AMSAC Recommended Practice Proposal

EMS Pilot Training Standards

With air ambulances being placed in all metropolitan and populated rural areas throughout United States, the need for qualified flight crewmember staffing is at an unprecedented level. Within this current development is an issue that is of increasing importance to the EMS helicopter air ambulance industry. There now is a shortage of qualified pilots to fulfill staffing requirements. In the near future, current trends indicate there will be a lack of any qualified candidates to fulfill the industry’s needs based on what today’s accepted hiring minimums are. As the first generation of EMS helicopter pilots move into retirement age, it is critical that an educational process be established for future air ambulance pilots. This needs to be in place to ensure a working knowledge of EMS operations is continued to a level that is required to perform the mission. Today, the educational process is gained only through extensive experience conducting the mission and through qualified mentoring by senior helicopter pilots. For the industry’s success in future operations it is essential that this knowledge base developed over the last thirty years by today’s EMS pilots not be lost to a generation of yet to be identified EMS helicopter pilots.

Each EMS operator’s pilot training needs are different and it is recognized the “one size fits all” approach is not an acceptable procedure in the overall training process. It is however necessary to provide a qualified pilot candidate with an education to make his transition into the EMS industry a successful one. This standardized approach to the training needs of the pilot is the critical element for the industry’s success in future pilot development. Regardless of what the minimum pilot hiring criteria is that is established by the industry, the AMSAC believes the EMS educational process begins with a solid foundation of piloting skills, aeronautical knowledge, EMS related aviation knowledge, and historical information that is the basis for the safety culture that is now predominate within the industry.   

As a minimum, the AMSAC has agreed a recommended practice for training all EMS pilots contain a basic curriculum which contains elements of the following example training program:

EMS Specific Pilot Training

Pilot Ground Training-EMS Specific Operations

- Judgment and Decision making

- Risk Assessment and Management

- Human Factors Management

- Preflight and in flight stress management - all phases of flight –

- Workload Management and Delegation

- Cockpit Distractions and Task Saturation

- Situational Awareness

- Air Medical Resource Management (AMRM)

- Inadvertent Instrument Meteorological Conditions Procedures

- Shift change and crew briefing procedures

- Flight requests - types of and response procedures

- Pre-launch and en-route communications, weather checks, & A/C procedures

- High recon, low recon, landing, shutdown, patient loading - procedures

- Wind considerations – en-route and at destination

- Post flight procedures - aircraft and mission requirements

- Crew de-brief procedures

- Flat Light and White Out

Federal Aviation Regulations

- FAR/AIM Application in EMS

  -FAR 61, 91, and 135; AIM; NTSB Part 830

- Airspace

- ATC Procedures

- NTSB and FAA EMS Accident Review

- Part 135 Operations Manual and Content

Meteorology and Weather Analysis

- Principles of frontal systems and thunderstorms.

- Weather information sourcing and interpretation.

Controlled Flight Into Terrain (CFIT) Avoidance

- Altitude management.

- Terrain and weather considerations specific to the base’s geographic area.

Loss of Tail Rotor Effectiveness (LTE) Training

- Accident and occurrence review.

- LTE Chart interpretation versus Critical Wind Azimuth Chart.

- LTE avoidance procedures.

- Aerodynamics

Hazardous Materials – CFR 49

Hazardous Materials – ERG (Emergency Response Guide)

Aircraft Systems: Company Aircraft Specific

- General description.

- Airframe.

- Crew compartment.

- Electrical system.

- Fuel system.

- Power plant.

- Drive train and rotors.

- Flight controls and hydraulic system.

- Operating limitations.

- Emergency and malfunction procedures.

Maintenance - AAIP

- AAIP inspection program (if applicable).

- MEL training and usage (if applicable).

- O² Refill system.

Flight Simulator/Flight Training Device Flight Training (if available)

- Judgment and Decision making

- Workload Management and Delegation

- Cockpit Distractions and Task Saturation

- Situational Awareness

- Flight controls and hydraulic system.

- Operating limitations.

- Emergency and malfunction procedures

- IIMC Procedures

Any company specific modification to the pilot training program is acceptable. However, any major change in format needs to be accepted by the EMS community that jointly has agreed to provide a specific format that will provide for all pilot applicants the EMS training they will receive. The hours needed for each section of the training program would be dependant on the operator’s FAA approved training program.   

The AMSAC believes the training content for each company should remain with the company's training manager and specific to their operations, but the general format for that content should remain standardized throughout all organizations that want to prepare their pilots for EMS operations.

Through the use of this recommend practice, individual pilot training organizations or operators could provide an educational service from which prospective EMS pilots would qualify from and could then be accepted in the EMS industry as having received training specific to the mission. This standardized approach to training will provide a level of EMS knowledge that is not now readily available within the industry. It also equates to  early attitude development of the pilot with a focus on safety paralleled with the requirements of the mission.

It is the intent of the AMSAC this recommended practice will help in reducing the training costs for the operator through standard training practices, increase the number of qualified helicopter pilots available for the EMS industry, and provide for a new level of safety awareness based on the EMS mission.