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The Life of an EMS Pilot (emergency medical services) By Dan Lassner

I became an EMS pilot last July. This is a short story of what I went through.

I was trained to fly helicopters in the Army at Fort Wolters , Texas (Hillers) and Fort Rucker Alabama in 1971. I learned to fly helicopters in Viet Nam in 1972 (C Troop(AIR)/ 16th Cavalry/Darkhorse11). I learned I didn't care for the peace-time Army at Fort Knox in 1973.

I went home and went back to my civilian job as a computer programmer, but I found office work too dull, and decided to make aviation my career. I continued my association with the Army through various national guard and reserve units, including being activated for Desert Storm(B Co 7th BN 158th Rgt). I made my real living as a Corporate helicopter pilot, while doing some airplane charter and flight instruction on the side. As I was between jobs last summer, I got a call from a couple of friends from my reserve unit and the Missouri National Guard that the company they worked for was hiring, ARCH Air Medical Service. All the jobs I have gotten in 30 years have been due to a friend telling me of an opening.

ARCH is a community based type of operation. That is, they pick an area where they think there is enough of a need to support the operation, build a base, place a helicopter there, provide the pilots, the nurses and the paramedics, and hope they get enough paying customers to pay for it all.

Other types of programs are the government funded & operated programs, such as those operated by the Maryland State Police, Los Angeles City Fire and Rescue, etc. There is also what is called the stand alone program where the hospital owns its own helicopter, and the crews are employees of the hospital. Finally, there is what is called a vendor program, where a contractor provides the helicopter and pilots, and the hospital provides the medical personnel.

So I was hired by ARCH at the end of July as a Single Pilot VFR employee. ARCH's hiring minimums for pilots, which are typical for EMS , are Commercial Instrument (prefer ATP), 2000 Helicopter (prefer 2500), 1500 PIC Helicopter, 500 Turbine, 250 unaided night. ARCH's starting salary has changed since I started, but basically they start at 42K with some increase for years of EMS experience, and time in type.

The average annual pay range for an EMS Pilot may be $40K for a pilot flying a light turbine such as a Bell 206L, $50K for light twins such as the A109 or the BK117, and $60K+ for Pilots flying medium twins like the Bell 412 or Sikorsky S76. The majority of EMS Operations utilize light twin aircraft. We basically operate BK 117s, about 10 of them. We also have a fixed wing side, which operate King Air B100s, but I don't know much about them.

I started my training at the main base in St Louis . The company provided motel, but no food expenses. My first day was spent on company training, Human Resources types of stuff, sexual harassment video (1 Hr) followed by a written test, drug and alcohol program video (1 hr) followed by a written test, and then a urine test. After having lunch with the chief pilot and director of ops, I spent the afternoon studying the Company Policy Manual. I must have passed the urine test because the second day I spent the morning signing the various insurance forms, medical, dental, life, disability, etc. In the afternoon we actually started the aircraft ground school.

This was my third experience with a 135 operator, and was by far the most professional of the three. There were plenty of training aids, one on one instruction, and if there was not a training aid for the point the instructor was covering, we went out to the hangar where there were a couple of aircraft undergoing maintenance that we could look at. Also there was a separate engine shop, where they had an engine on a stand that made it much easier to see the various components.

I was also shown the BK 117 preflight virtually every day of the ground school, with the typical show it to the student, go through it with the student, have the student demonstrate it to you, type of progression. Finally on Friday we took a familiarization flight. There did not appear to be a great expectation of my flying abilities at this point, as I had never flown a BK 117 before, but I am sure they were evaluating the experience level I claimed on my resume. The BK flew a lot like the Hughes 500 series in which I have about 6000 hrs, due to the use of the electric trim chinese hat on the cyclic.

On the other hand I had a bit of trouble with the twin engine operation, as you have to manually match the torques between the two engines as you pickup and takeoff, unlike the only other twin I have flown, the Blackhawk. All in all, I felt pretty comfortable in the machine even after the first flight.

The second week we flew every day with about a half day of ground school and a half day of flying. The ground school covered aircraft systems, emergency procedures, FAR's, Op Specs, etc. The flight training was worked around the slow work time of day, as the aircraft was available for medical flights, with a slight delay. The majority of the training was concentrated on emergency procedures, which we conducted at a nearby grass strip. It also included confined area operations, as well as pinnacle landings on the various nearby hospital rooftop helipads. We also did hood work, unusual attitudes, a few instrument approaches, including a single engine ILS for fun. Although the BK is fully instrument equipped, the lack of an autopilot does not allow us to operate it IFR.

