EMSWORLD.com | NOVEMBER 2017 45
after the call you should have a chat to resolve
the distraction.
What about your computer-aided dispatch
system? Again, the driver doesn't engage it
if the tire is rolling. The other person would
announce "I'm heads-down" and take care of
the message, then update the driver on any
need-to-know-right-now items. If you're the
only one in front and get a company message,
pull over—don't text and drive. If the tire's not
moving, it's hard to hit another stopped car.
I've stopped planes while taxiing to work on
problems many times.
Aeromedical
For this group use the term sterile cockpit—it's
understood in the aviation community. For EMS
and firefighters cockpit just doesn't fit. I sub-
mit that sterile cockpit rules for aeromedical,
helicopter and fixed-wing need to be a little
different. For one, many helicopters don't have
tires. And aeromedical does not fly under the
Federal Aviation Regulation (FAR) rules airline
pilots use (parts 121 and 135) but rather part 91.
Part 91 rules govern general aviation and do
not include federally mandated sterile cock-
pit restrictions. There is a long list of rules to
follow, but sterile cockpit is not among them.
Aeromedical pilots know they're overdue for
these rules. In the meantime, individual com-
panies can require sterile cockpit rules as part
of their flight operations.
For fixed-wing aeromedical operations, the
same sterile cockpit procedures as airlines
would apply as currently written. The medi-
cal crew in the back needs to be trained on
sterile cockpit procedures so as to not cause
problems. It takes training for the entire com-
pany to comply—that means the ground crew,
flight crew, medical crew, dispatcher and boss.
For helicopter-based aeromedical, since
there is no tire to roll, organizations need to
decide when sterile cockpit will start and end.
I suggest that if the rotor is turning even a tiny
bit, sterile cockpit should be in effect. A moving
rotor blade deserves respect.
Helicopters do not routinely fly above
10,000 feet but the current regulation allows
for this with: "and all other flight operations
conducted below 10,000 feet, except cruise
flight."
2
It ends at the top of the climb and
begins again at the top of the descent.
Conclusion
Take action. Talk to those you work with about
sterile crew; maybe show them this article.
Start putting it into effect. Look at your most
recent accidents—could you have done more
to prevent them?
Change can be difficult. It takes leader-
ship from every level to make it happen, but
you can start right now with yourself. Sterile
crew is based on a concept that's been proven
in aviation and can be adapted by EMS, fire
departments and aeromedical providers. Go
ahead—change and adapt.
REFERENCES
1. National Transportation Safety Board. Accident Reports: Eastern
Air Lines Inc., Douglas DC-9-31, N8984E, https://www.ntsb.gov/
investigations/AccidentReports/Pages/AAR7509.aspx.
2. Government Publishing Office. 14 CFR 121.542—Flight
Crewmember Duties, https://www.gpo.gov/fdsys/granule/CFR-
2017-title14-vol3/CFR-2017-title14-vol3-sec121-542.
ABOUT THE AUTHOR
Capt. Dick Blanchet (Ret.), BS, MBA, worked as a
paramedic for Abbott EMS in St. Louis, MO, and
Illinois for more than 22 years. He was also a
captain with Atlas Air for 22 years on the Boeing
747 with more than 21,000 flight hours. As a USAF pilot, he
flew the C-9 Nightingale aeromedical aircraft for five years.
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