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Do Smaller Aircraft Meet The Needs Of Our Patients?


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#21 NaCl

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Posted 14 August 2007 - 03:32 AM

Our program in Southern California has always used Twin Engine Aircraft such as the Bell 412, Bell 222 (B and U models) as well as the MD902's and even a BK at one stage. The counties that we serve in SoCal, insist that the aircraft that are used for the transport of patients ,are twin Engine. The bases that are located in the coastal areas need to be IFR twin engine aircraft to service calls further in the interior as well as out to sea where IFR approaches are utilised.
Many large corporations are looking at replacing many of the twin engine aircraft accross the country with the smaller Single engine AStars or similar. Hopefully though, the local regulations will ensure that we continue to fly larger more spacious airframes in the future. Looking forward to the new Bell 429's.



At least in your area, this seems to validate a common assumption that--sans a regulatory mandate for the more costly helos--economics alone rule ship selection.
I wonder if a private program exists that is able to balance profitability with a voluntary utilization of the better ships mentioned in this thread.


Great posts everyone.
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#22 NaCl

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Posted 14 August 2007 - 03:59 AM

Im from Sam. Air Evac and got to see the BK -> Astar as well as the EC135. I think that the days of large ships are going away. Its all about profit now as they are all in it for profit.

I am not picking on PHi/Sam. Air Evac, they have been nothing but good to me. However, these changes always start somewhere. Many feel that other companies which came into the valley are the ones who dropped the standard. I tend to agree. They brought in crappy aircraft with extremely low operating costs in comparison to the BK or BO. In AZ, anyone can drop an aircraft next to anyone else, effectively splitting the calls instantly. Its impossible to compete with aircraft which are 3-4X as expensive.


That was the same explanation I heard when the shift from Sam. AE to PHI came; bringing about the little A-Stars and Bell 206s. Companies like Native Air and LifeNet all seemed to converge on Arizona at the same time, effectively saturating the market and forever changing things.

However, do you know what has brought about the current trend in AZ for the better ships? I heard AE was running an (or some) EC-135 now, Native now has a Koala and had/has a 135, and LifeNet was flying a 222 out of Sierra Vista in the winters. That may be a promising trend???

I cannot understand EMS in Arizona. Ground ambulance restrictions via a "legislated monopoly" through the CON program were deemed improper and not in the public's interest by a state audit years ago; but thanks to the deep pockets and political connections of those at the controlling ambulance companies, the monopolies persist. On the opposite spectrum, the AZ HEMS system (if one could call it that) is nothing short of a textbook free market economy where anyone with enough capital can just plop down another service, like you mentioned, right next to a competitor. I can see how it des not make good business sense to have operating expenses higher than your competitor, especially when you have just split market share.
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#23 Guest_Guest_wyomed_*_*

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Posted 14 August 2007 - 04:36 PM

Nobody, but nobody understands Hems in AZ. It just makes no sense. I keep waiting for some legislation that would regulate the air ambulances, but none seems to be coming down the pike. If youre flying at a base that does more than about 45-50 flights per month, you can expect a competitor to land next door. Sad and wrong in my opinion. The thing is, it's sound financially or it wouldn't keep happening.

As for a private being able to compete in this market utilizing larger aircraft, there are persistant rumors about just such a thing, becoming more prevalent lately. I would love to see somebody stroll in here with nice twins and a good business plan, and see what would happen. Tri-state has upped the ante a bit (in my opinion) with the Koala's, but as of today, they really only compete with Native in Havasu. It's a single, but at least has adequate room to treat the pt... full body access in most of the configurations I've seen.

I suppose it's really a pointless debate. As long as the companies are allowed to utilize smaller, cheaper to operate aircraft, they will. As long as they give us A-Stars, we'll figure out a way to take care of the patients in them.

Good thread, good posts... thanks all.
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#24 JLP

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Posted 14 August 2007 - 06:38 PM

Up here in Ontario, you can't fly HEMS in a single engine chopper, the Ministry of Health specifies two engines and two pilots, both for safety reasons. The S-76 is exclusively used right now- but then, we're not in a competitive system (regulated monopoly), so price-per-call competition is not a factor.
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#25 Guest_Marc D_*

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Posted 19 August 2007 - 02:44 PM

Single vs Twin. Lots of agendas and lots of propaganda. Maybe on both sides of the issue. Here's a tip......follow the money.

I fly a twin. A well equipped, modern twin. I like it. It provides me with many effective tools and options that are designed to help me deal with various unforeseen situations that may arise during the course of a flight. It's not just an extra engine, it's an extra hydraulic system, fuel system, electrical system, fire suppression, autopilot, etc. Redundancy.

I won't enter the statistics/accident rate debate. (because it's too easy to skew) Suffice it to say that if I believed a single was safer, I'd be flying one tomorrow. I've got plenty of time in singles. Actually, I could make that change without even leaving my current employer. (In fact, I may have to change industry sectors (or at least employers) to stay in a twin if this current HEMS trend continues)

Does it not challenge common sense to claim that redundancy is undesirable or dangerous? It defies logic. Redundancy is a basic concept used in mechanical things to improve reliability. Machines break. Redundancy gives you a plan B. Pretty simple.

Twins do pose their own challenges and are not the "be-all, end-all" in and of themselves. Their systems tend to be more complex and they require an appropriate level of experience and "real" recurrent pilot training to proficiency. Do not try to run an IFR twin on a VFR single training budget. It will not end well.

I'm certainly not going to claim that a modern single engine turbine helicopter is unsafe or not capable. We typically don't hear that. Instead, what we do tend to hear is that a single is "just as good" as a twin, or something to that effect. The idea that a twin's redundancy only provides an "illusion" of safety is not something that I would agree with. A well maintained modern IFR twin with a proficient crew is a pretty good place to be.

