A review of risk analysis and helicopter air ambulance accidents.

The Federal Aviation Administration announced a final rule in February 2014 that includes a requirement for helicopter air ambulance operators to institute preflight risk analysis programs. This qualitative study examined risk factors that were described in 22 preliminary, factual, and probable cause helicopter air ambulance accident and incident reports that were initiated by the National Transportation Safety Board between January 1, 2011, and December 31, 2013. Insights into the effectiveness of existing preflight risk analysis strategies were gained by comparing these risk factors with the preflight risk analysis guidance that is published by the Federal Aviation Administration in the Flight Standards Information Management System. When appropriate, a deeper understanding of the human factors that may have contributed to occurrences was gained through methodologies that are described in the Human Factors Analysis and Classification System. The results of this study suggest that there are some vulnerabilities in existing preflight risk analysis guidelines that may affect safety in the helicopter air ambulance industry. The likelihood that human factors contributed to most of the helicopter air ambulance accidents and incidents that occurred during the study period was also evidenced. The results of this study suggest that effective risk analysis programs should provide pilots with both preflight and in-flight resources.

An investigation of pilot fatigue in helicopter emergency medical services.

Pilot error has caused the majority of helicopter emergency medical services (HEMS) accidents in the United States for almost 2 decades. Pilot fatigue may have contributed to some of these accidents. This nonexperimental quantitative study investigated the relationships between fatigue reported by on-duty HEMS pilots (the criterion variable) and consecutive HEMS pilot day shifts, consecutive HEMS pilot night shifts, age, and experience as an HEMS pilot (the predictor variables). Surveys completed by 395 on-duty HEMS pilots in the US were examined to quantify respondent fatigue with the Brief Fatigue Inventory (BFI). This study found some evidence of a statistically significant positive relationship between HEMS pilot night shift respondent BFI scores and experience as an HEMS pilot, while controlling for consecutive HEMS pilot night shifts and age. A 1-way analysis of variance suggested that the effect of experience as an HEMS pilot on HEMS pilot night shift respondent BFI scores was statistically significant. Multivariate regression analysis suggested that experience as an HEMS pilot predicted HEMS pilot night shift respondent BFI scores. Additional quantitative research is recommended to confirm the results of this study and to investigate relationships between fatigue experienced by HEMS pilots and other variables that were not considered in this investigation. Qualitative research to identify and document fatigue management strategies that are used by experience HEMS pilots is also recommended.