## m. Emergency Situations 

1. In the event of a helicopter accident in the vicinity of the LZ, consider the following: 

## (a) Emergency Exits: 

(1) Doors and emergency exits are typical- ly prominently marked. If possible, operators should familiarize ground responders with the door system on their helicopter in preparation for an emergency event. 

(2) In the event of an accident during the LZ operation, be cautious of hazards such as sharp and jagged metal, plastic windows, glass, any rotating components, such as the rotors, and fire sources, such as the fuel tank(s) and the engine. 

## (b) Fire Suppression: 

Helicopters used in HEMS operations are usually powered by turboshaft engines, which use jet fuel. Civil HEMS aircraft typically carry between 50 and 250 gallons of fuel, depending upon the size of the helicopter, and planned flight duration, and the fuel remaining after flying to the scene. Use water to control heat and use foam over fuel to keep vapors from ignition sources. 

## 10 − 2 − 4. Emergency Medical Service (EMS) Multiple Helicopter Operations 

a. Background.  EMS helicopter operators often overlap other EMS operator areas. Standardized procedures can enhance the safety of operating multiple helicopters to landing zones (LZs) and to hospital heliports. Communication is the key to successful operations and in maintaining organiza- tion between helicopters, ground units and communication centers. EMS helicopter operators which operate in the same areas should establish joint operating procedures and provide them to related agencies. 

## b. Recommended Procedures. 

1. Landing Zone Operations.  The first heli- copter to arrive on − scene should establish communications with the ground unit at least 10 NMs from the LZ to receive a LZ briefing and to provide ground control the number of helicopters that can be expected. An attempt should be made to contact other helicopters on 123.025 to pass on to them pertinent LZ information and the ground unit’s frequency. Subsequent helicopters arriving on scene should 

establish communications on 123.025 at least 10 NMs from the LZ. After establishing contact on 123.025, they should contact the ground unit for additional information. All helicopters should monitor 123.025 at all times. 

(a) If the landing zone is not established by the ground unit when the first helicopter arrives, then the first helicopter should establish altitude and orbit location requirements for the other arriving helicopters. Recommended altitude separa- tion between helicopters is 500 feet (weather and airspace permitting). Helicopters can orbit on cardinal headings from the scene coordinates. (See FIG 10 − 2 − 9.) 

(b) Upon landing in the LZ, the first helicopter should update the other helicopters on the LZ conditions, i.e., space, hazards and terrain. 

(c) Before initiating any helicopter move- ment to leave the LZ, all operators should attempt to contact other helicopters on 123.025, and state their position and route of flight intentions for departing the LZ. 

2. Hospital Operations.  Because many hospitals require landing permission and have established procedures (frequencies to monitor, primary and secondary routes for approaches and departures, and orbiting areas if the heliport is occupied) pilots should always receive a briefing from the appropriate facility (communication center, flight following, etc.) before proceeding to the hospital. 

(a) In the event of multiple helicopters coming into the hospital heliport, the helicopter nearest to the heliport should contact other inbound helicopters on 123.025 and establish intentions. Follow the guidelines established in the LZ operations. 

(b) To facilitate approach times, the pilot − in − command of the helicopter occupying the hospital heliport should advise any other operators whether the patient will be of f loaded with the rotor blades turning or stopped, and the approximate time to do so. 

(c) Before making any helicopter movement to leave the hospital heliport, all operators should attempt to contact other helicopters on 123.025 and state their position and route of flight intentions for departing the heliport. 

