Helicopter Safety for Field Operations A different approach

1. Helicopter Safety for Field Operations A different approach Russell Wise 770-366-0282 rwise@airmethods.com www.airmethods.com

2. The History of Helicopters

3. The Turbomeca Arriel is a highly-successful series of French turboshaft engines that first ran in 1974.1 Weighing 109 kg (240 lb), the Arriel 1 has a power output of 520 kW (700 hp). As of 2007, nearly 7,000 examples had been produced. Data from:2

4. Helicopter applications

5. Mount Everest

6. HEMS

7. Physics of Flight with Anti Torque Tail Rotor

8. Physics of Flight without Tail Rotor

9. Air Methods Who we are:

10. Air Methods Who we are: • Founded in 1980 • Roy Morgan • First hospital program • St. Mary’s, Grand Junction, Colorado. • Financial • NASDAQ Ticker: AIRM • Employees • 4,000+ • Headquarters - Englewood, Colorado.

11. Fortifying Our Market Presence • 1997 - Mercy Air Service • 2000 - ARCH • 2002 - Rocky Mountain Holdings • 2007 - CJ Systems • 2009 – Omni Flight North Georgia and Atlanta (Rescue Air 1, Life-Net, and Emory Flight) • 2011 – Omni Flight Nation wide

12. History • Began operations in June 1998 as Phoenix AirCare LLC with one helicopter strategically located in Griffin. • Have steadily progressed to locations in Griffin, Gainesville, Newnan, Kennesaw, Conyers Jasper, Augusta and Ft. Benning, Springfield and Vidalia. • Backed by a strong commitment from the largest Aero-medical provider in the world, AirMethods Inc.

13. Air Methods who we are: • Only air medical service provider with a national presence under two service delivery models • HBS • CBS • Offer all key core competencies in-house: • Aviation operations • Aviation completions • Aviation innovations • Billing and collections • Dispatch and communications • Field maintenance • Medical staffing and training

14. Hospital-Based Flight Programs

15. Community-Based Flight Programs

16. Combined Flight Services

17. HEMS First Mission, Trauma The “Golden Hour” concept provides that patients seen by a trauma surgeon in a trauma center within that first hour of injury have higher survivability and a better quality of life.

18. Where we transport patients to • Certified Stroke Centers? • Cardiac Centers? • Interventional Cardiac Centers? • Pediatric Specialty Centers • Burn Centers?

19. Scene Call EMS / Fire Determines The Landing Zone Cardiac Trauma Stroke Medical Emergency Adult and Pediatric

20. ADVANTAGES • Speed(“Time is human tissue”) Death and disability can be avoided if the right care can be provided quickly enough. • AccessMinimize the time out of hospital, point to point capable, avoid traffic delays. • Higher level careThe additional skills and equipment of a tertiary hospital; more advanced drugs, RN and Paramedic critical care capabilities.

21. Crew Capabilities • Maintain a critical care environment throughout transport. • Provide medications and equipment not commonly carried on ground units. • Vaso-active medications • Analgesics • Sedatives/Paralytics (RSI) • Advanced Procedures and Equipment

22. Medical Equipment • Propaq • EKG BP • Pulse Oximetry • ETCO2 • Monitoring of two invasive lines • ICP • Arterial Lines • Swan/Ganz • Cardiac Monitor/Defibrillator • LTV 1200 Transport Vent with adult / pediatric capabilities • C Pap Bi Pap • IVAC Med-system III med pumps. • (six line capable) • R.S.I. & Surgical Airway capable. • PYNG and EZ I.O. device

23. Weather and Visibility

24. Visibility • At 1000 feet on a clear day you can see approximately 200 square miles

25. Federal Aviation Regulations • Part 91 • Part 135 • TFR • Class B Air Space

26. Request • Crew is not given patient type info prior to go decision. • P.I.C. and the crew will either accept or decline the flight based on scene location and weather on the initial call, we would never want anyone to “push the envelope” on weather knowing a child is in need of our help. • Once the flight is accepted then further information follows, such as age, weight or other variables of condition.

27. Activating The System • When requesting air transport the following info should be given to the Comm Center: • Name of calling party, agency, and call back number. • Location of incident. • County, City, Street and Cross-Street and GPS coordinates as available. This is not mandatory information to start the process. • Multiple aircraft inbound to the scene • Ground contact and frequency • Patient information • Age (Adult or Pediatric) • Approximate weight

28. Flight Com and the 911 Center • Same type system • Specialized Team Approach • Aviation Understanding (They are not dispatchers……..only the Pilot In Charge (P.I.C.) can “dispatch” a flight F.A.A. Rules • Com Specs handle the call and route to the closest “station” as you would say or Aircraft Base

29. Weather Restrictions • “Go Flight / Air Alert” based on • 1. Weather minimums at our base • 2. Weather minimums at your scene • 3. Weather minimums at the receiving hospital • 4. Weather minimums between each point Call us ASAP so the pilot on duty can assure that all areas in the flight path are safe to fly!

