Years ago, the EMS helicopter industry painted themselves into a corner where they were close to being grounded, but not by the FAA, rather by the insurers.

Why? Because they were wrecking a lot of helicopters, and in the process killing a lot of people. In one instance, they picked up a car crash victim whose only injury was a broken leg. Road ambulance was on the way. Help crashed enroute to hospital, killing everyone.

And there were many. For a time, and maybe still, helicopter EMS almost had to have CAVU weather and no wind to operate.

But again, wreck airplanes, and especially kill people and you won’t be in this business long.

MTV

It is a hard call I know. It would be helpful, I think, if the EMTs on the scene could communicate with the 911 operator who is in communication with the victim. They could have told her to have him seal the chest wound. He was shot with his own 22 pistol. The head shot bounced off his skull. It took about thirty minutes for the deputy to get there to secure the scene, but there was no hurry at that point. Protocol can't foresee everything and there is some danger to any job. Perfect safety is to not do the job, to not go. In some states there is a good Samaritan law, which protects the EMT doing the best he can. It doesn't protect him from losing his job, however. Human factors can be positive or negative.

Flight safety is easier. We have lots of checks, and can fly all the way to the crash when things go wrong. When single pilot in a cheap and ugly airplane and alone in uncontrolled areas, there are few human factors to conflict us. IFR is safer but you have to follow the rules strictly. VFR in crowded uncontrolled areas with both aural and visual audience is ripe with human factors and therefore most dangerous.

What Mike said about the EMS crashes was true. Anything requires common sense. Most of the EMS jobs now pick the patent up at the airport or helipad where the ground ambulance brings them. Yes, Mike. Often it would be faster to just go to the hospital with the ground ambulance. Human factors.

Yeah no, so I did fixed wing EMS, we replaced a helicopter as it couldn’t handle the weather and ice, still short range critical transport.

I can not recall one flight that was just a broken leg, the lightest call we got was broken backs falling from tree stands, but the logic was it was a smoother ride going for a <30min plane ride than a 2.7hr ambulance ride on shit roads, also out Pt out of pocket cost was less than many ambulance rides.

Med crew wise, our level of care was high, and I don’t mean compared to a ambulance high, I mean often they were in better hands with us than the local level 3 band aid clinics.

Wx wise, I can’t even count the times the tones dropped at 0200 and we launched IFR with ice and landed IFR, we never even scratched paint

Per police and medical, might as well have the dispatch, who seldom get things right in the first place, try to read a how to fix humans script to a AAA tow driver, EMS is so under appreciated in this nation it isn’t funny, the level of education and experience a good provider has, plus the personal responsibility, compared to LE, it’s not even the same league.

But I do agree, many places are overly cautious with entering a scene, but unlike police they don’t have qualified immunity armor, weapons, and the much LE larger pay and pension, especially rural where a good number of EMS are volunteer, so it’s hard to fault them for being risk adverse.

mtv wrote:[snip]
I worked in Kodiak for eight years, and that was a superb place to learn weather flying and risk tolerance. The “old hands” there would fly in stuff I wasn’t about to at least initially, but they never talked down to you……”maybe wait an hour if you can, it’s improving from the south….” Etc. They weren’t interested in ego games (most of them, anyway), they had a vested interest in MY success. If I crashed, they were the ones who’d have to shut down their operations and come look for me.

So, they paid attention to the new guys, and offered carefully considered counsel. It was a great safety and learning environment.

MTV

This has been my experience with my part 135 sled job. We get advice but not pressure. I have made it to the morning briefing positive that no sane person would be flying (no part 91 flight in the 48 would), but 90 minutes later I'm launching and it is always as advertised. Only one day of my first shift was a complete no fly day. Another day we flew in the morning and around 10am I was in the plane about ready to turn the key when the dispatcher came out and gave the finger across her throat sign. It was a good call. I think my last day there it started out like crap and I expected to spend the day packing to go home. Instead I launched by 10:30 and flew my ass off until it was time to check my bags at the terminal.

There is always a chief/assistant chief pilot on staff watching weather, our satellite tracks, listening to COMs and talking with us all as we pass through the dispatch office. As (I think) MTV said, you can't stay in business wrecking planes and losing lives.

We complete a safety assessment prior to every flight. First flight of your two week shift, first flight of the day, unfamiliar destination, under 250 in type, under 500 in Alaska, ceilings below X, winds above Y, and many more - all have point values associated with them. Above a certain value and you need the chief/assistant chief to sign off. I haven't even been close to that threshold yet.