The conscientious helicopter pilot is almost always engaged in active accommodation of at least two completely separate sets of safety challenges. The first, of course, is the actual accomplishment of physical safety. The licensing and qualification mechanisms conventionally observed in U.S. helicopter operations ensure that legitimately experienced pilots are expected to be technically competent to safely command assigned aircraft within intended aviation settings. But an additional set of safety considerations exists as a function of the way helicopters are actually used in accomplishing real missions, very often placing them, and their pilots, in situations which can best be described as existing outside the parameters of aviation itself, and often directly involving human participation not formally standardized by the system.
Most helicopter activities, certainly to include EMS operations, involve active participation by human talent not governed by the above mentioned aviation standardization conventions. Whether participants are ground assistance crews, or on-board medical professionals, these individuals have to be convinced from the outset that what they’re doing is safe, and it falls on pilots, who may or may not have been trained to provide the kind of leadership required, to accomplish the convincing.
I remember a particular phase of preflight training at Navy Pensacola which had us—the humble flight students—located in a cold, windowless Naval Aerospace Medical Institute classroom, submitting to a long series of psychoanalytical written exams. It was intended that we would be made physically uncomfortable in order to maximize stress levels during rapid-fire forced answering of literally hundreds of oddball questions, most of which seemed to us to be totally unrelated to aviation. Being ambitious flight candidates, though, we were convinced that certain very critical questions were randomly buried in the many pages of queries, waiting to identify and disqualify those not worthy of aspiring to aviation leadership. We identified one particular question as highly suspect, and it went something like: “Would you, if you had to choose, prefer to vomit on a crowded bus, or smash your thumb with a hammer?” Though we could not have explained why, we were absolutely certain that answering this question correctly, as judged from the Navy perspective, was essential to our continuing success, and it turns out that we were right, but for reasons more meaningful than we could have ever suspected.
Civilian EMS helicopter programs usually employ professional nurses and medics as regular helicopter crews, but are not necessarily required to train these “air crew” personnel to certified FAA standards. The result is that these crews are often only partially trained with regard to aviation disciplines, and it is a well-proven axiom that partial knowledge can sometimes be less than completely useful. I once experienced a night bird strike over mountainous terrain, detected as a light thump, seemingly to the lower nose section of my AStar. I was able to determine right away that we had no obvious structural damage and that flight controls were functioning normally, and I carefully confirmed no oil temperature rise, concluding that our oil cooler radiators had not been fouled by bird debris. Our flight nurse, however, probably having been told somewhere in her limited training that precautionary landings were the central cornerstone of safety, was not convinced that all was well, and began enthusiastically suggesting that we land immediately. So I had to add calming and educating the crew to my response checklist, which already included further flight testing, improvising navigation to a safe location for a correctly prioritized PEL, communicating circumstances and intentions to my dispatch authority, and ensuring that program service responsibilities were minimally compromised. Having experienced scores of bird strikes over the years, I knew that this one was not a real safety problem, so I found myself describing to the crew that more airmen had historically come to harm overreacting to prematurely declared emergencies than by responding calmly, and that we certainly would not be well served at that point by rushing to a landing in unsuitable terrain. We ended up flying several minutes to a lighted airport, and I was able to show the crew a bird smudge on the underside of the nose of our aircraft, ultimately returning everyone to satisfactory happiness.
This scenario depicts the multi-level safety responsibility which must routinely be accommodated by most helicopter pilots, flying typical missions outside the military. Real safety absolutely must be delivered, but safe operations, as perceived by all participants throughout associated environments, must also be reassured. The Navy, it turns out, did not want thumb smashers. They wanted pilots who would take care of themselves regardless of perceptions by others, always bringing their aircraft home safely. But in the civilian sector we go a step further, making sure that the pilot is not alone in returning home safe and happy.