NTSB Examines Helicopter EMS Safety

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Key Takeaways:

  • The NTSB initiated a four-day hearing on helicopter emergency medical services (HEMS) safety due to an "alarming and unacceptable" record of 85 accidents and 77 fatalities in the last six years.
  • Expert testimony highlighted that the fatality rate for HEMS crews surpasses other high-risk occupations like fishing and logging, though patient fatality rates are much lower.
  • The NTSB aims to identify accident causes for prevention, contrasting the U.S. record with Canada's, which has never had a fatal HEMS accident.
  • Previous NTSB recommendations from 2006, including mandating charter aircraft regulations, flight risk evaluation programs, formalized dispatch, and Terrain Awareness and Warning Systems (TAWS), have not yet been acted upon by the FAA.
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The NTSB on Tuesday opened a four-day hearing on the safety of helicopter emergency medical services. The goal is for the board to learn more about HEMS operations so it can better evaluate the factors that cause accidents. “In the last six years, we have seen 85 HEMS accidents, resulting in 77 fatalities,” board member Robert Sumwalt, who is chairing the hearing, said in opening remarks on Tuesday. “The recent accident record is alarming and it is unacceptable.” 2008 was the deadliest year in HEMS on record, with 13 EMS helicopter accidents and 29 fatalities. The board is hearing sworn testimony from expert witnesses including pilots, medical personnel, managers and the FAA. On Tuesday, they heard from Dr. Ira Blumen, of the University of Chicago Hospitals, who said the average fatality rate for HEMS crews over the last 10 years was higher even than for high-risk occupations such as fishing and logging. The death rate for passengers, however, is much lower. Over 29 years, he said, 4.5 million patients were flown by HEMS, and 34 died in accidents. The panel also heard from several others, including Sylvain Sequin of Canada, who said there has never been a fatal accident in HEMS operations in Canada, where 20 helicopters are engaged in such work. Sumwalt said the board’s aim is to better understand the factors that cause accidents so they can be prevented in the future. Possible courses of action resulting from the hearing include an updated safety study on EMS operations, additional safety recommendations, or a white paper for use when advocating or testifying on EMS safety issues. Written testimony and webcast archives can be found at the NTSB Web site.

An NTSB special report completed in January 2006 called on the FAA to require that all HEMS flights with medical personnel on board be conducted in accordance with charter aircraft regulations, and all HEMS operators should be required by the FAA to develop and implement flight risk evaluation programs, use formalized dispatch and flight-following procedures including up-to-date weather information, and install Terrain Awareness and Warning Systems (TAWS) on aircraft. So far the FAA has not acted on those recommendations.

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