US Helicopter Air Ambulance Operations overvie...PHI Air Medical Group presence throughout the US....
21
UNITED STATES HELICOPTER AIR AMBULANCE OPERATIONS OVERVIEW Kurt Williams [email protected]Tim Wickersham [email protected]Copyright 2016 PHI Air Medical LLC 1
• Introduction • Helicopter Air Ambulance Operations / FAA Part 135 • Operations Specifications • Aircraft and Crew Safety • US Air Ambulance Fleet • Mission Types • Program Types • Types of Flight Profiles • Conclusion / Q&A
Copyright 2016 PHI Air Medical LLC 2
KURT WILLIAMS Area Operations Manager, PHI Air Medical LLC • President, National EMS Pilots Association
• EMS Line / Lead Pilot – 8 years • Corporate Helicopter Pilot – 2 years • Military Helicopter pilot – 22 years
Tim Wickersham Business Development Manager - LifePort • Sales / Business Development- 7 Years
• US Army MEDEVAC Officer / Pilot- 8 Years
Copyright 2016 PHI Air Medical LLC 3
Presenter
Presentation Notes
Brief Intro of Kurt and Tim. Overview of industry experience.
PHI Air Medical Locations
** Does not show Saudi Arabia – up to 5 bases in service.
Copyright 2016 PHI Air Medical LLC 4
Presenter
Presentation Notes
PHI Air Medical Group presence throughout the US. Both fixed wing and rotor wing assets. Single Engine and twin engine fleet. 77 Bases including Saudi Arabia. Up to 5 bases in service in Saudi, currently 3.
PHI Incorporated
• Parent company to PHI Air Medical LLC
• Operations experience in the following International Locations: • Angola, Antarctica, Argentina, Bahamas, Belize, Brazil, Bolivia, Cameroon, Canada, People’s
Republic of China, Colombia, Democratic Republic of Congo, Costa Rica, Dominican Republic, Ecuador, Egypt, French Guyana, Guyana, Honduras, Republic of Ireland, Jamaica, Kazakhstan, Kenya, Mexico, Papua New Guinea, Nicaragua, Panama, Peru, Philippines, Portugal, Puerto Rico, Russia, Saudi Arabia, Senegal, Sinai, Somalia, South Africa, Sudan, Surinam, Taiwan, Trinidad, Uzbekistan, Venezuela and Vietnam.
Copyright 2016 PHI Air Medical LLC 5
Presenter
Presentation Notes
PHI Incorporated is the parent company of PHI Air Medical. They are well versed in international operations around the world. Primarily utilized in the offshore oil and gas industry. PHI Air Medical still receives technical support in both maintenance and training from PHI Incorporated increasing our efficiency in operation.
FAA has direct oversight of all Helicopter Air Ambulance Operations (HAA) Part 135 Operating Requirements: Commuter and on demand operations and rules covering persons on board such aircraft
Copyright 2016 PHI Air Medical LLC 6
Presenter
Presentation Notes
The Federal Aviation Administration oversees/regulates all air medical operations. Helicopter Air Ambulance was formerly known as Helicopter EMS (HEMS) They publish the regulations and conduct regular surveillance to ensure compliance.
Operations Specifications (OPSPECS) • Detailed plan on how the company will meet the requirements of the FARs • Operators utilize General Operations Manual (GOM) for day to day operations
at the use level.
Copyright 2016 PHI Air Medical LLC 7
Presenter
Presentation Notes
Operation Specifications address each requirement set forth by the FAA. This is a detailed plan of how the company complies with each regulation in all areas, aircraft equipment, training qualifications, maintenance etc. This is a very large detailed document. The General Operations Manual is utilized for day to day operations. It is smaller and more direct in its approach to conduct of Helicopter Air Ambulance Operations.
HELICOPTER AIR AMBULANCE SAFETY
Crew Resource Management Risk Assessment/Analysis Training
Safety of the aircraft, crew and patient is our most important goal. We increase safety in many ways. Crew resource management, equipment requirements (autopilot/htaws/NVG) weather requirements etc. The standardization of aircraft and equipment across the fleet. Aircraft certification- all major systems part of aircraft type certificate, or installed with supplemental type certification (STC). Subsystem certification- certified by STC. This includes stretcher systems, oxygen and advanced life support systems, patient lighting, supplemental electrical power. These STC’s require that equipment developers design systems that are meet all aircraft requirements, ensure aircraft egress requirements are met, and also minimize crew human factors issues. A proper design and certification program will ensure all aircraft and operator requirements are met, and that optimal in-flight patient care can be performed. Carry on medical equipment, such as medical monitors, create confusion in the certification of aircraft interiors. Medical equipment is typically updated every three to five years, and does not attach to common equipment mounts due to the large number of equipment types available, and specific operator requirements. The trend for certification is via “one time field approval” for specific monitor mounts. The FAA allows use of these field approvals because of the cost to update an aircraft STC to incorporate a new piece of medical equipment. The trend in the United States is for medical interiors to provide several “Utility Mount” locations that provide a maximum object weight and center of gravity, and then allow operators to install mounts that are designed for their specific requirements.
