quote, you think 4000hours is high time? Maybe for you. The reason they have 4000hrs is that they are at the bottom of the EMS seniority. It takes a lot of hours to get that job. So, as was to be expected, the low timers are having the accidents. Weather related you say....go figure. People like you cause accidents. Know it alls.

[Jastapilot]

Back when I flew medevac, both as an FO and Captain, the Medic was always an important member of the team. We consulted each other, we coordinated with each other with regards to handling patients, potential destinations, issues with the patient enroute, etc. But, at NO TIME was a medic considered part of the CREW. And, at NO TIME did a medic THINK they were part of the crew. Team:Yes, Crew:No. And yes, there is a difference. Think about it.

[CD]

...at NO TIME was a medic considered part of the CREW. And, at NO TIME did a medic THINK they were part of the crew. Team:Yes, Crew:No. And yes, there is a difference. Think about it.

As you note, there is a difference. In Canada, it will depend on who the employer of your 'medic' is. If they are assigned to duty on board the aircraft by the air operator, they are a crew member. If they are not employed by the air operator, they are a passenger. The Regulations are quite clear about the fact that there are only two types of occupants on board the aircraft:

"crew member" - means a person assigned to duty in an aircraft during flight time; (membre d'équipage)

"passenger" - means a person, other than a crew member, who is carried on board an aircraft; (passager)

101.01 - Interpretation

The crew member will receive initial and annual training provided by the air operator in accordance with the CARs. The passenger doesn't.

[Doc]

"Ladies and Gentlemen, this is the chairman of the "shall we go, or not" committee. Before we taxi to the active runway, I assume you have all had time to peruse our enroute weather, destination weather and enroute NOTAMS. You will notice, on page four of our brief, the ILS at our proposed alternate is out of service till midnight GMT. You have, no doubt noticed we will be assisted today, by a low level jet. If you have completed your weight and balance reports, you may send them to the front of the aircraft, along with you signed "permission to proceed" forms. We will need a majority vote of 3-2 to enable us to depart today........"

[skymedic]

[quote="skymedic" "a little knowledge is dangerous".

The mean hours for pilots who have crashed a HEMS ship in the last 10 years have been > 4000 hr pilots, and >60 % were ATP rated. This is a FACT and cannot be disputed. The majority of these crashes were CFIT due to weather related issues...Again, statistical Fact......

Well, as an afterthought - Sorry to be Rude Skymedic, but you really don't know what your talking about here. As such, you have proven your former quote, about your little knowledge.

As per the second quote, you think 4000hours is high time? Maybe for you. The reason they have 4000hrs is that they are at the bottom of the EMS seniority. It takes a lot of hours to get that job. So, as was to be expected, the low timers are having the accidents. Weather related you say....go figure. People like you cause accidents. Know it alls.

Seriously, Please do your research before you challenge mine. Have you even checked the qualifications required for a ROTOR WING EMS job in the UNITED STATES? The hours required are as low as 1500TT! So, spare me the anecdotal thoughts on 4000 being low time.....SECOND.....If you noticed I said the mean was > ( this would mean GREATER THAN) 4000.

To quote you again, Sorry to be rude, but you really do NOT want to start challenging me on Statistics. I looked at just about every NTSB crash report for Rotor Wing HEMS in the USA for the last 10 years for my MBA research project. I know them very well....

One more time, we are discussing ROTOR WING SAFETY, NOT FIXED WING, Fixed wing is an entirely different variable. The only real issues I have encountered are poor PRE-FLIGHT weather planning, and not letting the crew know before take off....

Cheers,

[Cat Driver]

How often have used the FAA setting on your speed dial when you have determined the crew flying you are dangerous skymedic?