Crew Resource Management and HAA Flight Acceptance

Resource Management on HAA Flights

I hate waking up in the morning and seeing the EMS Wings symbol with a black line through it on social media. It means we lost another one. The latest tragedy claimed 3 more lives in Ohio. it is yet another sad reminder that even though helicopter safety and crew resource management has improved over the years, there is still a lot of work to be done.

EMS helicopter operators and regulators recognize the need for greater pilot situational awareness and decision making skills regarding the go/no go decision. At the very least, HAI’s Air Medical Committee has advised that a pilot go through a flight risk analysis before accepting a flight request.

The recommended items to be covered in the analysis include weather, fatigue, outside stressors, aircraft condition and whether another air medical provider has declined to accept the flight. During my 10 years with an EMS Air Medical Company, it used to amaze me when a call would come in and the dispatcher would casually mention that 3 other operators had turned down the flight for whatever reason. My response would always be an emphatic NO, unless conditions had changed dramatically by the time the request made its way to me.

The risk analysis is then scored and serves as a basis for discussing the flight with your operations center. We all know from our initial and recurrent pilot training that we can turn down a flight for any reason at any time, but it can’t hurt to have a documented “unfavorable” risk factor to back up your decision.

And while it is important to analyze all of the recommended factors known to cause risk in the HAA community, there is also a factor that should NEVER be included in a go/no decision – the condition of the patient. If your company is in the habit of including patient information with the initial flight request, you need to initiate a discussion with management to eliminate that practice immediately.

The med crews should also be advised against discussing this information within earshot of the pilot when he/she is making the decision to fly or not. Speaking from experience, it is very difficult to not think about the critically injured 3 year old barely clinging to life when you are leaning toward the no-go decision for other reasons.

If your company has a Flight Risk Analysis as part of your Standard Operating Procedures and integrated into your pilot training, then fantastic. Use it every time you are handed a flight request. If you do not use one on a regular basis, then now is the time to start. There are many examples that can be found on the internet or you can pay someone to develop an analysis that is specific to the needs of your company. Either way, by simply investing 5 minutes of your time, you will be making the skies safer for yourself, your med crew and your patients.