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42 NOVEMBER 2017 | EMSWORLD.com S A F E T Y s p o t l i g h t o n By Capt. Dick Blanchet (Ret.), BS, MBA The airlines' technique for preventing distractions can benefit emergency services too " S terile cockpit" is a mandatory avia- tion procedure for all U.S. airlines. It has nothing to do with germs or viruses but is all about keeping the air crew's environment free of distractions that might compromise safety. The idea has occasionally been applied to ambulance operations and has much that can benefit EMS. As a pilot for 40 years and a paramedic for 22 years, I know both sides of this story. Few would argue that our EMS, fire and even aeromedical safety records (helicopters and fixed-wing) are satisfactory. Truth be told, our record of getting to and from scenes safely isn't good. Can we do better? If we adopt a "sterile crew" concept, has it been proven? The answer to both is yes, and we are way past due. Cockpits and Beyond Sterile cockpit rules came about because many airline crashes had a common theme: pilot dis- tractions. A pivotal incident was a 1974 Eastern Airlines flight into Charlotte that crashed during approach in low visibility. The National Traffic Safety Board (NTSB) found "the flight crew engaged in conversations not pertinent to the operation of the aircraft. These conversations covered a number of subjects, from politics to used cars." 1 Further, the discussion "continued throughout the remainder of the approach and which contributed to the accident." This non- essential chatter directly contributed to the failure of the pilots to properly monitor the approach and altitude. Many died. It was not until 1981 that the Federal Avia- tion Administration (FAA) published the ster- ile cockpit rule (14 CFR 121.542 and 135.100). 2 This is not a casual suggestion for pilots; it is binding—fail to comply, and you stop flying. It has become an aviation fundamental, and as long as there are pilots at the controls, sterile cockpit procedures will likely be mandated. Sterile cockpit is just not the right term for EMS and fire departments. What we do have are crews. The aviation industry developed the term CRM, which in the beginning stood for cockpit resource management. Soon after it was put into effect, we real- ized CRM is not confined to the bubble of the cockpit but extends to the entire crew working and supporting the operation: the flight crew, ground crew, cabin crew, dispatchers, etc. CRM was broadened to crew resource manage- ment. So right here, right now, let's not make STERILE COCKPIT, STERILE CREW Photo: Dick Blanchet