On Tuesday of the third week I took my 135.293 and 299 checkride. The next day I reported to my lead pilot at my base. Arch operates on a schedule of (4/4) 4 days on 4 days off 4 nights on 4 nights off, with twelve hour days starting a 7am. There are many variations of EMS Pilot schedules. 4/4, 6/6, and 7/7 are some of the most typical. An EMS Base with one aircraft would typically be staffed by 1 lead pilot and 3 line pilots.

I then flew the next 3 or 4 "rotations" (4 days/nights) with the lead pilot. I flew the aircraft, with him in the left seat, to become familiar with the area, local hospital helipads, and with the way the company wanted things done. I then flew the following month with all day rotations, again so that I could gain familiarity with the area and hospitals. Finally at the end of the third month I was considered a fully operational pilot.

The various bases I have been at have been fairly comfortable. There are a couple of bedrooms for the crew. There is a living room with a company supplied TV and VCR. Most places the crews have chipped in for a satellite dish. There is a full kitchen. Usually there are two bathrooms, and a separate shower room. The flight planning room has WSI weather computer, and a computer with internet access. There is a laundry room. Sometimes the base is part of a hangar, sometimes it is separate.

Although I am fairly new to EMS , I really enjoy this type of flying. It is not for everyone , however. Our weather minimums , as shown in our OP Spec manual are quite low.

(DAY: Local 500/1, Cross Country 800/2; NIGHT 1000/3) It is the pilots decision about weather; the minimums are the lowest the pilot can accept. However, if he decides that the weather isn't good enough, no matter what is reported, it is his decision. The medical crew also can decide the weather isn't good enough for them fly in either, which means the flight is a no go, since it doesn't do much good to show up at the accident scene with no medical people.

In the time I have been working here I have never had anyone question me about a weather related decision. One of the downsides to this business is that you really don't get a whole lot of flight time. I have been averaging between 20 and 30 hours per month. Of course I have only been getting one fourth of the flight time as there are 3 other pilots, so our aircraft is averaging about 1,000 hours a year.

Our time from the word go to take-off is seven minutes. It is a goal we strive for, but is not set in stone. This is the time the dispatcher adds to our ETA when he quotes a response time to the ground people or hospital. The flight is normally 15 to 20 minutes to the scene, 20 minutes on scene, 20 to 30 minutes to the trauma center, 30 minutes at the trauma center, and 15 to 20 minutes back to base. So the majority of our flights are around 1.0 to 1.5 hours of flight time and 2.5 to 3 hours total. We normally have one to two flights per shift. This leaves some idle time you will have to deal with. I was told EMS stands for "Earn Money Sleeping." This is not completely true, although you can get some napping in. However, it is not likely that you will get a good night’s sleep on the night shift. For this reason, it is important that pilots use their rest time responsibly and report to your shift properly rested. Pre-shift naps are your best tool for avoiding fatigue during night flights.

Since weather decisions are the pilot’s responsibility, even when it is zero/zero outside, dispatch will call you for a weather check. Since you are required to respond very rapidly, sometimes even from a sleep, an EMS Pilot must be able to evaluate weather conditions from a number of resources very rapidly. Making rapid go/no-go weather decisions is a skill that will develop rather quickly. It is a huge help to develop a thorough understanding of the local weather patterns and phenomena. A good rule of thumb is that if you say to yourself, “let’s give it a try”, you probably should not be going. Flying a VFR aircraft into poor weather is a major leading cause of EMS Accidents.

Another characteristic of a good EMS Pilot is to be able to work as a team with crewmembers both on missions and back at base. You literally live with your co-workers for a large part of your life. It is in everyone’s best interest to try and get along. When the balance is upset to the point that it becomes a safety issue, someone will be removed from the situation and it may not even be the one causing the problem.

In closing, EMS flying is not for everyone. If you like variety and making many rapid decisions to a constantly changing flight environment, then you may find it rewarding and it just may be for you.

This article was contributed by Dan Lassner. Dan is an EMS Pilot flying for Arch Air Medical Service.

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