Air Ambulance Intel

[I fLy pLaNeS]

How is the job market right now in this sector? I've always wanted to do this type of flying, and now that I am furloughed I figure here's a chance to explore it again now that I have more experience. Thanks.

 

[HDA]

I am furloughed as well and was lucky enough to get a postition flying medical flights. It is a great job and the crews I work with are very good at what they do and very cool to boot! I like it alot.

The job market is tight. My company has no openings for fixed wing. You may have to relocate for a job because alot of the fixed wing positions are in smaller communities that dont have adequate trauma centers....thus the need for transport to larger facilities.

Good luck!

 

[avbug]

How's the job market in any sector? See an opening, apply. It's that simple.

Not sure what you mean by "now that I have more experience." Do you mean you tried to do ambulance work before, but couldn't because you lacked the experience? At 1750 hours you're not exactly highly experienced right now, either.

Without knowing your background, it's hard to make any statements or provide any counsel, save for very general comments. Ambulance flying can be broadly divided into administrative transports, and emergency flights. (Which can further be broken down for helicopters to include scene transports, which adds a whole new level of hazard and demand).

Administrative flights can be planned and executed about like any charter or corporate type flight. Unlike an airline operation, however, you're hired to use your judgement and experience in flight planning to decide how to make the flight safely, if it can be made safely, and to arrange all aspects of the flight.

Emergency flights often involve a critical patient with little notice, and you need to be able to make decisions that affect not only the safe outcome of the flight, but the medical decisions made on behalf of the patient. You need to do this with only the safety of the flight in mind, with the ability to disregard any external pressure.

A woman has been run over by her own truck. She slid off the road in a snowstorm. While standing outside her truck, the truck was struck by another vehicle and it went over here, pinning her and inuring her. She has been extricated and has experienced not only physical trauma, but a heart attack. Weather is low at the pickup airport, a rural field with minimal facilities. Weather is low at the destination airport, some 200 miles from the pickup field. Due to road conditions this woman cannot be transported by ambulance; it's up to you. If you don't pick her up, she will die. What do you do?

If any of that paragraph catches your attention aside from the weather at the pick up field and the destination, then you're paying attention to external pressures that can get you killed. None of it is relevant or important when it comes to making the right choice. You should be aware that the wrong choice will possibly kill someone, including you...and the right one might too. You don't have an option of not making a choice....choose one. Either you go, or you don't.

This isn't the kind of decision making that you have been doing at an airline. Nor flight planning. Nor taking care of the aircraft, making fuel decisions, or weather decisions beyond the simple and the mundane. With ambulance flying, it's all on you.

This doesn't mean you can't do it. You need to determine if you can meet the insurance requirements for the operator at hand, for the equipment at hand. I spoke with an operator last year who was looking at 4,000 hours plus for pilots in the King Air 200. He could insure for less, but wouldn't acccept less experience. He had a very low turnover rate, a very professional operation, and a respected one. I've seen others that hire at the bare bones 135 minimums. I worked for one myself, as my first multi engine job.

With your flight experience, you might find a king air job, or you might find a twin piston job, or even a single job in a Pilatus, or something along those lines. Get on Climbto350 and other internet sites and see what's open. Ambulance positions open up with some regularity, but then some operators have a high turnover and some don't. As a good rule of thumb, you're far better off working for an operator that has a low turnover.

Be very cautious about the particular operation. Many operators let their flights be dictated and run not by the pilots but by the medical personnel. The nurses tend to make a lot more money than the pilots, and their opinions tend to carry more weight. In such an operation, when a pilot makes a safety of flight decision and the nurse tries to countermand it, the safest and best choice is to walk away. Always be prepared to do that if the need be...and be prepared for that occasion to arise if you operate in the ambulance business for very long.

