Safety

People Who Live in Glass Houses Shouldn’t Throw Stones

Tom A. Østrem 5 Comments


The last couple of days people in various helicopter groups on Facebook have been quick to judge the pilot of a helicopter that strikes a palm tree as seen in the video above. And I will begin with stating a disclaimer for myself. Like most of the people in the comment sections of this video in various groups, I have no factual information about this incident. My observations are therefore based solely on the video.

Before I start my rant I’d like to give you a few of those comments here (unedited):
“What a moron!”
“Idiot, guess flight controls and CG felt fine haha”
“Fuckin chimp…..where and how to idiots like this get a licence”

Apparently none of these guys have ever made a mistake in their entire life. Which I guess makes them aliens, since it is a FACT (a word that actually had meaning up until recently) that ALL people make mistakes from time to time. This is widely recognized as one of the aspects of human performance. Everyone will mess up from time to time. In aviation we have recognized this fact, and have embraced the principle of “Just Culture”, which recognizes this flaw in human beings. Instead of trying to blame incidents like these on “morons” and “idiots”, we ask ourselves how did this happen? That is the ONLY way we can prevent another incident like this, because at the end of the day we are all “idiots”.

Was/were the individual/crew rested? If not, how does the operator handle fatigue?
Has/have the individual/crew undergone confined area training recently?
Does the operator have procedures in place for confined area landings?
Was the pilot by himself or was he a part of a crew, and if so, did they have CRM training? And to build on that, does the operator have procedures for confined area landings that utilize CRM? For example having other crew members check sectors not immediately visible to the pilot.

And these are just a handful of questions, there are many more that can be asked. But the gist of all of these are focusing on the system in which the pilot or the crew play their individual roles, and not solely on the individual. Sure it may very well lead to the point where it was a single rested pilot, having all the required training and experience to do this, that still forgot that he had a palm tree at his 7 o’clock. Does that mean I think he should lose his license and never fly again? No. Because he was human, and to err is human. Had he been doing something that he knew to be a clear violation of procedures or regulations, THEN we could start talking about repercussions.

To me it LOOKS like the drift is too big to be anything but conscious, and that the pilot have focused on clearing the obstacles he sees in front of him and to his right, probably having forgotten that there was a palm at his 7-8 o’clock. These are my ASSUMPTIONS. And I know to assume is to make an ass out of u and me, but seeing all these other couch pilots out there I’d like a jab at it too. Some have also commented that he should have landed as soon as possible, and I agree. We don’t know for sure though what he did after the video cuts out, so I’ll give him the benefit of the doubt. I can understand however that he doesn’t land at the same spot he just had a rotor strike, for obvious reasons.

All I am trying to get at here is that we are all brothers and sisters in rotary aviation. How about showing some common courtesy until the facts are in? It may very well be you next, and if you think this could never happen to you, Human Performance has a diagnosis for you, and that is “invulnerability”, look it up!

Cameras and Cockpits

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I’m frequently asked about how I’m able to capture some of my pictures when I’m flying. In this post I’ll try to explain how, and the considerations I take to do so safely. First of all I want to make it clear that one should always follow company procedures and policies and any regulation that may apply. However if no such guidelines are in place in your company, or you are flying recreationally,  these are some basic principles that I adhere to. I’ll admit when I started out in this game I wasn’t as disciplined as I am now, but that is also why I have denied requests from various helicopter media sources to have pictures published that are not in line with what I stand for now. Continue reading →

Flight Risk Assessment Tool (FRAT)

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Using a flight risk assessment tools is a great way of making flight crew and operations depts. aware of the risk level associated with a flight or series of flights. The concept is to run through a list prior to flight of items given a predetermined value, then seeing what it all adds up to. The forms are usually customizable to allow each operator to set the various values and alert levels for the total sum. Depending on the sum a flight may require supervisor approval or reassessment. This will keep you ahead the aircraft in terms of what risks may be lurking and make you aware of the expected risk level.

The items on the list may include crew composition and experience, crew rest, Wx conditions, airport environment, MEL-items and so on. The list can be modified to suit any operation be it airline long-haul or helicopter external load operations. I would really recommend those of you who are not familiar with the concept to check it out.

Links of interest:
USHST FRAT introduction (pdf)

Preflight Mitigators FRAT (one of the solutions I have been testing)

There are many available solutions out there, many are free, so google it an see what you can find.

