A review of risk analysis and helicopter air ambulance accidents.

The Federal Aviation Administration announced a final rule in February 2014 that includes a requirement for helicopter air ambulance operators to institute preflight risk analysis programs. This qualitative study examined risk factors that were described in 22 preliminary, factual, and probable cause helicopter air ambulance accident and incident reports that were initiated by the National Transportation Safety Board between January 1, 2011, and December 31, 2013. Insights into the effectiveness of existing preflight risk analysis strategies were gained by comparing these risk factors with the preflight risk analysis guidance that is published by the Federal Aviation Administration in the Flight Standards Information Management System. When appropriate, a deeper understanding of the human factors that may have contributed to occurrences was gained through methodologies that are described in the Human Factors Analysis and Classification System. The results of this study suggest that there are some vulnerabilities in existing preflight risk analysis guidelines that may affect safety in the helicopter air ambulance industry. The likelihood that human factors contributed to most of the helicopter air ambulance accidents and incidents that occurred during the study period was also evidenced. The results of this study suggest that effective risk analysis programs should provide pilots with both preflight and in-flight resources.