 

[340drvr]

.................
.......Be very cautious about the particular operation. Many operators let their flights be dictated and run not by the pilots but by the medical personnel. The nurses tend to make a lot more money than the pilots, and their opinions tend to carry more weight. In such an operation, when a pilot makes a safety of flight decision and the nurse tries to countermand it, the safest and best choice is to walk away. Always be prepared to do that if the need be...and be prepared for that occasion to arise if you operate in the ambulance business for very long.

Well said, avbug.
That "walk away" policy applies not only for air ambulance, but should be standard for all operations, charter, freight, corporate, 91/135/121. Just replace ".......nurses tend to make a lot more money......." with dispatcher/DO/boss/client/CEO as appropriate.

 

[I fLy pLaNeS]

Thank you for the thoughtful responses to my question. I realize this type of flying demands great responsibility; that’s one of the reasons I find it so interesting.

You’re correct, I have 1750 hours, and though it’s not much experience, I want to try. Thanks for the advice on what to look for in companies. That was very nice of you.

 

[007]

A woman has been run over by her own truck. She slid off the road in a snowstorm. While standing outside her truck, the truck was struck by another vehicle and it went over here, pinning her and inuring her. She has been extricated and has experienced not only physical trauma, but a heart attack. Weather is low at the pickup airport, a rural field with minimal facilities. Weather is low at the destination airport, some 200 miles from the pickup field. Due to road conditions this woman cannot be transported by ambulance; it's up to you. If you don't pick her up, she will die. What do you do?

At the outfit I'd like to get on with, they don't even tell you the circumstances of the patient. They only ask if the flight is possible.

 

[EdAtTheAirport]

IFP, there's good air ambulance, and bad air ambulance. The good operations are subsidiaries of hospital, or sole contractors, etc. They have set schedules, fairly good salary, and have built firewalls of some kind to keep the pilots from being pressured to fly. However, even with 5,000 hours at the time, I was a lowtimer there.

Then there's the other air ambulance: on-demand 135 charter stuff that takes the flights the "A" companies turned down. That kind of operation is no different than any other bottom-feeding 135 job. Imagine having your boss yelling at you: "That lady died because you didn't want to fly." (Disregarding the prospective flight into moderate icing, poorly lit, single strip NDB approach airport with a 30kt crosswind -- and btw you noticed the ancient RMI has been a little "sticky" in its needle pointing.) They're not all like that, but you get my drift.

I know of at least one, maybe two, pretty good operators if you're willing to live in the Boonies. If you PM me, I'll give you a Company. I have no idea if they're hiring, though.

 

[HDA]

Omniflight is opening a new base in Idaho. It will be staffed by 4 pilots and the aircraft is a PC-12. They are one of the good places to work. Check out the website.

Good luck!

 

[I fLy pLaNeS]

HDA- Thanks so much.

 

[hiropilot]

All very good info. I just started with an air ambulance company that was only helicopters and has added a king air for long range transports of burn patients. The key for me is the people are great, the schedule is excellent (7 on, 7 off) and as mentioned above, when the trip comes in, no details, just where the trip is to - pilot check the weather and determine if able to go. Chief pilot and DO both are very safety oriented and don't want anyone to go if there is slightest question of able to finish the trip.
Scenario...patient needs to be picked up, has severe burns over most of body and it will be at least two hours from facility to facility in transit. Start the trip and even knowing that weather is questionable for return, we go anyway. On way back, with the patient fighting for his life, weather goes to h**l in a hand basket and we have to land 100 miles away. Now it will be 1/2 hour or so to get ground transport to pick up patient and start towards burn center for another two hours of transport time. Patient dies enroute. I don't know about anyone else, but I don't like to think that I would have to live with that decision for the rest of my life.
Having a life in the balance adds a dynamic that most of us wouldn't ever have to consider for most any other trip we fly.
that's my $0.02 worth.

 

[avbug]

Are you describing a what-if situation, or are you describing what happened? Departing with a question as to whether you can return and then a death occuring on your aircraft as a result isn't a good decision, any more than departing into a condition that places your aircraft and crew in jeopardy.

 

[Prof. ATP]

At the outfit I'd like to get on with, they don't even tell you the circumstances of the patient. They only ask if the flight is possible.

