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- Dec 8, '06 by Shamira AizzaI did not divert this thread.
I responded directly to a clear comment made before mine.
I don't carry life insurance because I use alternative investments that won't question the reason for a payout. If I did choose life insurance, it wouldn't matter what the fine print said because the decision made by your insurance company to refuse payout in the event of death in an aircraft crash is not based on evidence, but rather sentiments such as can be found here.
I also know the first-hand pain of having colleagues perish in an air medical crash Memorial. I worked in that aircraft with these fine people...so if that adds some kind of credibility to the discussion, I ask not to be dismissed. But since I have siblings who are RW pilots and ASI supervisors (FAA), and I worked as an FN for 7 years, and held management positions before changing careers and returning to grad school, I believe I bring substantial experience and rational exposure to the discussion.
Here's what I've done here; I've merely asked that some kind of evidence be shown that working as a flight nurse is 'on-it's-face' dangerous. No-one has done that. I never said there weren't inherent risks, but when comparing the job of "flight nurse" to any other occupation, there is no academic, scientific, or statistical evidence to support the flat claim that working as a flight nurse is "dangerous." There are "inherent risks" to thousands of jobs, but loose application of that phrase does not make a job more dangerous than another. One way to qualify (or disqualify) such a claim would be to make comparisons to the rest of the work force; what you will find is that OSHA, NIOSH, NTSB (or any other data-gathering agency) specifically defines a dangerous occupation based on science and calculations. I think it's entirely reasonable to define occupational danger with objective terms instead of implying it's dangerous simply because of the complexity of the machinery.
I only ask one thing; someone show clear, objective, academic, scientific, statistically supportable evidence to qualify a general claim that working as a flight nurse is "dangerous." It's comments like that which may discourage some fine clinical talent from applying (and I know that it has), when the truth be known that the industry does not need to be handicapped by false stereotypes by spreading subjective opinions that working as a flight nurse is any more dangerous than working in any other less-glamorous nursing fields such as home-health or interventional radiology...and more.
- Dec 8, '06 by pfitz1079"The risk helicopter EMS poses to flight crews, including pilots,
paramedics, flight nurses, and physicians, is palpable. During the
same 22-year study period, there were 144 crew deaths. Still, the
22-year average annual odds of a helicopter EMS crewmember
experiencing a fatal crash were 1 in 1,158.5 Incidentally, The Book
of Risks7 has published a number of activities that generate a 1 in
1,000 risk of death. By their numbers, 33 hours of helicopter EMS
flight time compares with 25 hours of rock climbing, 50 hours of
skydiving, and 55 hours of riding a motorcycle.5
The dedicated crewmembers of the air medical industry do
expose themselves to an appreciable level of risk in their
profession, greater than that of any other profession tracked by
the National Safety Council. And many have lost their lives in
the line of duty. We owe them a debt of gratitude on behalf of
the patients for whom helicopter EMS makes a difference."
Souls on Board: Helicopter Emergency Medical Services and Safety, Annals of Emergency Medicine, Volume 47, Issue 4, April 2006, Pages 357-360 Alexander P. Isakov
"Based on estimates of the numbers of crewmembers and crew deaths during 1995 to 2001,2 the death rate of helicopter EMS crewmembers was 75 per 100,000 person-years, 16 times the occupational injury death rate of 4.6 for all US workers during this period (emphasis mine). Wright reported an average rate during 2000 to 2004 of 1.8 fatal helicopter EMS crashes per 100,000 flight hours. At this rate, a helicopter EMS pilot or crewmember flying 20 hours per week during a 20-year career would have a 37% chance of being in a fatal crash"
EMS Helicopter Crashes: What Influences Fatal Outcome?
Susan P. Baker MPHa, Jurek G. Grabowski MPHb, Robert S. Dodd ScDa, Dennis F. Shanahan MD, MPHa, Margaret W. Lamb JDa and Guohua H. Li MD, DrPHa
Center for Injury Research and Policy, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Annals of Emergency Medicine
Volume 47, Issue 4 , April 2006, Pages 351-356
I don't think the work's dangerous, but clearly there are risks involved which are not typical of the nursing profession. I don't think anyone should be discouraged from entering into flight nursing because of the dangers, but I understand those who chose not to because of the risks. One should enter into this job with both eyes wide open, and a fair hearing should be given to all sides before making a decision.
Good luck with the job search.
RN, CFRN, EMT-P
Writing from the Ninth Circle
- Dec 9, '06 by Shamira AizzaFinally some numbers.
I would like to point out that I read the Hopkins article before, and it is some of the most flawed data construction I have ever read.
They shared several examples of air medical accidents involving helicopters, but when they assembled their numbers, they included fixed wing data as well without clearly identifying the impact on the conclusion.
