Lesson From LifeFlight

Posted Aug. 27, 2009, at 6:16 p.m.

Medical helicopters have saved thousands of lives by quickly getting injured or sick people to distant hospitals. But they have also killed patients and, more often, crew members. According to a recent Washington Post analysis, working as part of medical helicopter crew is one of the most deadly jobs in America. There is a bright spot, the paper wrote — LifeFlight of Maine, which has not had an accident in more than a decade of service.

The Post recently reported that medical helicopter crashes have killed 211 crew members and 27 patients since 1980. The death rate among crew members — 113 deaths per 100,000 employees — is higher than logging, mining or police work.

Half the crashes have happened in the last decade and 2008 was the deadliest year of all, with 23 crew members and five patients killed.

Worse, the causes of the crashes — poor weather and bad visibility — have remained the same for decades. Many of the doomed flights were the result of helicopter shopping — hospitals calling companies until they found one that would make the flight, often despite bad weather.

Worse yet, federal regulators have done little to improve the situation. The National Transportation Safety Board, which investigates crashes, has recommended improvements for decades. The Federal Aviation Administration, which regulates air traffic, has so far refused to require any.

That must change.

LifeFlight, which operates just two helicopters — in Bangor and Lewiston — offers a system the FAA should consider a model. First, it is nonprofit run by Eastern Maine Medical Center and Central Maine Medical Center, freeing it from financial pressures. Second, it has invested in high-tech flight equipment and an on-the-ground network of weather stations to improve safety. Its helicopters are equipped with instrument flight technology, navigation and weather radar and satellite tracking, equipment that operators in other states say is too expensive. Night-vision technology was recently purchased. A recent bond issue paid for upgrades to weather monitoring systems around the state.

As a result, the service’s two helicopters have transported more than 9,000 patients since 1998 without an accident.

After two medical helicopters collided in Arizona last year, killing five crew and two patients, the FAA hurriedly arranged a meeting to talk with industry officials. The regulators asked them to “refocus” on safety, according to the Post.

Despite the rise in accidents, the FAA has issued only a few small fines and has not suspended or revoked any licenses.

Now, it appears the agency may finally be getting serious. It is currently working on rules requiring safety equipment such as terrain awareness and warning systems and night-vision goggles for pilots, changes the NTSB has long recommended and that LifeFlight of Maine already uses.

If the FAA rules fall short, Congress may have to step in. Earlier this year, Sen. Olympia Snowe introduced a bill that would allow states to set requirements for both medical and aircraft equipment for these services. Currently, states can only regulate the medical equipment. Some states are likely to adopt low standards so consistent federal rules would be preferable.

Medical helicopters provide a valuable service. Making them safer — for patients and crew — simply makes sense.

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