Helicopter Air Ambulance Fleet 1,045 Helicopters 400,000 Transports per year 150,000 Fixed wing transports
Copyright 2016 PHI Air Medical LLC 9
Presenter
Presentation Notes
Statistics from Association of Air Medical www.aims.org Total US fleet is about 1045 helicopters, this number changes quickly with the addition or deletion of programs from some operators that expand an contract rapidly.
Inter-Facility – Hospital to Hospital = 54% of transports
Copyright 2016 PHI Air Medical LLC 10
Presenter
Presentation Notes
These transports generally involve transport from smaller lower level of care hospitals to bigger higher level of care facilities. Higher level of specialty care for very sick patients.
Scene Flights – Accidents – Trauma =33% of transports Increased Risk Higher level of training required Universal communication systems Increased Safety requirements
Copyright 2016 PHI Air Medical LLC 11
Presenter
Presentation Notes
Scene flights are generally accidents, trauma, sometimes cardiac of stroke patients. The helicopter goes to the scene or near the scene to pick up the patient. These are also sometimes rendezvous with ground ambulances. Increased risk, higher level of training for crews (ground and air). Universal communication system from air to ground required.
Organ Transplant – 13% of Flights
Copyright 2016 PHI Air Medical LLC 12
Presenter
Presentation Notes
These can be both fixed wing or helicopter. Rapid transport. Same safety requirements as other air ambulance operations.
PROGRAM TYPES
• Hospital Based – Funded/operated by the hospital
• Community Based – Independently operated outside hospital systems
• Hybrid – Combination of the two above
• Contract – Various terms and conditions with a customer/vendor relationship
Copyright 2016 PHI Air Medical LLC 13
Presenter
Presentation Notes
Hospital based : Owned and operated by the hospital. They maintain all part 135 requirements and fund the program. Community based: An operator sets up a program in a community with no hospital affiliation. The operator funds and acquires all certfications. Hybrid: A combination of the 2. More shared risk between the operator/vendor and the hospital. Vendor provides aviation experience and sometimes the aircraft. Hospital provides clinical expertise Contract: Utilizing a proven helicopter vendor every part of the process can be contracted and provided. Aircraft/equipment/billing etc. It’s all spelled out contractually on who provides what.
Visual Flight Rules - VFR
Copyright 2016 PHI Air Medical LLC 14
Presenter
Presentation Notes
Day or night time. Visual flight rules are followed. Ceiling and visibility as directed by the FAA.
Copyright 2016 PHI Air Medical LLC 15
Night Unaided - VFR
Presenter
Presentation Notes
Night unaided. Most US companies are moving away from Night unaided. Some still conduct it.
Copyright 2016 PHI Air Medical LLC 16
Night Aided – Night Vision Goggles - NVG
Presenter
Presentation Notes
NVGS – Safety multiplier for the industry. Is now the norm in US operations. 2 sets required per aircraft. Regulated by the FAA. Training program in place for pilots and crews.
Copyright 2016 PHI Air Medical LLC 17
Instrument Flight Rules - IFR
Presenter
Presentation Notes
Increases the ability to fly in marginal weather. Requires special training and equipment for pilots. Twin engine aircraft. Single or dual pilot crews.
Single Pilot Operations Light Ships/Medium Single Engine/Twin VFR/Single Pilot IFR
Copyright 2016 PHI Air Medical LLC 18
Presenter
Presentation Notes
Most US operators conduct single pilot operations. Light ships (407/206/350) it’s nearly a requirement due to weight limitiations. Conduct both VFR and IFR operations single pilot.
Dual Pilot Operations Medium or Heavy Twin Engine IFR
Copyright 2016 PHI Air Medical LLC 19
Presenter
Presentation Notes
Dual pilot operations in bigger aircraft. IFR capable. S76/EC145 etc. Used in both scene and inter facility type flights.
Crew Composition: Never less than 2. Up to 4 not including pilots.
Copyright 2016 PHI Air Medical LLC 20
Presenter
Presentation Notes
Crews sometimes dictated by states. Never less than 2. can be up to 4 or more for specialty teams. Generally nurse/paramedic. Sometimes paramedic/paramedic or nurse/nurse. Some programs fly MDs as trauma doctors or nurse practioners and respiratory specialists. Depends upon the type of flight.
CONCLUSION/Q&A
Copyright 2016 PHI Air Medical LLC 21
Presenter
Presentation Notes
This has been a broad overview of the US Helicopter Air Ambulance operations. Any questions?