“Lyn, when making a decision to accept a flight, I want you to place no more value on the patient than you would a sack of crap.” My response, “Huh? Wait . . . what? Can you say that again?”
When my director of ops said this in the late ‘90s, I thought it was a bit harsh. He went on to say that he wanted me to give zero consideration to the condition of the patient at any point in my decision-making before or during the flight. He only wanted me to consider the things that may prohibit me from safely getting to the scene, the hospital, and back to base—things like weather minimums, aircraft performance, personal or crew limitations, and scene security. In other words, declining a patient flight will not get my crew killed, but ignoring weather and performance minimums will. His point about focusing on the right things when making decisions was well taken.
WHERE WE FAIL
Ever been flying along and something doesn’t feel right? Is the weather getting worse or fuel lower than expected? Maybe the landing zone looks a little sketchy? At that moment, you reevaluate and make a single decision: continue on the current path or take an alternate course of action.
I believe it’s at that single decision point where we fail most often. Just last month, the U.S. Helicopter Safety Team had this headline: “USHST Perceives a Deadly Trend-Helicopter Industry Headed for Highest Fatal Accidents in More Than a Decade.” They went on to point out several key actions that will save lives, three of which were: (1) Know How Much Fuel You Need or “May” Need; (2) Stop the Scud Running; and (3)Visual Flight Rules in Instrument Conditions Can Lead to Death. Yes, death.
I believe that in most of these situations, there’s an awareness by the pilot prior to going beyond the point of no return. But for whatever reason—whether fear, ego, or desire to complete the flight—when that single decision point comes, we don’t change course and break the accident chain.
USE THE EN ROUTE DECISION POINT (EDP) TO FORCE A DECISION
According to an article written by Randy Mains in 2012, the EDP is used to establish airspeed and altitude limitations for cruise flight. If at any time during a flight a limit is reached, do one of three things: (1) Turn around, (2) Land, or (3) Transition to IFR. But, DO NOT CONTINUE!
For example, NEMSPA recommends that if you select 30 knots less than cruise speed, or a minimum altitude 300 feet above ground level in daylight or 500 feet above ground level at night, or upon descending to the minimum en route cruising altitude that you’ve chosen, there is no question you’ve reached that EDP and you must choose one of the three decision options previously mentioned.
It’s my personal opinion that we need to spend more time training specifically in the area of aeronautical decision-making so that when the “big decision moment” comes, we make the correct decision and everyone goes home safely at the end of their shift.
En Route Decision Point Article: http://www.justhelicopters.com/ArticlesNews/CommunityArticles/tabid/433/Article/67533/My-2-Cents-Worth-Enroute-Decision-Point.aspx
NEMSPA No Pressure Initiative: http://www.nemspa.org/PubDocs/NEMSPA_NoPressureInitiative.pdf