They also made the conclusion that someone who flew 20 hours per week for 20 years had almost a 40% chance of being involved in a fatal crash.
I'd like to meet that flight nurse with 21,000 hours of actual airborne time.
- Dec 9, '06 by pfitz1079SA,
Why did you expend so much energy demanding numbers only to ignore them? This study has some unsettling conclusions, but it has survived peer review and has been published. Sorry, unless you're a Republican running for president, you can't ignore science.
I can't argue with your tactics. If one can't win an argument ("show me numbers"), one should change the argument ("those are bad numbers").
For the OP: Try flightweb.com, or individual program websites for jobs.
RN, CFRN, EMT-P
Writing from the Ninth Circle
- Dec 9, '06 by Shamira AizzaMaybe I should've revisited this publication before.
But since it's been brought, could I please review the article?
1. The conclusion was that fire and decreased visibility increases fatality rates, not that being a flight nurse is dangerous.
2. No potential bias was identified.
3. I doubt an FN could be found who has 21,000 hours of flight time. This statistic needs to be displayed in a manner truly reflective of the industry during the times evaluated. For example, the average flight nurse is airborne X number of hours per year (i.e. 200 hours). This is roughly how much time I spent airborne each year the last few years I flew, and I was one of the busier nurses. Alleging 20 hours of flight time per week is simply ridiculous. Hey, for discussion sake, I'll double that...let's say the average nurse flies 400hours per year, and that is being EXTREMELY generous. That means it would take 52.2 years to accumulate the amount of flight time equal to 20 hours per week at 20 years...and thereby expose themselves to the 37% chance of being involved in an accident. Do you see why I take this publication with a grain of salt? It also says that the amount of pilot flight time was not related to crash outcome...do you believe this? And 25% of all medical helicopters will crash over a given 15 year period. I cannot apologize for seriously questioning the validity of these numbers.
I theorize that the average nurse flies about 200 hours per year (some fly more, some fly less), and the average nurse would have to fly 105 years to expose themselves to the 37% chance of being involved in a fatal accident (not necessarily an accident that kills them, just involves a fatality). Looking at the numbers in the manner presented here, I can boldly claim that the average flight nurse has a 100% chance of dying before ever seeing retirement. But more realistically, I would theorize that the average flight career of a flight nurse is 10 years (I full expect that I could be years off the mark, but more than likely I overestimated the average flight career). This would make the estimated flight time about 2,000 hours...91% less than the 20hr/wk, 20 year nurse. I would like some help on the math here (I used the same formula as Baker did in the published study), but it seems to me that this means that the average flight nurse has around 3.5% chance of being involved in a fatal crash. Compare this to a statistic from the NTSB which says that the average American has about a 30% chance of being involved in a fatal crash involving an impaired driver during their lifetime...that's just the impaired driver and doesn't include the non-intox age-impaired (teen or elderly), weather-related, or sober folks who simply made a bad decision. That's why I say the most dangerous part of the job is the drive.
4. I recognize the comparison made to all occupations; that means they compared flight nurses to everyone from au pair to zoologist. It's too easy to make something look dramatically dangerous when you make a broad comparison like this.
I'm not ignoring the science, I am asking that it be presented realistically. BTW, the published conclusion did not at all report that EMS operations are dangerous, but that additional research will be required to determine cost-effective ways to reduce the fatal crash rate, and improve crashworthiness to avoid post-crash fire and avoid flight into IMC. As far as peer review (especially related to trade journals), when looking for articles of interest to it's readers, it does not always 'weed out' unsound research.
Personally, I think this research is extremely relevant, but naive in it's construction of the data. Sound science is reproducible (and I'm not aware of anyone who has visited this topic in this manner), but one study cannot be the basis for scientific conclusion or modification of practice.
- Dec 11, '06 by npingeorgiaI just wanted to add that the figures quoted here by pfitz are more than a little unsettling for me too. I am glad to see the numbers and that you were so diligent to find the data to report here. How can anyone argue with data that shows that this profession is at a 16 time greater risk than the rest of the U.S. population for loss of life or injury?? Now getting back to the research studies, I do agree that sometimes numbers can be made to reflect the hypothesis that you initially set out to prove or disprove. However, it's kinda hard to argue with numbers that are not a part of a research study such as provided by OSHA and as quoted by pfitz above. 16 times that of all other U.S. workers. WoW!!
Way to go there pfitz.
- Dec 11, '06 by 58flyerI wasn't going to add any more to this thread but I came across some new data. I just received the current edition of Air Beat magazine, the official journal of the Airborne Law Enforcement Association (ALEA). A number of police agencies also have an EMS operation along with their Law Enforcement function. Among these are Maryland State Police, Nassau County (NY) Police, San Bernardino County (CA) Sheriff's Department, U.S. Park Police, Broward County (FL) Sheriff, Volusia County (FL) Sheriff, just to name a few of the 34 agencies that are a part of A.L.E.A.
