Most Wanted Transportation Improvement - Essay Example

Most Wanted Transportation Improvement Introduction The National Transportation Safety Board (NTSB) is responsible for coming up with ways of keeping our roads and our transportation system safe and efficient. A list of the most wanted transportation improvements in aviation have also been identified by the NTSB. This paper shall discuss the improvement of safety of Emergency Medical Services (EMS) flights. It shall evaluate the elements of this improvement and the steps being undertaken in order to implement these improvements. Discussion: Improve safety of Emergency Medical Services flights The NTSB Most Wanted List of Safety Needs was first seen in 1990 when the Board saw the need to alert the public about the different safety regulations which have to be imposed and which have to be complied with in the transportation sector. The safety of Emergency Medical Services flights, more particularly the Helicopter Emergency Medical Services (HEMS) flights were recently added to the list. The NTSB accurately pointed out that the mission of the EMS is to save lives; therefore, operating an EMS flight in an unsafe environment “just makes no sense” (Rosenker, as quoted by Air Safety Week, 2008). This most wanted improvement identified by the NTSB involves the “conduct of flights with medical personnel on board in accordance with commuter aircraft regulations” (NTSB, 2009). This improvement is also being described in terms of developing and implementing flight risk evaluation programs; requiring formalized dispatch and flight-following procedures plus up-to-date weather information; and installing terrain awareness and warning systems on aircrafts (NTSB, 2009). In 2006, the NTSB adopted the NTSB Special Investigation Report where they sought out to establish the importance of the EMS and of guaranteeing the safety of these flights. This report assessed EMS accidents from January 2002 to January 2005 and they were able to uncover about 55 EMS accidents during said time with 29 of these accidents preventable through corrective measures (SafeMedFlight, n.d). Most of these flights involved helicopters deployed by the EMS where, most recent figures registered a total of 35 casualties. The preventable nature of these accidents is an important indicator of the need to implement changes and improvements in EMS flights. The report above prompted the NTSB to seek the assistance of the Federal Aviation Administration (FAA) in order for the latter to adopt measures in order to improve the safety of EMS flights. The NTSB was able to establish, during its investigation and assessments, that there seem to be less stringent requirements for the flight operations which do not have patients on board (Wisniewski, 2008). They were also able to establish that there seem to be no flight risk evaluation programs for EMS flight operations; and there also does not seem to be any consistent and comprehensive dispatch procedures for EMS flight operations (Wisniewski, 2008). They were also able to establish that there seems to be no requirement for EMS flights to use safety measures and technologies, especially those which can warn them of impending danger (Wisniewski, 2008). Consequently, it is perhaps not a big mystery why there is a high rate of accidents for EMS flights. The very fact that these EMS flights fly only during emergency operations and under high-risk situations is an important consideration because then there is a need to expect more than the usual precautions undertaken in order to ensure the safety of these flights. The standards that are set by the NTSB and the FAA for EMS flights are crucial standards in aviation because ultimately, they will spell the meaning between the life and the death of the emergency flight crew and passengers who are being rescued. In the United States, there are about 840 emergency medical service helicopters (Duquette and Dorr, 2009). In instances when it is decided that emergency medical transport is needed, the same or even more safety precautions have to be taken by the medical team and the flight crew in order to ensure that the flight will be successful and safe. The flight team needs to check on weather conditions, maintenance, and crew readiness (Duquette and Dorr, 2009). The usual precautions have to factor in different elements which would normally not be present during non-emergency flights. With these considerations, the steps being undertaken to ensure safety of EMS flights shall now be discussed. These suggestions shall cover recommendations by the NTSB and by the FAA and the actual moves already being implemented in order to achieve the safety of EMS flight crews. The FAA actions started in August 2004 when it established a task force which would assess and guide the efforts taken in order to minimize EMS accidents. A meeting was first held with the EMS industry representatives in order to lay out the initial groundwork on the discussions regarding the topic on safety. Feedback was encouraged. The FAA then published a notice for safety inspectors to assist the operators in reviewing pilot and mechanic decision-making skills and crew resource management practices (Duquette and Dorr, 2009). Risk assessment programs were issued to inspectors in August 2005 by the FAA. Air Medical Resource Management (AMRM) was then established in order to guide EMS operators, flight crews, pilots, and the members of the medical team. Other offices were also established like the Commuter, On Demand, and Training Center Branch in order to help implement the regulations of the FAA. Rules on the Loss of Control and Controlled Flight into Terrain were also passed and established by the FAA (Duquette and Dorr, 2009). Trainings were also conducted for EMS pilots and emergency medical teams. On January, 2009, the FAA issued notices to the EMS operators and to the public in general on improvements that were seen with the introduction of the changes in the EMS flights. This report established that, as to decision-making skills and risk assessment programs, about 94 percent of EMS operators complied with the programs; as to response to FAA guidance on Loss of Control and Controlled Flight into Terrain avoidance, there was an 89% compliance rate; in the integration of operation control center – 89% compliance; in the installation of flight data recorders and devices that can re-create flight – 11%; for TAWS equipage – 41% compliance; and in the use of radar altimeters, there was an 89% compliance rate (Duquette and Dorr, 2009). Based on the above established facts, the FAA published its