How IFR proficiency can improve HEMS safety

Helicopter dashboard
Instrument helicopter anyone?

There is a huge difference between being legal to file and fly IFR and being proficient, comfortable and safe to do so. Mike Biasatti explains more

2008 was the deadliest year on record for US HEMS operations with eight fatal accidents and 29 fatalities

In 2009, I wrote a paper entitled Rule #1: go home at the end of your shift. The previous year, 2008, was the deadliest year on record for US HEMS operations with eight fatal accidents and 29 fatalities, so the article’s intent was to start a discussion among air medical crews on what we could learn from these tragedies in order that we never have another year like that again.

There have been a lot of changes in the air medical industry since that fateful year: standardisation across the industry, new equipment requirements and several new helicopter air ambulance (HAA) specific FARs (Federal Aviation Regulations) geared toward improving safety, including FAR 135.603, which goes into effect on 24 April 2017. FAR 135.603 establishes that ‘no certificate holder may, nor may any person serve as the pilot-in-command of an HAA operation unless that person holds a helicopter instrument rating’. In reality, most HAA operators in the US already require an instrument rating as a condition of employment; however, this impending regulation sets a benchmark for current and future air medical pilots as a minimum rating requirement for entry. What FAR 135.603 doesn’t do is speak to the topic of instrument currency or proficiency of operating a helicopter in the IFR (instrument flight rules) system. It is a start though.

“A superior pilot uses his superior judgment to avoid situations which require the use of his superior skill.”

– Frank Borman

When I began pursuing my first helicopter pilot’s certificate back in 1989, the idea of an instrument rating was nowhere on my to do list. I assumed the road to a successful career in the commercial helicopter world involved a commercial certificate with a rotorcraft rating, and, as a civilian pilot, a CFI (certificated flight instructor) rating. I can remember as if it were yesterday gazing across the ramp at the Oakland International Airport, standing next to an Enstrom F28A (for my private pilot training) and then later next to an R22 (commercial and CFI training) and looking longingly at a Bell 206 that was used by the local news stations. Inside that beautiful airframe was a LORAN (long range navigation) that, compared to the wet compass I navigated by, looked to be the coolest thing I’d ever seen on a helicopter radio panel. I thought to myself that the Bell 206 equipped with the LORAN represented the absolute pinnacle of the commercial helicopter pilot’s career path and upon reaching that peak, I would have arrived professionally.

A few years later, it became apparent that an instrument helicopter rating was no longer a luxury, but an absolute necessity to career advancement. The Robinson Helicopter Company had produced an instrument helicopter package (not certified for flight in IMC, instrument meteorological conditions) that allowed flight training under the hood to simulate flying the aircraft with sole reference to the instruments. Even during this training I expected that I would never see the inside of a cloud while operating a helicopter and never did I think that I would one day be piloting both a twin-engine and a single-engine HAA under IMC.

Helicopter dashboard

Fast forward many years and the air medical programme I worked for operated three Bell 412s SPIFR (single-pilot IFR) and a Bell 206L3 SPIFR as a back-up aircraft. Yes, you read correctly, we flew a single-engine helicopter under IMC. Now, the fuel range on the Bell 206 wasn’t substantial, so it wasn’t useful for longer-range flight requests, but it allowed for safe acceptance of flights that might not otherwise be accepted because of our ability to enter the IFR system, complete instrument approaches at hospitals as well as airports and, perhaps more importantly, it gave us the freedom to resist the temptation to push forward into deteriorating conditions safely, versus descending into unknown circumstances as ceilings lowered and visibility reduced.

It may surprise many to know that it is still possible to certify a single-engine helicopter for flight into IMC – it’s possible but far from practical, with cost and weight providing significant obstacles. CFR Part 27 lists the certification requirements for helicopters in instrument flight, although it relies heavily on Advisory Circular (AC) 27-1. AC27-1 is a policy paper of over 1,000 pages that while like all ACs isn’t regulatory, is however generally accepted as the benchmark requirement edict for manufacturers looking to engineer or augment a new or existing rotorcraft airframe for IFR certification. In 1999, AC27-1 was revised and then revised again in 2001, each time making the standard for a helicopter to receive IFR certification much more difficult to meet. Interestingly, while the FAA was making it more difficult for helicopters, it was making it easier for single-engine airplanes to receive certification, recognising that ‘most aircraft accidents are caused by something other that equipment failures’.

