Landing Zone Operations

1
Landing Zone Operations
2
Course Purpose

• The purpose of this presentation is to provide
  you with information to properly, safely and
  efficiently select a site for a remote landing
  zone, perform reconnaissance of that site,
  properly identify and secure the site and
  communicate with the flight team to provide for a
  safe landing and takeoff.

This presentation is NOT intended to replace
formal classroom training by qualified personnel.
It should simply be used as a guide to orient
new personnel or refresh existing personnel on
Landing Zone Safety. Local protocols should
always be followed. If you have any questions
please contact our program at [phone]
Please utilize this information to educate
personnel in your department.
3
About The Aircraft

• Sikorsky S-76B

Aircraft is piloted by 2 State Police
pilots Crewed by 2 medical personnel
Can hold 2 patients (conditions permitting)
4
What area does Southstar cover?

• SouthSTARs primary coverage area is from
  Interstate 195 south to Cape May point.
• Should NorthSTAR, our sister ship, require
  that we assist in the northern area of the state
  we will respond there as well.

5
The most critical part of our entire mission are
the landing and take-offs we perform at remote
landing zones. There comes a point in which we
rely HEAVILY on the ground team ( YOU ) to
properly select, establish and secure our landing
zones for the safety and benefit of all involved.
This is a duty not to be taken lightly or handled
complacently. The dedication and
professionalism of the ground team leads us to be
one of the SAFEST air medical programs in THE
NATION. YOU are the first link in conducting a
safe medevac operation by establishing a SAFE
landing zone.
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Step 1 Physiology
PATIENT CRITERIA
Adult Trauma Triage Guidelines

• Glasgow Coma Scale /- 12
• or AVPU P or U
• Systolic BP lt90
• Pulse 60/min or gt130/min
• Respiration ,lt10min or gt29/min

YES
To Trauma Center with ALS (if Available)
Source http//www.state.nj.us/health/ems/guideli
ne.shtml
7
Step 2 Anatomy
Adult Trauma Triage Guidelines

• Penetrating Injuries
• Gunshot Wounds
• Stab Wounds
• to Head, Neck, Torso, Extremities (above the
  elbow and knee)
• Flail Chest
• Fractures - More Than One
• Fracture InvolvingHumerus and/or Femur

• Paralysis or Evidence of a Spinal Cord Injury
• Amputation Above Wrist or Ankle
• Burns When Combined with Other Major Injuries
• High Voltage Electrical Injury
• Pelvic Fractures

YES
To Trauma Center with ALS (if Available)
Source http//www.state.nj.us/health/ems/guideli
ne.shtml
8
Step 3 MECHANISM OF INJURY (Required Consult
with Medical Command, when Available)
Adult Trauma Triage Guidelines

• Ejection from Motor Vehicle
• Extrication gt 20 min with an injury
• Falls gt 20 feet
• Unrestrained Passenger in Vehicle Roll Over
• Pedestrian, Motorcyclist or PedalcyclistThrown
  or Run Over

YES
To Trauma Center with ALS (if Available)
Source http//www.state.nj.us/health/ems/guideli
ne.shtml
9
Fly or Drive ?
Fly or Drive?

• When Making an Informed Decision Consider the
  Following
• Ground travel time to the nearest trauma center
  (e.g., distance, traffic congestion)
• The helicopter's estimated time of arrival
• (ETA), the transfer time, and flight time to the
  trauma center
• Whether multiple patients are involved

Source http//www.state.nj.us/health/ems/fly_dri
ve.shtml
10
Fly or Drive ?
Fly or Drive?
Guidelines

• Ground transport should be used for an
  un-entrapped patient who is within 20 minutes
  ground travel time from a trauma center.
• Entrapped patients are an exception to the
  20-minute rule, if the helicopter can reach the
  scene while the patient is being rescued or
  extricated.
• The helicopter should generally be called to a
  scene which is more than 30 minutes by ground
  from a trauma center.

Source http//www.state.nj.us/health/ems/fly_dri
ve.shtml
11
Fly or Drive ?
Fly or Drive?

• Helicopter use when ground travel time is between
  20 and 30 minutes is a Gray area
• You need to consider factors such as the
  helicopter's estimated time of arrival, in-flight
  time, extrication time, etc.

