Pax Input (Medevac) - Split from ORNGE thread

[skysix]

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[skymedic]

Oh boy,

Where to start with you DOC and CAT!

First, I am a Pilot and Flight Medic, I have been through all the same training as you have, Commercial, Instrument, Multi, blah blah blah.....

When you PIC's can start making proper weather decisions and stop .. running, then I will keep my mouth shut, but as long as you boys and girls continue to keep parking them into the ground, I am going to keep looking at the weather! It is that simple!


Cheers.

[skymedic]

DOC, CatDriver

Some reference material for your lame ass CRM argument. Stop parking them into the ground!

[sky's the limit]

Skymedic,

You are comparing apples and oranges I'm afraid.

The US air medical system, particularly the rotary side of things, is a shambles on a regulatory level which is the culprit of the statistics you provided. Perhaps you should look at Canadian Helicopters, Cougar Helicopters, STARS, and VIH Helicopters here in Canada for accurate comparisons.

stl

[Bede]

I will play Doctor Phil here:

I think skysix does not trust the pilots he flies with because of past experiences. The pilots here do not like the fact that someone doesn't trust them. When I did medevac's I always tried to earn the trust of my medics, but in the end, the decision was mine to go or not.

[sky's the limit]

I have been through all the same training as you have, Commercial, Instrument, Multi, blah blah blah.....

I have a feeling you might be a bit short on the "blah blah blah," and that, is the most important part.

When you PIC's can start making proper weather decisions and stop .. running, then I will keep my mouth shut, but as long as you boys and girls continue to keep parking them into the ground, I am going to keep looking at the weather! It is that simple!

Really?

I have a career spent ".. running" in abject safety into places where you can't get to any other way - you're telling me that flying VFR under the clouds is not acceptable to you? What may I ask is a "proper" weather decision?

"Parking them into the ground?" Really, how many Medivac flights crash each year, how many are flown each year in Canada? How many THOUSANDS of medivacs are done outside the system from the bush each year in total safety? I'm curious how you have come to think that there is one way to skin a cat, and that you seem to know it?

Most of the pilots responding to this thread have considerable flight experience all over the planet, yet you don't seem to trust their opinions because you "have all the same training?" Question is, do you have anything like the experience?

stl

[skysix]

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[skysix]

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[sky's the limit]

I don't think you'll find many in the US HEMS industry who don't acknowledge that RW medical flight in the US is a mess and that Canada and Europe do it better. One of the main reasons is 2 pilots in my opinion - which many here think worthless.

But that difference is also helped by the fact that the US does a lot of NVG and night scene calls, has very low levels of IFR flights (as a % of the RW flights made) and skill/experience. Despite the high number of hours most pilots there have.

The issue with US HEMS is that it is set up as a competitive, cost-plus system that has flexible rules governing the flights depending on whether or not there is a passenger on board. Part 135 with, Part 95 without. There are enormous differences in these flight rules, and that the aircraft are only paid for on "Loaded" legs leads to massive pressure.

NVG is here in Canada to stay, as it should be. It makes life infinitely safer, and you will see it expand here.

Again, little of this has anything to do with the issue at hand here in Canada.

stl

[Cat Driver]

DOC, CatDriver

Some reference material for your lame ass CRM argument. Stop parking them into the ground!

skymedic I have no idea why you are making such a unfounded statement as in the quote from you above.

I have an accident free record after flying for over thirty thousand hours in the past fifty six years.

Also a large part of my flying has been in some of the most challenging types of flying in aviation.

As to lame ass CRM some of the biggest companies on earth did not feel my CRM was lame ass and I am not about to accept that kind of comment from you especially in that you know nothing about how I fly and make decisions.

[skysix]

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[sky's the limit]

The issue with US HEMS is that it is set up as a competitive, cost-plus system

little of this has anything to do with the issue at hand here in Canada.

Not sure I agree - look at all the FW charter operations competing with each other in Manitoba and Northern Ontario.

But I'll grant that (IIRC) AB, YT, NT, NU, NF, NS, PEI and I think NB have pretty much gone the RFP/fixed term sole supplier contract route.