CRM Thoughts from Randy Mains

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This was posted on Facebook a few days ago, and I think Randy has many good points. Below is his post that went with the video below. More information about Randy Mains here. 

I was sent an excellent video by Dan Faust that I plan to use as a case study in future CRM Instructor’s courses because it has excellent CRM and AMRM learning points. He made the valid statement when he said, “I thought you said the British were far ahead of the US in regards to flight standards. Not being sarcastic, just looking at the fog, cliffs, trees, and deciding to continue the flight.” His point is an excellent one and here is what I wrote back to Dan after I’d viewed it. Dan you bring up an excellent point. Continue reading →

Procedural Compliance

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Following procedures is critical to ensuring a safe flight!

This NTSB video on procedural compliance for flight crews, which is targeted at pilots, airline operations departments and aviation regulators, uses findings from seven commercial airplane accidents to show how deviations from standard operating procedures can initiate a chain of events that can lead to devastating consequences.

“Strengthening Procedural Compliance” is on the NTSB’s Most Wanted List of critical safety improvements.

 

IHST Publication: 7 Decision Making Tips That Every Helicopter Pilot Needs to Know

Tom A. Østrem 2 Comments

For a complete list of fact sheets from IHST go here.

Contact: Tony Molinaro
tony.molinaro@faa.gov or (847) 294-7427

7 Decision-Making Tips That Every Helicopter Pilot Needs to Know

The following strategies can improve decision making. Training pilots on these solutions will allow them to make better choices before and during their flights.

Follow Standard Operations Procedures – SOPs are widely used throughout the commercial aviation community as a means to manage risk. The establishment of safety oriented SOPs (including personal and weather minimums) provides pilots with pre-planned responses that manage the risks and break the “chain of events” leading to accidents. To be effective, SOPs must be clear, concise and free of conflict. Use of SOPs is a form of “rule-based” behavior and is less error prone than “knowledge-based” behavior.

Conduct Pre-Flight Planning – Planning that is conducted prior to a flight in a low stress environment can enable a pilot to produce a safe strategy for the flight (i.e.: the pilot can be proactive and plan ahead to select a safe route and establish “decision points” during each flight phase). Collaborative decision-making with air traffic control, weather services, and other pilots will help to size up a general situation. Good pre-flight planning also reduces the workload once airborne.

Forget the Illusion of Plan B – Research has suggested that having a plan B safety net encourages continuation and possibly more risky behavior. Naturally it is easier to take a risk when you know that you can count on a plan B. Pilots however rarely assess their plan B properly; so the protection can be weaker than expected.

Learn Single-Pilot Resource Management – This is a practical way to teach pilots better decision-making and judgment strategies. Single-Pilot Resource Management is the capacity to manage all resources (both on-board the aircraft and from outside sources) available to the single-pilot prior to and during the flight to ensure a safe flight. It is a form of Crew Resource Management for single pilot operations. Single-Pilot Resource Management includes several components such as Aeronautical Decision Making, Risk Management, Task Management, Automation Management, Controlled Flight Into Terrain Awareness, and Situational Awareness. Single-Pilot Resource Management training helps the pilot to maintain situational awareness by managing the flight and navigation tasks and to enhance the social skills needed to communicate and interact, for instance, with air traffic control and passengers. Single-Pilot Resource Management training enables the pilot to accurately assess and manage risk and to make better decisions.

Practice Threat and Error Management – Training for Threat and Error Management training can be referred to as a form of ‘defensive flying’ for pilots. The objective of Threat and Error Management is to manage in an effective manner the risks stemming from threats and errors to ensure a safe flight. Undetected, unmanaged or mismanaged, threats and errors have the potential to impact the safety of the flight by creating Undesired Aircraft States, which usually can be recovered from, but if not properly managed, it can lead to accidents or incidents.

Get Some Simulator Training – Simulators can allow training decision-making in high stress, high workload situations with poor or conflicting information. Training scenarios can be tailored to the trainees needs. In addition, simulators allow exploration of the consequences of poor decisions without endangering the safety of the aircraft and its occupants.

Understand Good Decision-Making – As early as possible in their training, pilots should be made aware of the characteristics and limitations of human decision making. Trainers should emphasize the importance of maintaining Situational Awareness, of prioritizing responses to Undesired Aircraft States, and of contingency planning, i.e., “What if something goes wrong during the flight?”