FAA issues final rule to improve HEMS safety

The new rules include stricter procedures for landing in remote areas or flying in poor weather, equipping helicopters with additional safety devices and improving pilot training


Updated Jan. 5, 2015

In an effort to staunch the string of deadly helicopter EMS crashes that have killed dozens of patients and providers over the past two decades, the Federal Aviation Administration (FAA) issued a final rule on Feb. 20 that introduces wide-ranging new safety requirements for air medical operators. The new rules include abiding by stricter flight rules and procedures for dealing with situations such as landing in remote areas or flying in poor weather, equipping helicopters with additional safety devices and improving pilot training. In an FAA news release, Transportation Secretary Anthony Foxx called it a “landmark rule for helicopter safety.”

More stringent air medical safety rules were first proposed in 2010, after the National Transportation Safety Board (NTSB) held a series of hearings to address the high rate of crashes and suspected over-use of helicopters in emergency response. Yet the NTSB’s resulting recommendations for improving air medical safety appeared to languish for several years.

The 159-page FAA final rule incorporates many of the NTSB recommendations. Among the new rules, helicopter EMS operators must:

  • Equip helicopters with radio altimeters, which measure height above the ground, used to help during hovering, landings and flying in bad weather; and helicopter terrain awareness and warning systems, used to help maintain awareness of terrain and obstacles
  • Require that pilots are tested to handle flat-light, whiteout and brownout conditions
  • Equip helicopters with a flight data monitoring system within four years
  • Establish operations control centers if they operate 10 or more air ambulances
  • Institute pre-flight risk-analysis programs
  • Ensure that pilots in command hold an instrument rating, or the ability to fly using instruments rather than sight
  • Ensure that pilots identify and document the highest obstacle along the planned route before departure
  • Comply with visual flight rules (VFR) weather minimums, instrument flight rules (IFR) operations at airports/heliports without weather reporting, procedures for VFR approaches and VFR flight planning
  • Conduct safety briefings or training for medical personnel

According to the FAA, 2008 was the deadliest year for helicopter accidents, with 21 deaths occurring in five crashes. The FAA estimates the new requirements will cost the air medical industry an estimated $224 million over 10 years.

Read the FAA’s news release here.

White paper calls for expanded EMS role 

A group of EMS physicians from AMR, MedStar Mobile Health Services, Wake County EMS and colleagues recently published a white paper urging support for mobile integrated healthcare practice (MIHP). The white paper reports that when associated with EMS, these types of programs are often referred to as “community paramedicine.” But that term is too confining, according to the authors, because it focuses on defining new roles for paramedics and EMTs instead of considering the full range of potential mobile integrated healthcare assets.

Even so, EMS systems and personnel are “uniquely positioned to support MIHP,” according to the authors.

The white paper, “Mobile Integrated Healthcare Practice: A Healthcare Delivery Strategy to Improve Access, Outcomes, and Value,” was supported by a grant from the Medtronic Foundation to the AMR Foundation for Research and Education. Read more here.

Join the CPR challenge 

Imagine a local park on a beautiful May day. Joggers make their way along running trails and families spread picnic blankets beneath the kite-dotted sky. Someone strums a guitar.

This peaceful scene is interrupted by the wail of sirens as several emergency vehicles enter the parking lot. But this is no ordinary response: As the first responders step out of their vehicles, a disco beat emanates from a boom box, and the bystanders quickly recognize the tune: “Stayin’ Alive.” Before the Bee Gees get to the part about the New York Times’ effect on man, responders have set up a mannequin on the grass and begun doing CPR. More mannequins are deployed as the crowd grows, and the responders invite onlookers to take a turn doing chest compressions.

What’s going on here? It’s part of the AMR World CPR Challenge. Sponsored by American Medical Response, this year’s event will take place May 21 across the United States and overseas, in locations ranging from public parks to schools, beaches, shopping malls and more. Last year, more than 54,000 people were trained in compression-only CPR; this year’s goal is to teach tens of thousands more people how to save a life and make their community safer.

For more information on how you can get involved, visit facebook.com/AMRCPRCommunity.

EMS Week goes to college 

Lauren Chavis, an EMT and senior at Johns Hopkins University, volunteers 24 hours a week as EMS operations director for her campus EMS service, Hopkins Emergency Response Organization. Although she’s thinking of going to law school, Chavis says working in EMS has given her experience in leadership and handling difficult situations she couldn’t find anywhere else.

“In EMS, you can do good while at college, not in an abstract way, but in a very real way, where you’re helping real people in real time,” she says.

Chavis is one of hundreds of U.S. and Canadian college students who participated in 2013’s Collegiate EMS Week, which is modeled after the national version of EMS Week but is held during the second week of November to accommodate college schedules. (In May, many students are either taking final exams or on summer break.)

Sponsored by the National Collegiate EMS Foundation and the American College of Emergency Physicians, Collegiate EMS Week is endorsed by Congress. It is a weeklong recognition of campus-based EMS—a time for those organizations to publicize their services and educate their communities. The week kicks off with National Collegiate CPR Day, which focuses on training fellow students and faculty in CPR. Other activities can include open houses, blood drives coordinated with local Red Cross chapters, local or campus media ride-alongs, joint training with other local EMS or fire agencies, and dorm safety events.

At Johns Hopkins, volunteers for the BLS ambulance service taught hands-only CPR to more than 50 people in the quad and created a hands-only CPR video that was shown on monitors in university buildings. Set to heart-thumping music and depicting the sudden collapse of a young male student, the video has received more than 700 views on YouTube.

In Houston, volunteers for Rice University EMS offered free blood pressure checks, taught hands-only CPR in the quad and held a special AED and CPR training session for employees in a campus building where a woman had recently died from sudden cardiac arrest.

“Celebrating Collegiate EMS Week lets the members of the organization know how much they do and how appreciated they are,” says Rice’s Patrick McCarthy, an EMT majoring in biochemistry and cell biology and captain of a team of 70 campus EMTs who answered about 750 calls for service last year. “It also raises general awareness among the student body, the faculty and the community about our capabilities, how much time we put in and how dedicated the personnel in the organization are.”

The National Collegiate EMS Foundation was founded at Georgetown University in 1993, when the Internet made it easier for campus rescue squads from around the country to connect with one another about ideas and challenges. Since then, the organization has grown to include nearly 250 campus EMS groups in 41 U.S. states and four Canadian provinces, collectively handling more than 90,000 responses annually. Their annual conference draws nearly 1,000 students for lectures, skills labs and roundtable discussions.

Check out the Hopkins Emergency Response Organization video here

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