Again, with all due respect, they are very different animals.

The US system often has up to 5 or 6 competing companies/hospitals competing for EACH patient, and they are run on a totally different set of air regs. It's not really open for debate, it's fact.

stl

[AuxBatOn]

skysix: I do not think the medical crew should have any part in the go/no-go decision. As I said, bring up your concerns, sure, just like any passenger could do on an airliner (ie: ice on the wings for example), but in no circumstances the medic should have any input in the decision process itself. He just doesn't have the professional experience to make such a decision. Just like the pilot would not decide whether to put a tube down a patient's throat for breathing or not.

[skysix]

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[skysix]

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[AuxBatOn]

Clarification again. I DO NOT think the med crew have ANY role in the "GO" decision.

But please clarify why they should be prohibited under all circumstances (extreme wording I know but to make the point) from making a NOGO decision? They don't get to make that decision before the pilot does (actually they do but purely on medical grounds and before the pilots are even activated) but only if the pilot has ALREADY MADE A GO DECISION that they (for whatever reason) disagree with.

And there's nothing to say that at that point the entire team cannot come up with another way to get the patient moved. Which the pilot then has to approve or they don't fly!

If you don't want to go, then you can get out of the plane and explain your boss what more than the pilot did you know that prevented you from boarding and going.

[CD]

TP 13537 Right to refuse dangerous work on board aircraft while in operation

[AuxBatOn]

TP 13537 Right to refuse dangerous work on board aircraft while in operation

As long as you can successfully argue that it was dangerous work, you should not have any issue with your boss. Otherwise...

Because you feel it's dangerous doesn't mean it is dangerous.

[Doc]

Because riding in an aircraft is inherently more dangerous than say, staying in bed, I think our friend should find employment in some other field of endeavor.

[CD]

That's the beauty of the Code... You don't have to argue anything -- it is a right.

You know, a number of folks on the forums over the years have been trying to educate pilots regarding their right to refuse dangerous work (one example is the thread AvCanada: Pilots - Stay Safe, Know Your Rights). The Canadian medevac industry is pretty good but there have been accidents over the years highlighting deficiencies that in some areas, likely continue to exist today. There was a working group formed following the Wollaston Lake accident in 1995 to address some of the identified issues but, likely many other initiatives, it wasn't followed through to completion.

So, notwithstanding the professionalism and abilities of those commenting in this thread, we should remain aware not all individuals share these traits. We need only look at some of the other threads in the forum to validate that. I feel that we should keep that in mind when considering the point of view of the other crew members on board the aircraft -- especially if they have perhaps had an encounter or two with some of those "other" individuals whose abilities may not quite be up to par.

[sky's the limit]

So, notwithstanding the professionalism and abilities of those commenting in this thread, we should remain aware not all individuals share these traits. We need only look at some of the other threads in the forum to validate that. I feel that we should keep that in mind when considering the point of view of the other crew members on board the aircraft -- especially if they have perhaps had an encounter or two with some of those "other" individuals whose abilities may not quite be up to par.

Excellent point CD.

Unfortunately, the issue does not lie with Med crews, pax, or FA's having more input into decisions, it lies in the standard to which we train in Canada, both initial and recurrent. It also lies in how companies make money, how pilots make money, and how the Gov't (like Skysix points out) hands out contracts.

These are complex issues we're talking about here, and they go far deeper than just exchanged between front and rear seats.

stl

[skymedic]

I have been through all the same training as you have, Commercial, Instrument, Multi, blah blah blah.....

I have a feeling you might be a bit short on the "blah blah blah," and that, is the most important part.

When you PIC's can start making proper weather decisions and stop .. running, then I will keep my mouth shut, but as long as you boys and girls continue to keep parking them into the ground, I am going to keep looking at the weather! It is that simple!

Really?

I have a career spent ".. running" in abject safety into places where you can't get to any other way - you're telling me that flying VFR under the clouds is not acceptable to you? What may I ask is a "proper" weather decision?