32. Commitment to Safety • Investments in Safety Technologies • Night Vision Goggles (NVG) • Helicopter Terrain Avoidance Systems (HTAWS) • Garmin GPS • XM Satellite Weather • Satellite Tracking • Reinvestment of revenues into safety

33. Pilots • Our pilots average more than 20 years of flying experience. • All Pilots working on the Air Methods Georgia team have the following: • A minimum of 3000 helicopter flight hours. • Commercial instrument rating. • A minimum of 500 hours night flying. • 1000 hours of turbine time.

34. Alert Status Alert / Standby Request awaiting confirmation Crew prepares for potential flight Air Stand By’s (Over 20 miles/10 minutes) or as requested by calling agency

35. Adult, Pediatric Male, Female If known, current condition Radio communicationGround contact inbound Flight Crew Radio Information Landing Zone Information / HazardsPt. update – if possible Any Other Pertinent Changes

36. Estimated Time En-route Lift off time = 5 minutes day , and 7 minutes at night Distance from Helicopter Location to Incident Scene = X miles X miles divided by 2 = Flight Time in minutes Lift time + Flight time = ETE Ex. (24 miles) (24 / 2) + 7 = 19 min Weather can affect Lift Off Times

37. GPS - Global Positioning System Computer aided Flight Following systems is revolutionary for Air Medical organizations. Dispatch can maintain contact with the flight crew at all times, even on the ground. This reduces errors inherent in voice-based radio communications and enhances safety.

38. ROTOR GEAR • Type: AS 350 B2 • A-STAR • Speed: 120+ Knots (140+ MPH) • Cruise Distance: 300 miles • Capability: One patient • Weight of patient dependant to location of LZ and fuel load.

39. BK 117 • BK117 Cruise - 135 Knots or 155 MPH Range 300 Miles Capable of 2 patients or 1 500 pound patient

40. When you consider using a helicopter, ask yourself…. • Do I have a good landing zone, a designated landing zone coordinator and safety officer? • Do you have adequate crowd control police or fire? • Do we have good communications with the helicopter crew?

41. Helicopter Shopping Why we do it and what is the cost

42. Marking the Landing Zone • Good communications! • Emergency lights are helpful (day and night). • Strobes and/or dimmed headlights at night. • Consider parking Emergency vehicle under any nearby obstructions.

43. Choosing a Landing Zone (LZ) • Try to select an LZ that is adjacent to the scene to avoid the need for ground transport that could prolong a patient’s pre-hospital time. (However, when necessary, a remote LZ is 100% appropriate.) • Select a landing zone that will allow for an angled approach from at least two directions. This approach and departure path should be clear of towers, poles, wires, trees, signs, and other obstructions

44. Hazards in or near the LZ • Wires – Electrical horizontal • Wires – Guy wires vertical • Unlit Towers • Dust • Smoke • Chemical Exposure • Crowd Control

45. Landing Zone • Select a LZ that is as level and firm as possible. • Parking lots, roads, sport fields, and other locations are most desirable, free of debris • The size of the landing zone during the day must be at least 60’ square. The size of the landing zone during the night should be 100’ X 100’. • Keep pedestrians and vehicles away from the landing zone. • The pilot has the final say on the selection of the LZ. And the pilot may divert.

46. LZ Minimums

47. Dark or decreasing light operations LZ 100 ft x 100 ft

48. Night Vision Preservation • Night vision is affected by white light never point lights at the aircraft. • Studies show a 2-3 hour exposure during the day can increase the initial phase of dark adaptation by 10 minutes.

49. The Landing Zone Officer • Designate a landing officer ( Ground Contact ) to communicate with the helicopter crew as soon as the helicopter makes initial contact. • Notify the emergency dispatch center of the frequency you intend to communicate . • Provide the helicopter crew with a description of: • The landing zone. Include the size of the landing zone, how it is marked, a list of any nearby obstructions. • Any other air traffic in the area. • Patient report is actually a disruption to aircraft on approach. • Notify the helicopter crew when you have them in sight. (Arms straight up overhead, with back to wind.) Immediately notify the crew if any last minute hazards are detected or if an unsafe condition develops. (Crossed arms back and forth overhead to alert an abort) • Please use plain language instead of “10 codes.” Affirmative or Negative is the preferred response to a yes or no question.

50. Highway Landing Zones • When selecting the LZ on any Highway, select the site that has the best approach and departure route. • Keep in mind Wires, Bridges, Adjacent Buildings etc. • With a divided highway, use best judgment when deciding to designate LZ on same side vs. opposite direction of travel lanes. • Stopping “ALL” traffic may be the best option when dealing with the distractions of a Air Medical Helicopter landing on your accident scene. “Rubber Neckers” may create a much more hazardous situation than than what you are already dealing with. (Avoiding Secondary Crashes)