The least expensive option is not always the best choice. It is, however, always the cheapest.


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#26 Guest_Marc Durocher_*

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Posted 19 August 2007 - 03:03 PM

Single vs Twin. Lots of agendas and lots of propaganda. Maybe on both sides of the issue. Here's a tip......follow the money.

I fly a twin. A well equipped, modern twin. I like it. It provides me with many effective tools and options that are designed to help me deal with various unforeseen situations that may arise during the course of a flight. It's not just an extra engine, it's an extra hydraulic system, fuel system, electrical system, fire suppression, autopilot, etc. Redundancy.

I won't enter the statistics/accident rate debate. (because it's too easy to skew) Suffice it to say that if I believed a single was safer, I'd be flying one tomorrow. I've got plenty of time in singles. Actually, I could make that change without even leaving my current employer. (In fact, I may have to change industry sectors (or at least employers) to stay in a twin if this current HEMS trend continues)

Does it not challenge common sense to claim that redundancy is undesirable or dangerous? It defies logic. Redundancy is a basic concept used in mechanical things to improve reliability. Machines break. Redundancy gives you a plan B. Pretty simple.

Twins do pose their own challenges and are not the "be-all, end-all" in and of themselves. Their systems tend to be more complex and they require an appropriate level of experience and "real" recurrent pilot training to proficiency. Do not try to run an IFR twin on a VFR single training budget. It will not end well.

I'm certainly not going to claim that a modern single engine turbine helicopter is unsafe or not capable. We typically don't hear that. Instead, what we do tend to hear is that a single is "just as good" as a twin, or something to that effect. The idea that a twin's redundancy only provides an "illusion" of safety is not something that I would agree with. A well maintained modern IFR twin with a proficient crew is a pretty good place to be.

The least expensive option is not always the best choice. It is, however, always the cheapest.

\

I agree 100%.

I fly a very well maintained vfr(ifr equipped), single, goggle equipped Astar B3 in the mountains and I fly it like a vfr single in the mountains. Maintain higher altitudes and over safe landing areas except for brief periods and STRICTLY vfr. None of this, "I can see one light 12 miles off to my nine oclock so I'm vfr" business. I have made flying a vfr single as safe as I can and I am comfortable with where I am at. Great flight crews and no pressures to fly. Great department safety culture. No pressures from headquarters either. We know what we've got, and we work within the limits. My wife and I considered leaving this area last year and you better believe that a modern well maintained IFR twin is what I narrowed my search down to. I looked at single programs and then shifted my looking toward modern twins. Of course maintainance is key. I would take any well maintained reputable single over an old poorly maintained piece of junk twin any day.

Marc D.
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#27 Guest_Marc Durocher_*

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Posted 19 August 2007 - 03:09 PM

Up here in Ontario, you can't fly HEMS in a single engine chopper, the Ministry of Health specifies two engines and two pilots, both for safety reasons. The S-76 is exclusively used right now- but then, we're not in a competitive system (regulated monopoly), so price-per-call competition is not a factor.


I don't know why I am not logging in on the forums. I am logged in on the main page, but it drops me when I come to the forum?

Anyway, I think that even though it doesn't look like it right now, I expect the U.S. to follow this pattern within the next 10 years or so. Just my opinion.

Marc D.
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#28 justapilot

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Posted 03 September 2007 - 06:36 AM

Nice post!

I love to see pilot input on these threads.

I would love hear what you think about the old twins vs the new ones. It is my understanding that old twins (like the BK) were not able to manage well on a single engine and thats what skewed the safety stats suggesting they were not any safer as singles. Now, however, the EC 135 can manage on a single engine. Is this correct?

I apologize for "semi-ignoring" your question. It's just that I see it leading me into that single/twin statistical debate that I've already declined.

Short and sweet: It's a rare civilian twin, old or new, that can hover OGE on one engine. Even more rare to do it at altitude in the heat with a load. (Do not trust the information provided by the manufacturer's marketing team. Ask someone that actually operates it on revenue flights)

If a particular model cannot do this in the real world (and most can't), it is vulnerable to a forced landing during portions of takeoff and landing maneuvers. Those of us that operate twins accept this and limit our exposure as much as possible within these areas. Above a certain airspeed (it varies) the twin is capable of safe climbout and flight on a single engine and can safely land in that configuration. Every checkride that I take includes a single engine hand flown ILS to minimums as well as an engine failure on takeoff.

Old vs new is not what skews safety stats. People with agendas do.

That's all I got to say 'bout that!
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#29 Beauregard

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Posted 16 May 2009 - 12:38 PM

For my brothers and sisters in the smaller aircraft (A STARS, 206, 407) when it comes to new employees, how do they obtain their training flights? With the weight and space requirements, it's tough having them ride as a 3rd person. And with safety issues, is it acceptable to have them become a 2nd crew member on day 1? Any thoughts????
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#30 Flightmedic317

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Posted 16 May 2009 - 09:08 PM

For my brothers and sisters in the smaller aircraft (A STARS, 206, 407) when it comes to new employees, how do they obtain their training flights? With the weight and space requirements, it's tough having them ride as a 3rd person. And with safety issues, is it acceptable to have them become a 2nd crew member on day 1? Any thoughts????


Very good question... For someone who is new to a program I would not suggest them to become the 2nd instead of the 3rd. It is possible with the higher end Astars like the super B3 to have a 3rd on board and round trip it anywhere. Its been done before. I think experience should be obtained with new flight crew members by watching first and gaining knowledge of the area and then work your way in the back. The aircraft I have has a seperate cabin. New crew members ride up front in the beginning and then work their way back and trade places with another crew memeber. It works out well. Good luck!
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Justin, NREMT-P, CCEMT-P, EMS I/C
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