Would flying an IFR-certified helicopter, whether a single-engine or a twin, reduce the number of helicopter encounters with IIMC (inadvertent instrument meteorological conditions), thereby leading to a reduced number of CFIT (controlled flight into terrain) accidents? Would the industry embrace the ongoing training requirements to keep pilots proficient? When the time came to make the decision to punch in and commit to putting their aircraft in IMC, would enough pilots make that decision, or would there be a significant number who would continue to try and duck under (scud run) in the hopes of improving conditions, only to fall victim to spatial disorientation and loss of aircraft control?

NTSB 2011 figures show that 45 of the 52 IIMC accidents occurring that year were fatal … that is 86 per cent, giving you a 14-per-cent survivability rate if you go IIMC!1

Of course, there’s no way to know the answer for certain, but when I talk with visiting pilots, many express disbelief that our programme not only routinely flies under IFR, not as a last resort to get out of trouble or sneak back into town, but rather for a good part of the year, files and flies from departure to destination planned IFR. Many of these pilots convey that they have no interest in qualifying and then utilising their instrument rating for anything other than recovery.

They welcome the opportunity to fly an instrument-equipped helicopter under VFR, but the pilots I spoke to rejected the idea of intentionally entering IMCs in the furtherance of HAA operations, citing a lack of real-world experience, comfort level and confidence.

“The pilot’s failure to maintain terrain clearance as a result of fog conditions. A contributing factor was inadequate weather and dispatch information relayed to the pilot.”


“The inadvertent encounter with inclement weather, including snow, freezing rain, and reduced visibility conditions, which led to the pilot’s spatial disorientation and loss of aircraft control.”


“The pilot’s improper decision to continue visual flight into night instrument meteorological conditions, which resulted in controlled flight into terrain.” – NTSB

There is a huge difference between being legal to file and fly IFR and being proficient, comfortable and safe to do so

There is a huge difference between being legal to file and fly IFR and being proficient, comfortable and safe to do so. It is a very perishable skill and one that requires frequent practice and training, particularly in a single-pilot configuration. Would an increase in the number of air medical helicopters certified for instrument flight reduce these accident numbers? If a more affordable single-engine IFR helicopter were available, would the HAA pilot population welcome this opportunity if given the initial and equally important, ongoing training?

At one time, a large majority of air medical helicopter pilots came from the military ranks and had the opportunity to acquire flight in actual instrument conditions, even though their IFR experience was in a dual-pilot configuration in larger, multi-engine helicopters. They had the opportunity to develop proficiency and comfort with operating in the instrument environment and then bring those skills to the civilian air medical industry. The civilian pilot world, however, doesn’t possess many of these opportunities for pilots. As the industry grew, more and more VFR bases opened, and civilian-trained pilots began to fill the ranks established with the expansion of the industry. Civilian-trained pilots with instrument ratings have likely completed the bare minimum training to achieve that rating and in all likelihood never once acquired any flight time in actual instrument conditions. Would the industry embrace the idea of training a predominantly VFR pilot community to IFR currency and then commit the resources to bringing a more expensive IFR helicopter online, as well as provide the pilots an opportunity to maintain their newly acquired proficiency?

From 2001 to 2013, the International Helicopter Safety Team reported that there were 194 accidents worldwide involving single-engine helicopters, IIMC or CFIT and low-level flight to avoid weather (fifty-seven occurred in the US). Of the worldwide total, 133 were fatal accidents that killed 326 people. None of the accident helicopters were IFR-equipped.2

Perhaps a more practical idea, and one that will be more feasible in implementation, is what industry giants Air Methods and Air Evac Lifeteam are incorporating into their light single-engine turbine helicopters: a two-axis autopilot. The autopilots being installed allow pilots to select a specific altitude and heading, freeing up the pilot’s hands: the aircraft will maintain level flight, and a specific heading, while allowing the pilot to assess the situation, contact air traffic control and formulate a plan. By reducing pilot workload, particularly during the heightened stress of an IIMC encounter, he or she is able to allow the autopilot to aviate and navigate in the selected flight profile, freeing the pilot to communicate, enlisting the assistance of air traffic control, the onboard crew and his/her dispatch centre. Even in VFR conditions, the ability to set the autopilot reduces pilot fatigue and requires very little in the way of training.

Today’s HAA crews operate in challenging environments, often to unimproved areas at all hours of the day and night with only minutes to prepare. Using good, sound judgement to avoid VFR flight into IMC is crucial. Complementary to that judgement are the enhancements to cockpit instrumentation, advanced navigation, night vision imaging systems, and terrain avoidance warning systems, and now an autopilot adds another in a growing line of safety related technologies that give the air medical pilot, whether in a single-engine, multi-engine, IFR or VFR helicopter, an incredible collection of resources to assist as they and their crew strive to continue to provide exceptional care in the air and, above else, to always follow Rule #1.