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—6 Ways To Fly Strong In an Air Medical World Full of Dumb

How do you know

if you’re smart crew?

If you’re reading this, you pass the smart test.

You care enough to learn.

Step one complete.


Smart isn’t nearly enough to keep you safe.

I wish this weren’t true. But we both know it is.

Now is a tough time

to be flight crew.

Nobody likes headlines about medical helicopter crashes; or worse yet, sensationalism about the reasons why.

And lately, tragedy seems closer, more personal than usual, right?

It was easier before.

It was easy when the program was far away. Or had known “issues.” Or a crappy pilot training program. Or whatever else we could rationalize to make sense of it.

These last few crashes hit closer to home, right?

Industry leaders with presumably the best training programs money can buy. So what’s different? Why does it feel more personal this time?

Are you paying attention? Did you catch it?

It’s okay if you didn’t.

It’s the reason for this article.

It seems closer because now you know it can happen to you too. But before you hit the panic button, realize this is actually a very good thing. It means your internal radar is calibrated and working properly.

It means you’re one step closer to getting smarter about your own safety.

Your wake up call is the “closeness” of recent crashes. And the fact you can hear it and feel it, means it’s not too late.

What Smart Flight Crews Know

Smart flight crews know they’re one flight from humility.

Smart flight crews know it could happen to them.

Smart flight crews pay attention.

So what the heck is going on? And how can you protect yourself, if at all?

I hope you’ve heard this before. Because it’s not a cliche. It’s completely true.

“Your best tool is your brain. Your best guide is that uneasy feeling in your gut.”

You already know whether or not everything is as it should be at your flight program. You don’t need my help for that. You simply need to see things for what they really are.

For you, flying air medical is about patient care and job satisfaction, right?

But it’s completely different for people with no skin in the game. For helicopter companies and health systems, it’s about the money.

Is that too much reality for you?

Because if it is, you’re doing the wrong job. And you should do something else right away.

Don’t get me wrong.

Air medical is important work. Air medical saves lives. Air medical needs good folks. I loved flying. I loved the people I got to work with. And I loved my job.

But I never once saw air medical for anything different than what it is.

I was never naive enough to believe anybody cared about my safety more than me.

I was naive enough; however, to voice my concerns publicly (which led to my early retirement plan)… but that’s a different article.

This article is about teaching you how to fly air medical smarter. How to fly strong.

Be warned..

I don’t have a magic pill to keep you safe in all situations. But what I do have is almost as valuable. I have something no active flying air medical crews have…

I have the ability to speak freely and tell you the truth.

Just realize, the truth may not be what you want to hear. I know you think it is. But…

Want more harsh reality?

Air medical managers could put an almost immediate stop to medical helicopter crashes.

So why don’t they do it?


It’s not their problem.

It’s your problem.

Their problem is how to squeeze another ten cents per share out of the company stock this quarter.

Your problem is not getting killed by how they do it.

This article gives you some real world ways to survive today’s air medical climate.

Here are 6 Ways Smart Flight Crews Stay Safe

#1 Set Limits

Know your limits before takeoff.

Reality is no matter how well you plan, there will be times when circumstances change drastically. There will be times when safe flights move from a safe zone -to cautious to dangerous. Your best defense is knowing exactly when you’re done.

It’s crucial to set your limits before you fly. Why?

Because it’s impossible to remove all emotion after you start a flight. Even the most stoic humans are human.

The way you manage deteriorating weather and changing circumstances is knowing exactly when you’re turning around or picking a spot to land — BEFORE you start flying.

This sounds simple, but it’s not.

If you’re not sure how to set limits, or exactly what limits to set, start with your fellow crew. Ask questions. Get help.

You’re worth it.

#2 Engage Your Whole Team

Nobody sits the bench in EMS Flight Safety Network. Everyone matters. Everyone has a job to do.

The challenge is making sure everyone clearly understands their role.

There’s more to landing zone training than making a big box and putting lights in the corners. And shame on you if that’s all you’re teaching.

My point is to engage the whole team. Use all the resources you have.

Teach your ground crews how to help you. They’re extremely capable and always willing. But they’re only as smart as you (flight crew) empower them to be.

They can’t tell you about an unfastened latch on an engine cowling, if they don’t know where to look or what a cowling is.

See what I mean?

#3 Challenge the Status Quo

One of the positives from recent air medical crashes is the change in attitude I see in medical folks who fly the line.

Flight nurses and flight medics are speaking out. They’re (rightfully) more afraid of dying than overbearing, non-flying bosses.

It’s happening under sad circumstances, but it is happening and it’s a very good thing.

Challenge the status quo.

The status quo is what keeps failing you.

A good forum for more information is the facebook group Flight Paramedics and Nurses.

Check it out. You’ll be glad you did.

#4 Avoid Old School Stupidity

If you see something stunningly wrong, question it. Don’t let it go.

The professional flight programs will thank you. They want you to bring problems to their attention. Because they can’t fix what they don’t know about, right?

The problem is not every program is professional. Thanks to the med crews it’s better than it used to be. But there’s still room for improvement.

Here’s a no-brainer that is often overlooked:

Flight nurses are some of the smartest people on the planet. Many flight nurses hold formal education and degrees beyond the requirements of their jobs as a nurse.