30 Min.
20 Min.
H
Source http//www.state.nj.us/health/ems/fly_dri
ve.shtml
12
Fly or Drive ?
Fly or Drive?
Things to Keep in Mind

• While a helicopter is fast once in the air,
  getting to the landing zone and loading the
  patient can easily add 5 to 10 minutes, or more,
  to on-scene time.
• Consider requesting a helicopter for incidents
  involving more than three critical patients.
• Additional manpower, communication with medical
  control, and transport options can be obtained by
  using the air medical helicopter system.

Source http//www.state.nj.us/health/ems/fly_dri
ve.shtml
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Calling for a Medical Helicopter in New Jersey

• PLEASE NOTE Calling for a specific Medical
  Helicopter directly by phone is Not permissible.
  
• The State requires that all requests for Medical
  Helicopter response in New Jersey MUST initiated
  through REMCS.
• REMCS can be reached by contacting your local
  dispatch center or by calling 1-800-544-4356

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We are already ON A MISSION
Reasons why SouthSTAR may not be available
Weather throughout the Complete Flight is
below SouthSTARS minimum flight standards
Maintenance Requirements
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OUR Weather Limitations

• Day 800ft ceiling with 2 mile Visibility
• Night 1000 Foot ceiling with 3 mile visibility
• Weather is checked throughout the entire flight
  plan.
• Never hesitate to call pilots will make the
  final fly decision.
• Be sure to notify pilots of significant weather
  conditions at THE LANDING ZONE ( i.e. ice,
  fog, thunderstorms ).
• Weather can change AND deteriorate quickly.
• We are relying on your input to conduct a safe
  operation.
• Most all Air Medical Crashes are WEATHER RELATED!

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What is required for a SAFE Landing Zone?
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Do I have a communications officer?They should
have a familiarity with all areas your team
serves. Have excellent communication skills, a
good sense of direction and is completely free
from providing direct care to the patient (s).
What are the high risk / accident areas in the
area?Check out possible landing zones in advance
close to these areas. Assess and make note of
their associated problems and risks. Note
landmarks to help locate the area. Note hazards
that need to be relayed to SouthSTAR prior to
their arrival.
Questions to ask yourself
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A SAFE LANDING ZONE CONSISTS OF

• Flat, hard surface is preferred
• 110 X 110
• - Approx. 2 lengths of attack line
• Clear of overhead obstructions
• Clear approach and departure paths
• Note some important info
• Helicopters dont take off and land vertically.
• We take off and land into the wind when possible.
• High heat and humid conditions effect our
  aircraft performance. We may need more area to
  operate under these conditions

• Marked out with 4 FLARES
• Secure the area of vehicles and pedestrians
• Area should be free of debris
• All WHITE lights off !!
• Emergency apparatus
• Other vehicles (headlights)
• Flashlights
• Scene lights
• By turning these lights on, you are in effect
  BLINDING the pilots
• No flash cameras !!!
• DO not look directly at the helicopter as it is
  landing unless you have eye protection.

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Tasks before Aircraft arrival

• Locate an area as described. Be prepared to have
  a request to change the LZ by SouthSTAR should
  the pilots request you to do so.
• Utilize available apparatus / scene lighting
  PRIOR to aircraft arrival to assist in
  identifying LZ hazards
• Deploy your personnel, with hand lights, to walk
  the LZ. Have them scan overhead the LZ
  surrounding area as well as the LZ itself for
  hazards, slopes, wires, etc.
• Identify access sites to be secured.
• Allow no unnecessary vehicles near the LZ
• Deploy personnel to secure ALL access points
• Keep bystanders, family etc. well away from the
  actual LZ
• Deploy flares as prescribed ( placed in each
  corner of LZ )
• Ensure that your radio is on the proper frequency
  for contacting SouthSTAR
• Stand by and await contact from SouthSTAR for an
  LZ description/briefing

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Can YOU See The Ground???
IMPORTANT !!! During night operations, DO NOT
shine any form of light on the LZ or at the
aircraft. You are hurting our operation, not
helping us by destroying our night vision. This
action can lead to an accident. Once the
aircraft is on the ground and awaiting the
patient, again, No lights are to be utilized to
illuminate the area while transporting the
patient to the helicopter .
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A Thought on Wires

Electrical lines pose one of the greatest dangers
to the helicopter crew as well as the the ground
crew. Failure to notify the pilots of surrounding
wires in the immediate area as well as
surrounding area could result in a catastrophic
accident NOTE WE CANNOT SEE WIRES WHEN
AIRBORNE, WE ARE RELYING ON YOU TO ADVISE US OF
THEIR LOCATION.
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From a Pilots view, it is not easy to identify
hazards even under day flying conditions. Night
time is even more difficult. We completely Rely
on your Assistance.
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Possible LZ Sites ???
SCENE
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Possible LZ Sites ???
NOTE the Location of wires...
LZ
LZ
LZ
SCENE
LZ
LZ
LZ
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Communicating With the Pilots
How to Provide a Landing Zone Briefing
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What is a Sterile Cockpit ?