In medical flying, the patient is already dead. When I flew LifeFlight the hospital's standard request was "Check the weather, call us back if it's OK." Never any mention of the patient.

 

[Say Again Over]

Having a life in the balance adds a dynamic that most of us wouldn't ever have to consider for most any other trip we fly.
that's my $0.02 worth.

Yes, it's hard to put that information aside when the patient roles up in an ambulance and your company is stupid enough to put a distraught family member in the right seat with you.

I flew my share of transplant teams and expediting was even worse than normal air ambulance missions.

Many missions require leaving with no idea about actual weather conditions, it's just part of the program when there is no instrument approach at the destination. Maybe not the best paying job in the world but very rewarding.

 

[avbug]

Yes, it's hard to put that information aside when the patient roles up in an ambulance and your company is stupid enough to put a distraught family member in the right seat with you.

It had better not be hard to put the safety of flight first.

I spent a lot of time in ambulances as a firefighter-EMT working on people, as well as flying them from A to B. On occasion I met a volunteer EMT who had emotional issues, once in a while because they knew the victim. I invited them to leave. You're no good if you can't be objective and place the safety of flight, and therefore the needs of the patient, first.

One of the most important things you can say when asked to take an ambulance trip, is NO. Being able to say in the interest of safety, despite any other tales of need and woe, is critical to your longevity and that of the patient.

There are no "hiropilots" in EMS flying. Being a hero will get you killed. It does no good rushing a medical patient to the hospital and killing them on the way.

I flew my share of transplant teams and expediting was even worse than normal air ambulance missions.

I also flew my share of transplants in turboprops and turbojets...and there was never any "expediting." Every flight a normal, routine flight. It can be done quickly, safely, but the pressure on the pilot should be zero. On one occasion, while preparing to fly the approach into Mountain Home, Idaho at night, we determined that the weather had worsened. We had no de-ice, and with hoar frost forming and freezing fog, the airplane would be unsafe when the crew returned from the hospital with a heart. The heart was waiting down there for us, the crew on board. We advised them we were cancelling and went home. Our decision making process did not include the patient, did not include the heart; it included what we knew we could safely do as pilots.

I've done a lot of emergency flying, medical, fire, law enfocement, emergency supplies, etc. I've flown people who were desperate to quickly reach a dying relative to spend the last few minutes. One things I learned long ago is that fast hands kill. If you wouldn't do something on a bright, sunny, calm, clear day with nothin to do but loaf around, then don't do it on an emergency flight.

Do you know that most jurisdictions have laws preventing emergency vehicles such as fire engines and ambulances from exceeding the speed limit by 10 mph...on their way to the scene? True enough...because there have been too many crashes of emergency vehicles on their way to the scene...creating new emergencies, and not only failing to help out at the scene, but causing more casualties, more victims.

We don't need that in an air ambulance situaiton.

If you find yourself saying "I wouldn't normally do this, but this is an emergency," then you should see a big, red flag waving over your head and know that you're in error. If you wouldn't normally do it, then don't do it.

Many missions require leaving with no idea about actual weather conditions, it's just part of the program when there is no instrument approach at the destination. Maybe not the best paying job in the world but very rewarding.

How is this legally justified under Part 135?

You've at least got an area forecast. The destination may not have a terminal forecast...but you've got something to go on, and certainly must have something to meet your 135 requirements.

I always found I had enough time on the way to the airplane to file and brief, including establishing an alternate, while the medical crew arrived and boarded...to do it right. I knew others who subscribed to the panic mentality..."It's an emergency. Just go!" Very, very wrong.

When I flew LifeFlight the hospital's standard request was "Check the weather, call us back if it's OK." Never any mention of the patient.

This is how it should be.

 

[Say Again Over]

while the medical crew arrived and boarded...to do it right. I knew others who subscribed to the panic mentality..."It's an emergency. Just go!" Very, very wrong

I have a hard time believing you were cool and collected about anything considering how defensive you are on your self imposed pedestal that you make for yourself.

