This document outlines procedures and recommendations for Yukon EMS helicopter operations. It reviews current practices and identifies risks. Key recommendations include developing standards for training, equipment, and decision-making processes around helicopter responses. A new decision matrix and forms are proposed to help assess safety factors like weather, landing zones, and weight capacities before helicopter missions. The goal is to ensure a risk mitigation strategy that allows YEMS to safely meet patient needs across the territory.

1. Yukon EMS
Helicopter Operations
Procedures
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2. Yukon EMS
Project Overview
Background
• Whitehorse Medevac program
• Community remote response current state
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3. Yukon EMS
Objectives
• Review current practices,
policies/procedures, guidelines
• Review current training program
(medevac/community)
• Review current equipment listing
• Identify industry best practice principles
• Present specific deliverables
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4. Yukon EMS
Deliverables
• Recommendations for best practice principles to
ensure a risk mitigation strategy that meets the
service mandate of YEMS.
• Recommendations for revised policies,
procedures, guidelines, process flow
• Recommendations for training for rotor wing
operations
• Recommendations for minimum equipment listings
for rotor wing operations
• Recommendations for a comprehensive program
that integrates with all emergency services to meet
the YEMS mandate of service delivery
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5. Yukon EMS
Guiding Principles
• When in Doubt … Drive!
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6. Yukon EMS
Guiding Principles
• When in Doubt … Drive!
• YEMS is NOT a rescue organization
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7. Yukon EMS
Guiding Principles
• When in Doubt … Drive!
• YEMS is NOT a rescue organization
• YEMS is a basic life support provider
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8. Yukon EMS
Guiding Principles
• When in Doubt … Drive!
• YEMS is NOT a rescue organization
• YEMS is a basic life support provider
• A helicopter response is NOT a Medevac
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9. Yukon EMS
Risk Framework
• Risk Management Theory
• Risks and Hazards
• Justified Risks
• Procedures vs. Training
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10. Yukon EMS
What Are The Risks?
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• February 8, 2008 2150 hours…
– Ontario Air Ambulance Flight Operations
Centre notified of a multi-system trauma
patient in Temagami, Ontario. BLS on scene
requests medevac to Level 1 Trauma Facility
– Within 15 minutes 7798 departs Sudbury for a
28 minute flight to Snake Lake helipad,
weather at the time clear skies, operating
under VFR to an established helipad.

11. Yukon EMS
What Are The Risks?
• At 2228 hours – 7798 advises Flight
Operations Centre that they are on final for
Snake Lake helipad and are in sight of the
land ambulance
• At 2231 hours – Ontario Air Ambulance
Flight Operations Centre receives an
emergency notification from the land
ambulance that 7798 has crashed on
approach to the helipad.
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12. Yukon EMS
What Are The Risks?
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13. Yukon EMS
YEMS Training Problems
• The BIG Training Problem
• Realities of Remote Response
• Training required for Helicopter Responder
• Pro QA or not Pro QA
• Pilot and YEMS Personnel Interaction
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14. Yukon EMS
Situational Awareness
“Situational Awareness involves being aware
of what is happening around you to
understand how information, events, and
your own actions will impact your goals and
objectives. Lacking SA or having
inadequate SA has been identified as one of
the primary factors in accidents”
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15. Yukon EMS
EMS Personnel on
Helicopters without a patient
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16. Yukon EMS
Risk reducing EMS Interaction
with Flight Crew
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17. Yukon EMS
Helicopter Specific PPE
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18. Yukon EMS
Hover Exits and Entries
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19. Yukon EMS
Insertion vs. Recovery
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20. Yukon EMS
Transportation of Remote Low
Acuity patients
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21. Yukon EMS
Scene Safety Evaluation in
Remote Operations
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22. Yukon EMS
Verifying Helicopter Safety
Margins
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23. Yukon EMS
Weather
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24. Yukon EMS
Weight and Centre of Gravity
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25. Yukon EMS
Night
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26. Yukon EMS
Transport of Other Agencies
Personnel
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27. Yukon EMS
Single Practitioner Missions
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28. Yukon EMS
One Way Missions
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29. Yukon EMS
Communications in Remote
Locations
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30. Yukon EMS
The ERCO is the Risk
Manager
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31. Yukon EMS
Current Decision Flow
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32. Yukon EMS
Proposed Decision Flow
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33. Yukon EMS
Project Risk Assumptions/Constraints
No. Risk Description Effect Probability Planned Mitigation
1
There are insufficient funds
allocated for training crews to
meet the HOP requirements
Critical High Delay until funding available
2
There are insufficient funds
allocated for equipment to
meet the HOP requirements
Critical Moderate
Implement HOP to the
maximum extent possible
with the equipment available
3
There are insufficient funds
allocated for implementing the
HOP
Critical Low Delay until funding available
4
The HOP is not approved by
YEMS management
Critical Moderate None
5
The HOP is not accepted and/or
integrated by current crews
Critical Moderate
Develop a more robust
training program
6
The training level required by
the HOP is not sustained
Critical Low
Develop a more robust
training program
7
Continuous improvement is not
used to develop and refine the
HOP
Marginal Low
Assign continuous
improvement of HOP to one
or more YEMS staff
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34. Yukon EMS
Beta Testing and Continuous
Improvement
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35. Yukon EMS
Recommendations for
Improvement
• Standing Offer Agreements
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36. Yukon EMS
Recommendations for
Improvement
• Standing Offer Agreements
• Training
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37. Yukon EMS
Recommendations for
Improvement
• Standing Offer Agreements
• Training
• Equipment
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38. Yukon EMS
Implementation Strategy
• Review and Beta Testing
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39. Yukon EMS
Implementation Strategy
• Review and Beta Testing
• Staff Assignment
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40. Yukon EMS
Implementation Strategy
• Review and Beta Testing
• Staff Assignment
• Release and Roll-Out
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41. Yukon EMS
The New Decision Matrix
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42. Yukon EMS
How to Use the Decision Matrix
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43. Yukon EMS
How to Use the Decision Matrix
• Safe Landing Zone
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44. Yukon EMS
How to Use the Decision Matrix
• Safe Landing Zone
• Practicable
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45. Yukon EMS
How to Use the Decision Matrix
• Safe Landing Zone
• Practicable
• Patient Severity/Condition/Potential to
Deterriorate
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46. Yukon EMS
How to Use the Decision Matrix
• Safe Landing Zone
• Practicable
• Patient Severity/Condition/Potential to
Deterriorate
• Closest crew vs. most appropriate crew
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47. Yukon EMS
Flight Preparation Form
Helicopter Registration: Type and Model
Pilot in Command: YEMS Crew:
YEMS Call Number: ERCO:
Description Calculation Result
A YEMS Maximum Gross Weight AFM Max Gross x .9 Lbs.
B Crew, patient and all YEMS gear actual
weight (do NOT estimate, use a scale) Lbs.
C Gross Weight at Takeoff from origin Lbs.
D Anticipated patient weight Lbs.
E Gross Weight at takeoff from scene Lbs.
F Hover in Ground Effect at origin Gross Weight per AFM Lbs.
G Hover in Ground Effect at scene Gross Weight per AFM Lbs.
H Worst weather forecast during flight
(MVFR is less than 3000’ and 5sm)
Circle yes or no.
Ceiling = __________
Visibility = _________
MVFR:
YES NO
PiIot in Command Signature: YEMS ERCO or Crew Signature
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48. Yukon EMS
Risk Assessment Tool (RAT)
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49. Yukon EMS
Equipment
• Rotor Response Bag
• Overnight Survival Kit
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50. Yukon EMS
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