• Once the Aircraft begins its final approach to
  the landing zone.
• ALL RADIO TRANSMISSIONS MUST CEASE.
• This includes all conversations within the
  aircraft and ALL radio communications with the
  landing zone team unless absolutely URGENT.
• ANY radio transmission to SouthSTAR while on
  final approach to the LZ alerts the pilots to the
  possible need for evasive actions and the
  possibility to abort the approach to land.
• Any urgent problems threatening the safety of the
  Aircraft landing are signaled by
• ABORT, ABORT, ABORT
• (On The Appropriate Radio Frequency Being
  Utilized)

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Communications

• Usually done on South Jersey Net frequency
• Each radio channel used possesses its own unique
  problems.
• Please know your radio frequency
  ahead of time.
• Note We limit radio transmissions when
  starting our approach into the landing zone.
• ONLY necessary communications should be made
  regarding potential hazards. NO patient updates
  etc.
• We ask that you employ radio discipline so that
  we may maintain a Sterile Cockpit Environment
• Approximately 2 to 3 minutes out SouthSTAR will
  ask for a landing zone briefing via the radio
  frequency utilized by your department.

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Communications (Continued)
Provide information on the landing zone such as

• Location
• In reference to the scene as well as area
  landmarks.
• Simply stating You have been here before is
  unacceptable.
• Describe area to be landing in
• Grass Field
• Parking Lot
• Roadway
• 3. Surface type
• Asphalt
• Grass or
• Dirt
• Please advise the pilots if the surface is wet,
  dusty, or covered in snow

• 4. The approximate size of the landing zone
• 110 x 110 MINIMUM
• 5. HAZARDS !!!
• Wires
• Towers
• Light standards
• Trees, etc.
• Make note of their location North, South, East
  and West of the LZ.
• Relay this very important information to
  SouthSTAR
• Advise how the LZ is marked out
• Your LZ is marked out by 4 FLARES

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Radio Communication Example

• SouthSTAR ABC LZ from SouthSTAR, we are
  approximately 2 minutes out, can you provide us
  with a description of the LZ?
• Landing Zone SouthSTAR your landing zone is set
  up to the west of the accident scene. You will be
  landing in a plowed cornfield in excess of 100 x
  100. Your obstructions are, telephone poles with
  wires approx. 50 feet high to the north along the
  roadway. You have a tree line to the east and a
  fence line to the south. There are no overhead
  wires or obstructions. You do have an unlit cell
  phone tower to the west outside the LZ area. The
  LZ is marked out with 4 flares. The area is
  secure awaiting your arrival, patient is on
  location at this time.
• SouthSTAR SouthSTAR received, please advise
  when you have a visual on us.
• NOTE
• Please do not reply You have been here before
  when asked to describe the LZ.
• This may not be the case for the pilot (s) on
  duty that given day.

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• SOMETIMES WE MAY NEED HELP FINDING THE ACTUAL
  LANDING ZONE
• Should you hear us or see us and there has been
  no radio communication established, reach out for
  us on the radio frequency being utilized.
• PLEASE NOTE
• Our dispatch coordinates only place us within an
  approximate 1 mile radius on the scene when
  correct.
• We look for emergency lights, flares and the
  actual scene when we are close.
• An aid to our navigation would be you advising us
  that we are in your sight.

EXAMPLE SouthSTAR we have a visual on you at
this time, were off to your 2 oclock position
(make note that when using the clock method the
pilot is facing 12 oclock).
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Approach and Landing

• Once over the LZ we will perform a High Recon
  (circling overhead) to identify the LZ and check
  its suitability.
• We will then perform a Low Recon to identify
  any unreported problems or obstructions and
  determine the safest approach path.
• Once deemed suitable and safe we will begin our
  final approach. This initiates the STERILE
  COCKPIT procedure.

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Instances that May Require an ABORT TO LAND

• A person or vehicle entering the landing zone
  area rendering it unsafe.
• SouthSTAR heading towards wires or obstacles
  known to the ground crew. DO NOT ASSUME WE SEE
  WHAT YOU SEE !!!
• Mechanical Issues .

