In the wake of the deadliest helicopter emergency medical services year on record - 12 accidents and 29 fatalities in 2008 - the US National Transportation Safety Board has issued 19 new recommendations to augment the four it offered in 2006.

Of the 19, 10 are directed at the US Federal Aviation Administration and include improved pilot training, collection and analysis of flight, weather and safety data, flight data monitoring, development of low altitude routes, autopilot use and installation of night vision imaging systems. Others include recommendations for the federal organisations that reimburse operators for Medicare and Medicaid-related services.

The 2006 recommendations included equipping helicopters with terrain awareness warning systems.

For the FAA's part, recommendations that are accepted are likely to be reflected in a proposed rulemaking for the sector.

Dawn Mancuso, executive director of the Association of Air Medical Services, says operators are encouraged by the safety focus the NTSB has put on the problem but there is concern over the potential costs.

"While we're supporting the work of the NTSB, we are in the process of evaluating what the recommendations might mean in terms of affordability," Mancuso says.

Of particular concern is a recommendation that helicopters either have an autopilot or use two pilots, particularly since some helicopters are not configured for a second pilot. The association is researching how many already have autopilots, devices Mancuso says cost about $100,000 at a minimum to install.

Other technologies are making rapid headway in the fleet. Mancuso says about half of the 750 emergency medical services helicopters have night vision goggle capabilities and about 40% have terrain awareness warning systems.

Source: Flight International