So it makes no sense for them to work for a guy with “G.E.D.” on his barbecue sauce-stained t-shirt, right?

And the stunning part?

The stunning part isn’t the weirdness of the situation (even the GED guy gets this part).

The stunning part is the people who setup this situation and continue to let it fester. Nothing good is coming from it.

It puts people at unnecessary risk and hurts flight programs.

If you look at the numbers, you already have the proof.

Promote the best people. Not the program manager’s BFF. Or some strange employee reward program from companies so talented they no longer exist.

Enough said.

#5 Fight The Pressure

Do you think your flight program is pressure free? Do you believe it’s up to the pilots to make their own decisions about accepting or declining flights?

If you answered yes…

In almost all cases you’re wrong.

Human nature (just like with crashes) is to convince yourself your program is different. Your program is the exception. Your program does it better.

The problem, whether you accept or deny it…

is pressure to fly is very real.

A second (even less visible) problem is how air medical managers apply pressure from a variety of sources and directions. To be fair, some don’t know they’re doing it. Others, know exactly what they’re doing.

Here’s a personal “favorite” example:

Your program has a safety meeting and you get asked what to do when you’re “on the fence” about taking a flight? “What do you do when you’re not sure what to do?”

You give your best pilot answer in front of your entire team.

You say something like “I take a conservative approach and turn down the flight because I can’t be sure we’ll complete it with no issues.”

All good…

Publicly, you’re praised.

“Good decision newbie. That’s exactly what we expect you to do.” Your boss even chimes in with something like “if you have to think about it twice, then you’re thinking about it too much, and should turn it down.”

You feel great. Glad to be on the team. A team that believes in safety and supports you.


After the meeting your phone rings.

It’s your boss.

And apparently something happened to him because he’s not the nice guy he was in public. In fact, he screams at you and makes it painfully clear you will “at least try” each and every flight request. Period.

Think I’m kidding? I wish I were.

My point isn’t to scare you. It’s to get you thinking about how to handle a situation like this ahead of time.

The more prepared you are, the better you’ll do.

#6 Connect With Your Pilots

One of the most valuable resources in air medical is sitting right next to you.

Your pilot.

He wants what you want.

Good equipment. Good people. Good flights.

Everyone goes home after every shift.

If you work together with your pilots, you definitely can improve your own safety. Collectively, you can be safer today. But you both have to put ego aside and focus on what really matters. Hint: It’s about your safety, not your numbers.

Realize there are times your pilot needs you to “man up” or “woman up” and admit you canceled or turned a flight around because of your comfort level.

Also realize (in most cases) the pilots don’t have the same options as med crew in regard to their careers.

They can’t leave flying today and walk into a hospital job tomorrow.

Air medical managers know this and manipulate it. But if you work together, you and your pilot can both win.

What To Do Now?

I have a confession.

I read this article out loud and was shocked by the rawness of it.

I almost changed it. I almost softened it.

But then I decided it needed said – raw or not. So here it is. I’m still not sure the air medical world is ready for an article like this one. Denial is easier than reality. This article is maybe too much reality. I’ll let the comments be my guide.

Now is when I normally encourage you to sign up for my free Crew Newsletter.

Crew Newsletter is where I share all the good stuff first. All the special offers for coaching, and gear, and all the stuff we offer at EMS Flight Safety Network.

But under the circumstances, I’m just going to share it here:

If you have aspirations of flying air medical professionally, but want real world advice and help (like this article), for a limited time you can join…

EMS Flight Safety Network INSIDER training program here.


You can show your support for air medical with a FLY STRONG t-shirt from Amazon. If you order now, you can get it 25% cheaper than it will eventually be offered to the public.

Troy Shaffer
Troy Shaffer

About the Author: Troy is an Air Medical Career Expert passionate about a team approach to improving air medical safety from the ground up. Troy is a former Army medic, Army pilot, Coast Guard pilot and EMS pilot. Troy has taught hundreds of wannabe flight medics, flight nurses and EMS pilots the exact steps needed to launch air medical careers.

    8 replies to "How Smart Crews Stay Safe"

    • Alice Dycus

      Stay safe!!!

      • Troy Shaffer


        Thanks for taking time to comment. We appreciate you!

        Clear Skies & Tailwinds

    • Angela Girolami

      I always check my gut on my walk around… i encourage my crew to speak up, stay safe and we all go home. Crew safety above all!

      • Troy Shaffer


        Good on you. Like I mention in the article, it’s a really good idea to have set limits before you take off. It’s simply easier to establish and set limits on the ground.

        Thanks for sharing your experience.

        Clear Skies & Tailwinds

    • Christian Guevara

      This is Gold.

      • Troy Shaffer


        Thanks for the feedback. I hope this article helps you.

        Clear Skies & Tailwinds

    • Wayne Wright

      This is a mission brief introduction/lead off that I picked up in my early Army Chinook Crew Chief days. I carried it with me when I became a pilot, I still start all of my daily HEMS crew briefs with this.

      “Success of the mission is based on the collective effort of the crew as a whole.”

      It binds us as a crew and sets the tone before we even walk out the door.

      Great article.

      • Troy Shaffer


        Thanks for sharing your experience. It’s greatly appreciated!

        Clear Skies & Tailwinds

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