Maybe I didn't live in your perfect world, in my 135 experience, rules were broken, the key to safety in my opinion is not necessarily following all the rules and regulations, but knowing your own limitations. With 10+ years experience in 135, I have yet to see an operator that doesn't occasionally break the rules.

My experience includes neonates, transplant teams and normal transport stuff, predominantly in New Mexico, Colorado and Arizona. Many airports have no instrument approaches, and with MEA's from 10,000 to 16,000 feet, most reports were useless, were there ways to do it legally, yes.

As far as the speed limit on an emergency vehicle, thanks for filling me in, on my last transplant, a heart for a senator, the police car was doing 90MPH all the way to the airport, the town was Tupelo, MS if you'd like to report them.

Sorry, I didn't live in your perfect world and think you may be just a bit naive for thinking there is one, I am a long way from ambulance operations now and still haven't found it.

 

[avbug]

My experience includes neonates, transplant teams and normal transport stuff, predominantly in New Mexico, Colorado and Arizona. Many airports have no instrument approaches, and with MEA's from 10,000 to 16,000 feet, most reports were useless, were there ways to do it legally, yes.

I operated ambulance in the same area and always found a way to do it legally, in compliance with the regulation. It's a shame you were unable.

Sorry, I didn't live in your perfect world and think you may be just a bit naive for thinking there is one, I am a long way from ambulance operations now and still haven't found it.

Perhaps. In my many years of aerial firefighting emergency operations, law enforcment surveillance and emergency operations, and air ambulance/air evac emergency operations, etc...I suppose I never found the need to panic and break rules like you did. Chances are I did it a lot longer and a lot more than you, over a substantially wider area of operations...but perhaps given a few more years of experience I'll learn to place imagined needs above the safe and legal operation of the aircraft, too.

But I doubt it.

Maybe I didn't live in your perfect world, in my 135 experience, rules were broken, the key to safety in my opinion is not necessarily following all the rules and regulations, but knowing your own limitations. With 10+ years experience in 135, I have yet to see an operator that doesn't occasionally break the rules.

You advocate violation of the regulation. Interesting.

I found that operating by the premise that while one may be safe but not legal, and legal but not safe...operating legally and safely all the time offered the best protection to the customer, employer, and to me.

You can justify your illegal operation any way you like. It's wrong, of course. Justification is the narcotic of the soul. You, apparently, are an addict.

A professional, on the other hand, knows when to say no...if it's unsafe or illegal, that's the time. You apparently never figured that out. Pity.

 

[Say Again Over]

professional

Panic? How do you assume that I've panicked, I don't ever recall panicking in my experience as a pilot, maybe you can refresh my memory. As I said, in my experiences in 135 operations, there were no operators that I worked for the complied fully with regulations. I really don't think you have a clue what a real professional is, I have had a very successful career and can receive recommendations from all still in business.

You can justify your illegal operation any way you like. It's wrong, of course. Justification is the narcotic of the soul. You, apparently, are an addict

Please state the name of the air ambulance companies you worked for, chances are that I am familiar with them, I was in that area from 81 to 96, I would be curious to know what companies in that area were complying fully with regs.

 

[avbug]

Based on what you've said, you wouldn't know them. Compliance seems somewhat outside your realm of experience, and your personal preference.

 

[EdAtTheAirport]

I operated ambulance in the same area and always found a way to do it legally, in compliance with the regulation. It's a shame you were unable.

Yeah I'm curious which operator you worked for also, with the level of sanctimony you're displaying. I know that turf pretty well too. Perhaps you didn't have the same challenges that the rest of us had.

 

[avbug]

I'm not going to cite the employers here; other than to state they're no longer in business.

Even in uncontrolled operations in Class G under Part 135, operating rules and regulations apply...even on dirt airstrips on the reservation, they still apply.

If you find compliance with the regulation to be sanctimony, you've got a serious problem.