Eileen Frazer: Eileen Frazer is the executive director of the Commission on Accreditation of Medical Transport Systems (CAMTS) — an organization dedicated to improving the safety of both air- and ground-based medical transportation, which she both founded and has led for the past 25 years.
In the mid-1980s, Frazer was an emergency room nurse and chaired the safety committee of what is now the Association of Air Medical Services. The committee drafted criteria for peer review safety audits to address a growing number of air ambulance accidents. But Frazer and the committee felt the audits should be performed by an independent organization. So in 1988 and 1989, Frazer did a feasibility study, modelling her proposed organization on the Joint Commission on Accreditation of Health-Care Organizations, which accredits hospitals.
Today, there are 184 CAMTS-accredited air ambulance programs in six countries around the world. CAMTS completes, on average, 75 new or reaccreditation applications every year and processes approximately 100 progress reports as operations correct deficiencies found during audits.
In keeping with CAMT’s values of imposing standards to improve patient care and safety of transport, the 11th Edition of the CAMTS Standards will encourage all helicopters to have a Crash Resistant Fuel System (CRFS) that meet the crashworthiness requirements of 14 Code of Federal Regulations 27.952 or 29.952.
As an industry dedicated to continuously improving the level of safety for those that we transport, it is essential that we begin the process of incorporating the highest level of safety technology in the aircraft we operate. Incorporation of Crash Resistant Fuel Systems (CRFS) is a significant financial investment of a relatively simple technology that may have a profound impact on the patients we transport. Because of the significant financial impact of this requirement, it is strongly encouraged that any future helicopter introduced into service, whether purchased, leased or contracted, by a CAMTS program or vendor have a crashworthy fuel system meeting the requirements of 14 Code of Federal Regulations 27.952 or 29.952. As manufacturers make retrofit kits available, we should also begin the process of financial planning to retrofit existing helicopters.
In recent years, there have been incidents of thermal fatalities due to post-crash fires in survivable accidents. In 1970, the U.S. Army required CRFS on all newly manufactured helicopters and began an extensive retrofit of all existing helicopters. The International Helicopter Safety Team’s Year 2000 report recommended “The use of helicopters with a CRFS should be encouraged and a requirement on contracted efforts.” More recently, the National Transportation Safety Board recommended the FAA “Require, for all newly manufactured rotorcraft regardless of the design’s original certification date, that the fuel systems meet the crashworthiness requirements of 14 Code of Federal Regulations 27.952 or 29.952, “Fuel System Crash Resistance.”.
This proposed future revision of the CAMTS Standards was unanimously approved by the CAMTS Aviation & Safety Advisory Committee, comprised of industry safety experts including non-CAMTS Board members, and was approved by the CAMTS Board of Directors.
We are in the Holiday Season and you can feel it every time you leave home – more traffic- longer waiting lines and more stress. This only adds more risk to our profession this time of year. Medical transport crews are already over worked, fatigued and under time-related pressure to do the best for their patients and their families.
There have been 2 fatal helicopter crashes within the past 10 days. This is distressing but unfortunately not surprising. In 2009, there was a crash on Christmas Day. In 2010, there were 4 crashes in December. In 2011, there were 2 December crashes and in 2012 there were 3 December crashes – one on Christmas Eve.
Remember your overall responsibility is to get back home safe to your loved ones. Do not make this a Holiday to remember with regret and sadness. If you see something – say something. If you are uncomfortable – speak up. Get proper rest and be aware of signs of stress and fatigue in yourself and your teammates. Let’s end 2015 without any further tragedy.
The latest draft of 10 Edition Standards revisions including Types of Care were posted in January and we are now receiving many comments asking: “Why are paramedics not included in the Specialty Care Type”. Most of the comments have been very professional and we greatly appreciate the feedback. There seems to be some confusion, however, as we are getting angry comments from paramedics stating: Paramedics will lose their jobs; CAMTS prefers hospital sponsored programs; CAMTS prefers RNs over paramedics, etc. NONE OF THESE RUMORS ARE TRUE. The Types of Care are just our attempt to more accurately describe the care provided – not a way to limit or delete what is currently being done. The Emergency Critical Care and Intensive Care Types specifically include paramedics on their teams who are doing Critical Care that may include things like IABP and indwelling LVAD transports.
We realize we will need to define Specialty Care in more detail because CAMTS was envisioning this Type of Care addressing those specialty care teams such as Neonatal/Peds teams that only transport the sickest patients from one hospital to a higher level of care (i.e.: PICU or Neonatal Unit) using medications and treatments that are not typically found in an adult team RN or a paramedic’s scope of care or specialty care teams transporting adult patients receiving very highly specialized therapies that are outside routine care even provided in the typical ICU setting. Most programs either refer these patients to a specialty team or have their own team that only does this type of transport. We expect very few programs to fall within this level of accreditation. It also does not mean that a service accredited at one level cannot provide care at a higher level.
All in all, these are drafts. We will share all these comments and suggestions with the full CAMTS Board. There will be one more draft after the April 2015 Board meeting before final approval at the July Board meeting. We encourage you to read the Types of Care draft on the camts.org website instead of the misinterpreted hearsay that seem to be widely circulated over the past 10 days.