ANY INSTANCE THAT YOU AS THE GROUND CREW
DEEMS AS UNSAFE !!! YOU HAVE THE AUTHORITY TO
ABORT OUR LANDING.
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Flight Team Interaction

• Once safely on the ground the Aircraft will SHUT
  DOWN (approximately 1 minute).
• The Medical Flight Team will exit the Aircraft
  and come to you.
• Please DO NOT APPROACH THE AIRCRAFT !

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Operating around the aircraft

• NEVER approach The Aircraft While the Blades are
  Spinning.
• The safest approach is 90 degrees from the side
  doors.
• Begin approach outside of the span of the rotors.
  Rotors extend 24 feet from top of helicopter.
• NEVER approach the aircraft from the rear.
• NEVER approach the Aircraft on your own,
• Signal us first and well come to you.
• There have been instances of the rotor brake
  disengaging and the blades spinning.
• If you hear the engines running and the blades
  are not spinning assume that they could start
  spinning at any time !
• STAY OUT OF THE DANGER ZONE !
• If wearing a hard hat, beware of rotor blades.

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How do you approach the aircraft ?? Stay away
from the front and rear of aircraft. Approach
from the side and walk directly to the rear cabin
door. Exit the area in the same manner you
approached.
DANGER!!! Rear of aircraft, tail rotor danger
area !!
DANGER !!! Front of aircraft, main rotor danger
area !!
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SouthSTARS blade has the potential to go as low
as 46 in the front of the aircraft. PLEASE
STAY CLEAR OF THE FRONT !!!
4 ' 6"
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NEVER WALK AROUND THE BACK !

Tail Rotor is 65 from ground on a level surface
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In case of a Fire

• Southstar has on - board fire protection
• Do not approach the aircraft unless escorted by a
  crew member.
• Beware of the blades
• They may still be spinning !!
• If Fire Is Seen (not just smoke) Signal Pilot
• They will escort you to the proper area of the
  ship to fight the fire.
• In the event of a fire, and the crew is unable
  to extinguish it, make note of the areas to fight
  the fire
• Engine compartment access
• One under each engine on each side of aircraft
  provides access to that particular engine
  compartment.
• Nose of aircraft Electronics Batteries
  Remove safety plate, fight fire.

Both Sides of Aircraft
39
Our aircrafts Fuel Bladder Location
May contain up to 280 gallons of jet fuel
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If You Want To Help

• Copy patient information (if time permits).
• Ensure Patient is Properly Secured To Long
  Board.
• Ensure patient is properly covered.
• Transfer patient to the aircraft with flight
  crew.
• Transfer may require 2 to 4 members.
• - One member at each point of the
  stretcher facing forward
• - NO BACK PEDALING !
• - Take your time, use controlled urgency
• Load patient with the flight crew present.
• Exit the area promptly .

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Patient Loading

• Use caution approaching the aircraft.
• Avoid rotor blades
• Flight crew will advise whether the patient is to
  be loaded head or feet first.
• Get stretcher close to pedestal.
• All stretcher straps off.
• Long board straps remain on.
• Color coding the straps recommended for speed and
  ease

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Patient Loading (continued)

• One Member at each side of head
• One Member at each side of feet
• One Member at each side only if needed
• Watch IV lines!
• Lift together
• Make sure patient does not slide off of the
  pedestal

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Exiting the Area

• Please take your O2 bottles with you.
• Walk out of rotor span using caution to avoid
  rotors.
• Gather in place out of the immediate area but
  remaining in view of pilot.
• Well secure doors and secure the patient.
• Please make sure no equipment is left behind.
  
• If you notice equipment immediately outside the
  aircraft after the blades start spinning Do Not
  return for it.
• Signal the pilot and a flight crew member will
  retrieve it.

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Demobilization
Once the aircraft has safely departed, the LZ may
be broken down.

• Extinguish flare
• Debrief / Critique with members
• Discuss what worked, what could have gone
  better and any suggestions you might have for
  future improvement

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Any questions regarding SouthSTAR operations
please call the on-duty flight crew
at 856-325-4880 The SouthSTAR Hangar Virtua
Health, Voorhees, N.J. 08043

• Additional information
• Issues
• Assisting with critique
• Training opportunities with your organization
• Community outreach programs

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• When any one Medical Helicopter launches on a
  mission, we are all part of a large, integrated
  team

IF ANY ONE PART FAILS WE ALL FAIL
You literally hold our lives in your hands during
the most critical phases of a mission
THANK YOU FOR KEEPING US SAFE !