"Parking them into the ground?" Really, how many Medivac flights crash each year, how many are flown each year in Canada? How many THOUSANDS of medivacs are done outside the system from the bush each year in total safety? I'm curious how you have come to think that there is one way to skin a cat, and that you seem to know it?

Most of the pilots responding to this thread have considerable flight experience all over the planet, yet you don't seem to trust their opinions because you "have all the same training?" Question is, do you have anything like the experience?

stl

I never said I didn't trust their training, however, IF and when the major cause of crashes becomes something other than pilot error, I might be persuaded to let you do all the decision making. However, since, I can fly the airplane just as easily as you can, and have no problems flying approaches to minimums, when I think you are pushing the limits, I am going to continue to speak up or just not get in the aircraft to begin with and nobody will be going anywhere regardless if you think the flight can be done safely. Also, please do not think i am saying " YOU" specifically, I am speaking in general terms here, not trying to flame anyone in particular.

Yes, I realize i was not comparing apples to apples, was not my intent to begin with.

The bottom line is some pilots have a real problem with whether or not the medical crew should be allowed to make their own decisions as to whether or not they are comfortable getting in the aircraft....This is absurd as to why you guys even care to begin with? Would you get into an aircraft with a pilot and or conditions you were not comfortable with? Seriously, as long as medical crew can justify their denial of a flight to the mgt, that is all that matters......You guys should be a little more proactive.

And just to clarify before anyone thinks otherwise, I have NO problem telling mgt why I refused a flight as med crew, especially when it is weather related. None of them dare try to tell me otherwise due to my FAA ratings...They know damn well I would be on the phone with the local FSDO the next day....I have the education and experience in both jobs, it might be hard for you to relate, but it is what it is.....

Respectfully,

[Cat Driver]

Also, please do not think i am saying " YOU" specifically, I am speaking in general terms here, not trying to flame anyone in particular.

DOC, CatDriver

Some reference material for your lame ass CRM argument. Stop parking them into the ground!

None of them dare try to tell me otherwise due to my FAA ratings...

Seeing as we are flashing qualificatinns skymedic I also hold FAA ratings....and Australian CASA....and JAR which includes an unrestricted airdisplay authority....and South African CAA ...and of course my Canadian licenses both fixed and rotary wing.

When you get into a dick measuring contest you should check out your competition before you whip it out.

Respectfully:

[sky's the limit]

Skymedic,

Interesting.

I must ask a couple questions though. What are you doing prior to a flight that lets you have the time, energy, and access to all the weather, SOP's, and conversations of the flight crew?

Do you not agree that if a flight is conducted in a legal manner it is safe? It is the flight crew's job to ensure the flight is conducted safely - that is their job, yours is to look after the patient.

You make reference to pilot error. How many patients die due to med error? How many people have lost their entire retirement to financial planner error? My point, is that people make errors, full stop. I fail to see how you as a medic sitting in the back doing your job prior to, or after departure is going to effect this phenomenon. If you do not trust your crews to conduct the flights in said "safe" fashion, then by all means vote with your feet and walk away. As I posted above in response to CD, the area of crew capability is entirely different, and one that is very deep and complex.

You very well may "know both jobs," but you cannot do both jobs at the same time - one will suffer, and as you get paid to medic, that is the one you should be prioritizing imho.


stl

[Minimums]

Just throwing this out there, but if those of whom are afraid to work/fly because they've had bad experiences with rogue pilots, bad decision making, etc, should spend more time hounding thieir management to fork out the doe for more experienced crews, rather than bothering/studying/ quizzing crews on what they learned on a freaking 2 hour deicing coarse or thier "thousands of hours of experience in the back", then maybe the medivac regime wouldn't be at the bottom of the pile like it is today. Until then the medivac business will continue to be at the bottom with low to average pay, and one of the crappiest schedules around. You want professional? You want experience? Quit whining and watching every switch that is flicked and complain cause they didn't tell you what they did, and pester your bosses to fork out the doe and get what you deserve. 90 large a year, 7 days on, 7 off, now you've peaked interest. Not just for someone for a couple years, but maybe a career, which is what most of you 'flight paramedics' likely are as well. Sounds reasonable to me.