Anyway, there is an article called MEDEVACS ARE NOT ROUTINE in the current issue. The article mentioned the NTSB report stated in earlier posts. It added " the issues that most concerned the NTSB - nighttime flights, adverse weather conditions, inhospitable terrain, flight crew fatigue, pressures to attempt missions despite adverse conditions, the absence of aviation-knowledgeable flight dispatchers, and the lack of flight following." The FAA has published Advisory Circular 135-14A "Emergency Medical Services/Helicopter (EMS/H)," "and other FAA notices that provide temporary guidance to aviation safety inspectors, but said that further action was justified."
Getting into specific data......." The John Hopkins University's Bloomberg School of Public Health conducted a study of EMS accidents between Jan 1, 1983 and April 30, 2005 from data taken from the NTSB's accident database. The study reported that there were 182 helicopter accidents during the 22 year study period, an average of 8.1 per year. From 1998 through April 2005, there were 88 helicopter EMS accidents, an average of 12 per year, compared to 8.6 per year from 1983 to 1989 and 4.3 from 1990 through 1997. Seventy-one (71) crashes (39 percent) were fatal. 184 occupants died, a rate of 1011 per 1000 accidents, or one fatality per accident. 20 of 44 patients (45 percent) and 164 of 513 crew members (32 percent) died."
Further... "The contribution of darkness and bad weather that affects EMS flights and Law Enforcement flights is well documented. The John Hopkins study noted that when a helicopter accident occurs, darkness more than triples the risk of fatalities, and adverse weather increases the risk eight-fold. Both threats underscore the importance of clear standards, good risk management, and decision-making when determining the necessity for such flights."
What I found especially interesting was "While there was no comprehensive empirical data that NVG technology reduces EMS accidents, there have been no reports of EMS accidents due to controlled flight into terrain while using night vision goggles."
I know that such numbers may not mean much to some folks. Realistically, some folks beat the odds while others don't. If something happens to you personally, then your chances of that something happening are 100 percent, regardless of what the statistics say. In my experience, I had an hydraulic failure (helo) occur at 980 hours (my flight time), and an engine failure (helo) occur at around 6000 hours. In talking to the Bell Helicopter Textron safety people, I was told that most pilots go through an entire career with neither failure, based on statistics. My catastrophic engine failure was one in a milllon. I remember when I took my commercial helicopter checkride, the examiner asked a number of questions that were designed to test my judgement. I thought my answers were sound, but the examiner simply smiled and said "wait 'till you get a few thousand hours behind you and had a few helicopters break on you, and you will have a different answer." Up to that point I had every flight go perfectly. Now having had an engine failure, hydraulic failure, sensor failure, and a few chip lights, I now look at those strange machines a little differently. They are as dangerous as hell. Let no one tell you otherwise.
No one questions the safety record of flight in commercial airliners. It is statistically the safest way to travel. Yet my very first flight as a passenger in a commercial airliner ended in an horrendous crash. Lots of fatalities. Again, statistically, that should not have happened. But it did, at least I was among the survivors. It illustrates my point that regardless of what statistics say, when it's your time, it's your time.......
Relating to flight nursing, it doesn't matter if you are the pilot, or some other member of the crew, you are all aboard the same helicopter, and the dangers are the same for all.Last edit by 58flyer on Dec 13, '06 : Reason: If I could spell things right I wouldn't have to edit.
- Dec 30, '06 by skysixre: 21,000 flight crew, I know of an active FW CFN who has been flying since 4/1978, in 12/1995 when I met her she had just under 14,000 hours, so I expect she is over 23,000 by now.
21,000 over a 28.666 year career is only 61 hours a month which if you are working a 21 of 35 day schedule is only about 3.5 hours a day and I KNOW she averages over 4 hours a day...
I have only been flying for just over 6 years and already have 2850 hours, so I expect by the time I quit flying and retire I will have about 12,000 or so but then my schedule is a lot easier!!
- Dec 30, '06 by skysixOOPS - not done and accidntally posted.
So I am currently averaging about 475 hours a year which means that I would have to fly 44.2 years. As it happens, I plan to retire at about 25.25 years so I guess I should only have a 22% chance??? I am not sure you can manipulate the numbers that easily...
- Jan 1, '07 by Shamira AizzaThose are fixed wing numbers and have nothing to do with the research that was published by Ms. Baker.
It's not even reasonably possible that someone would accrue 9,000 hours of rotor wing flight time over 11 years.