recommendations for EMS operators. They recommend the use of night-vision goggles (NVGs) and Terrain Awareness Warning Systems in order to ensure the safety of the EMS flight (Duquette and Dorr, 2009). In order to help improve the weather capabilities of the EMS flights, the FAA, in cooperation with the University Corporation for Atmospheric Research conducted a weather summit in March 2006. This summit sought to assess issues in relation to EMS flights and the possible improvements which may be adapted to handle changes in the weather. In the course of the summit, the FAA was prompted to fund the development and implementation of a graphical flight planning tool for ceiling and visibility assessment for direct flights in areas with limited available surface observations capability (Duquette and Dorr, 2009). This flight planning tool is considered a big step towards improvements in go/no-go decisions of the EMS operators. The approval and imposition of new technologies for use during EMS operations include the use of the night vision goggles. Night-vision goggles help improve the safety and the efficiency of EMS flights and the EMS has now trained many of the EMS crews on the application and the use of these NVGs. Certification from the FAA is required before these NVGs can be installed; nevertheless, they are important and crucial gadgets which can improve the safety of flights of EMS crews (Duquette and Dorr, 2009). Another important development in EMS flight safety is the installation of flight data recorders. These recorders help during accident investigations. They help determine flight path and attitude of the helicopters before the accidents. Improvements on flights of these EMS crews can then be made based on such recorders. Another improvement is the Terrain Awareness Warning Systems (TAWS) (Duquette and Dorr, 2009). The TAWS is an important assessment tool because it helps to scientifically and accurately judge the safety of a terrain for landing and for flight. The NTSB also made its own recommendations on this issue of safety in EMS flights. They emphasize that helicopter emergency medical services have to be regulated in terms of training and procedures. NTSB chair Deborah Hersman importantly points out that “The pressure on HEMS operators to conduct their flights quickly in all sorts of environments makes these types of operations inherently more risky than other types of commercial flight operations” (as quoted by Grady, 2009). Therefore, all possible moves and measures have to be undertaken in order to ensure the safety of these flights. They recommend that the FAA should impose better pilot training for EMS pilots, improvements in its data collection process, development of low-altitude airspace infrastructure, and they should require crews to use night-vision systems (Grady, 2009). The NTSB also recommends that the NTSB must be stricter in requiring the use of autopilots in single-pilot HEMS operations. On the part of the EMS operators, the NTSB recommends that they should work hard in order to improve pilot training and to upgrade their equipment (Grady, 2009). Furthermore, the NTSB makes firm recommendations to the FAA and the agencies involved in the EMS flights. They recommend that the Centers for Medicare & Medicaid Services at the Department of Health and Human Services and the Federal Interagency Committee on Emergency Medical Services should also work together in order to link Medicare reimbursements to patient transport safety standards (Grady, 2009). The integration should also be seen in the local and regional emergency medical systems in order to guarantee the delivery of the most appropriate emergency transportation mode to trauma and accident victims. The EMS flights are delicate operations which require the most prudent and the most efficient safety systems in place. The usual flight standards in aviation cannot be used to assess and ensure their safety. The NTSB is working well with the FAA in order to guarantee the efficient imposition of flight safety measures for the EMS helicopter crews. The NTSB was able to establish that the use of the TAWS and other safety gadgets like NVGs may have helped to prevent 17 of the 55 accidents which were recently reported (Air Safety Week, 2008). The NTSB also recommends improved “runway safety, reduction of dangers to aircraft flying in icing conditions, and a requirement for image recorders that show cockpit environment leading up to a crash” (Air Safety Week, 2008). The NTSB also prudently pointed out how exhaustion in EMS flight crews is a factor which can also contribute to unnecessary accidents befalling EMS flights. In this regard, they also recommend “work hour limits based on fatigue research, circadian rhythms” (Air Safety Week, 2008). These recommendations have yet to be fully implemented yet by the FAA. The FAA has so far laid out the groundwork for the implementation of these changes based on the NTSB recommendations. Meetings have been called and rules have been drafted in aid of eventual implementation, however, no definite implementation has been seen as yet. The succeeding steps which have to be taken will be crucial to the safety of EMS flight crews and trauma patients. Therefore prudence and efficiency on the part of the NTSB and the FAA is important at this point in time. Works Cited Air Safety Week (03 November 2008) NTSB Adds EMS Ops to Most Wanted Aviation Safety List. Find Articles. Retrieved 07 November 2009 from http://findarticles.com/p/articles/mi_m0UBT/is_42_22/ai_n30965016/pg_2/?tag=content;col1 Duquette, A. and Dorr, L. (27 April 2009) Fact Sheet. Federal Aviation Administration. Retrieved 07 November 2009 from http://www.faa.gov/news/fact_sheets/news_story.cfm?newsId=6763 Grady, M. (01 September 2009) NTSB Issues New Recommendations for Helicopter EMS Safety. AV Web. Retrieved 07 November 2009 from http://www.avweb.com/avwebflash/news/NTSBIssuesNewRecommendationsForHelicopterEMSSafety_201087-1.html NTSB Most Wanted Transportation Improvements: Improve the Safety of Emergency Medical Services Flights (n.d). Safemedflight.org. Retrieved 07 November 2009 from http://www.safemedflight.org/documents/MostWantedNTSB.pdf NTSB Most Wanted List: Transportation Safety Improvements (2009) National Transportation Safety Board. Retrieved 07 November 2009 from http://www.ntsb.gov/recs/brochures/MostWanted_2009.pdf Wisniewski, M. (17 October 2008) FAA under pressure to improve safety for EMS flights. Suburban Chicago News. Retrieved 07 November 2009 from http://www.suburbanchicagonews.com/beaconnews/news/1226785,2_1_AU17_SAFETY_S1.article Read More