The 10th Edition Accreditation Standards – DRAFT #5 – have been posted on thewww.camts.orgwebsite as of December 1, 2014.
Types of Care
Medical Escort revisions
There is a comment document for your suggestions, additions or changes. Please reference the standard by section and number if you would like to provide feedback no later than March 1, 2015.
We will review all comments and responses at the April Board meeting and prepare the last draft that will then be posted for an opportunity to comment before they are finalized and approved by the Board of Directors in July 2015.
A near miss with a drone – Geisinger Life Flight – one of the CAMTS accredited services in Pennsylvania as described by the pilot.
Last evening while on route to Zerby for Hershey to refuel a drone was encountered – the details are as follows:
At 1635 SkyTrac had us at 40 40.58 076 22.22 which is located in Schuylkill County, Foster Township 2.06 Miles Southeast of J.Zerbe Airport. Our altitude at this time was 2398 MSL (on a descent from 4000msl) heading 030 degrees at 121knots. I had just made my second CTAF call to Zerby when the crew member in the copilot seat yelled watch out. At the same moment I witnessed an object approaching the aircraft at a very high rate of speed. The drone was at our altitude and 1230 -0100 clock position approximately 2-4 rotor discs away, I banked to the right to avoid collision. The collision avoidance system did not pick the object up.
In the event this happens to you, an Air Traffic Mandatory Occurrence Report must be submitted, just call pilot brief and they will take the details.
Safety Directors are getting regular reports on close calls.
It appears drones are here to stay so be careful!
Many other events are being reported:
An NYPD helicopter 800 feet in the air had a near-miss with a drone as the cops searched for a missing teenage boy in Brooklyn. According to the NY POST “The hovering gizmos have become increasingly popular in New York skies.” http://tinyurl.com/q7n9uj8
The Fiscal Times reports: “Pilots around the United States have reported a surge in near-collisions and other dangerous encounters with small drones in the past six months at a time when the Federal Aviation Administration is gradually opening the nation’s skies to remotely controlled aircraft, according to FAA records.
Since June 1, commercial airlines, private pilots and air-traffic controllers have alerted the FAA 25 episodes in which small drones came within a few seconds or a few feet of crashing into much larger aircraft, records show. Many close calls occurred during takeoffs and landings at the nation’s busiest airports, presenting a new threat to aviation safety after decades of steady improvement in air travel.” http://tinyurl.com/obg6yqz
Pilots across the United States have reported a surge in near-collisions and other dangerous encounters with small drones in the past six months – some of which came within mere feet of hitting drones in flight, according to newly released data from the FAA.
The data reveals nearly 200 incident reports between February and November of this year, including several near misses with commercial airliners. The FAA says it receives approx. 25 reports per month from pilots who have seen drones or model aircraft flying near their aircraft. While most of the reports suggest the incidents were not threatening enough to force pilots to take evasive action, one alarming report out of Cleveland, Ohio, describes a helicopter having to bank to avoid a quadcopter 50 feet away. Another medical helicopter was “almost struck” by a drone while taking off from a Las Vegas hospital.
The FAA is expected to issue regulations related to the operation of small drones by the end of the year, and FAA Administrator Michael Huerta says his agency is working to regulate drones throughout the country to ensure the safety of all aircraft – a staged integration to possibly allow commercial use of unmanned aircraft, starting with lower-risk uses and then moving on to other applications.
The FAA can fine drone operators for flying unmanned vehicles in a reckless or careless manner, according to a recent ruling by the National Transportation Safety Board (NTSB), representing a turnaround from an administrative law judge’s earlier decision that had represented an embarrassing setback for the aviation agency’s drone regulation efforts.
The Commission on Accreditation of Medical Transport Systems (CAMTS) has re-established an Aviation & Safety Advisory Committee (A&SAC) to provide recommendation to the CAMTS Board of Directors that will increase the level of safety for air transport of patients using a CAMTS accredited organization. To ensure a broad level of professional aviation safety experience, the committee includes industry representatives that are not members of the CAMTS Board of Directors. The current focus of the A&SAC is to review and propose changes to the accreditation standards. The committee plans to review the standards annually and develop strategic chnges that will raise the level of safety for the industry. Additional tasks of the A&SAC include:
Address site visit findings by the Quality Management Committee to track and trend aviation and operational issues identified during a site visit.
Refine the aviation track syllabus for site surveyor initial and recurrent training.
Review and update the maintenance checklist for use during site visits.
Develop or endorse third-parties’ (e.g. IHST) safety promotion material that can be shared via the CAMTS website or presented at industry conventions/seminars, e.g. AMTC, AIRMED etc.
Monitor aviation safety trends and summarize for the Board, at least annually, accident causes and industry best practices.
Address Safety Culture Surveys tracking and trending – protected information that should/could go through a third party.
Monitor, analyze, and when applicable address, aviation regulatory actions, standards or activities that may impact CAMTS standards. When applicable present such changes to the Board and/or train site surveyors on such changes.
Serve as advisors, via email or telephonically, to CAMTS Board members who may have an aviation related question.
The A&SAC is currently comprised of the following members:
Charter members and CAMTS Board Directors
Fred Brisbois – Chairman, CAMTS Ad-Hoc Member (retired Sikorsky, U.S. Army & IHST)