Par 3-3 Page 18
(1) HAA VFR flight planning must take into consideration factors including the determination of highest obstacles and minimum cruising altitudes along planned routes as well as contingencies such as deviations due to medical necessity, dynamic weather and changes to the planned flight. The procedures defining these planning methods must be documented. (Refer to § 135.615 for regulatory requirements.)
(2) IFR/VFR Procedures. For operators with IFR authorization, procedures for transitioning from IFR to VFR on approach or from VFR to IFR on departure are required to be documented.
b. Approach Procedures Minimums (refer to §§ 135.609, 135.611 and 135.613).
(1) When executing Point in Space (PinS) Copter approaches that include a “proceed visually” transition, the flight will remain under IFR from the missed approach point (MAP) to a served heliport and the transition must be conducted in accordance with the ceiling and visibility limitations published in the PinS Copter Instrument Approach Procedure (IAP).
(2) When executing PinS Copter approaches that include a “proceed VFR” segment between the MAP and a served heliport, flights must be conducted in accordance with the ceiling and visibility limitations published in § 135.613(a).
(3) When accessing a heliport near an airport served by an IAP, the pilot may execute a published IAP to an airport which is not the intended landing site, and then break off that published approach after visually acquiring the airport served by the approach and then proceed to a landing area other than the airport to which the approach was conducted. The pilot may accomplish this only under VFR weather minimums in accordance with § 135.613(a) or under VFR as appropriate to the class of airspace involved and in accordance with ATC clearances.
(The airspace between the protected area surrounding the approach to the airport and the intended landing area located nearby may not be surveyed and obstructions may exist between the airspace protected for the airport served by the IAP and the intended landing site.)
c. Departure Procedures Minimums (refer to §§ 135.609 and 135.613).
(1) HAA Helicopters may depart on an IFR clearance from the surface, at heliports that are not served by weather reporting, providing the heliport is served by a departure procedure (Standard Instrument Departure (SID) or Obstacle Departure Procedure (ODP)) containing ODP and takeoff minimums, and the pilot determines the weather at the departure point meets or exceeds the published takeoff minimums. The flight may depart and proceed visually in accordance with the instructions contained in the DP.
(2) When departing VFR from heliports with the intent of acquiring an IFR clearance at or before reaching a predetermined point (usually the Initial Departure Fix (IDF) not more than 3 nautical miles (NM) from the departure point, the flight must be conducted in accordance with the DP instructions and the ceiling and visibility limitations contained in § 135.613)(a). If the distance between the departure point and the IDF exceeds 3 NM, the flight must be conducted in accordance with the VFR ceiling and visibility minimums for the class of airspace involved. The operator should document procedures for transitioning from IFR to VFR on approach or from VFR to IFR on departure.
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(3) If the departure involves a VFR to IFR transition and does not meet the requirements of § 135.613(b)(1), there is no departure procedure, and/or the IDF is more than 3 NM from the point of liftoff, the VFR weather minimums required by the class of airspace apply. If the flight is within Class G, airspace, refer to § 135.609, if within Class B, C, D, or E airspace, refer to § 135.205.
(4) These regulations do not restrict or prohibit “diverse departures" from airports from which IFR departures can be made in accordance with 14 CFR part 97. These are departures from airports with IAPs that have had an obstacle analysis conducted and from which it was determined IFR departures can be performed safely without a published ODP or SID.
(5) An IFR clearance and departure with “proceed visually” text is not considered a VFR maneuver and is not subject to § 135.609 limitations unless the pilot is instructed by ATC to maintain VFR. For this type departure, the weather must meet or exceed either the published “takeoff minimums” contained in the DP, or the restrictions in contained in § 135.613 or in § 135.609, as applicable.
d. Flight Into Locations Without Weather Reporting (refer to § 135.611(a)(3)). In accordance with the provisions of § 135.611(a)(3), the PIC may assess the weather at a departure point where weather reporting is not provided. This is a process where the PIC applies his own professional judgment to determine the weather conditions. The pilot may be assisted by access to enhanced situational awareness provided by the OCC or other aviation or non-aviation weather sources. (See Chapter 6 of this AC and AC 120-96 for more information.)
(1) Based on this weather assessment, the PIC may:
• Takeoff when the observed ceiling and visibility is greater than the weather minimums as published in a departure procedure; or
• Takeoff when a documented departure procedure is not available and when the observed weather is greater than the higher minimum ceiling and visibility limitations required by § 135.609, or for the Class B, D, or E airspace overlying the departure point, as applicable.
(2) The FAA intends to permit HAA flights to enter the National Airspace System (NAS) under IFR when visibilities and ceilings are below VFR minimums, based on the pilot’s weather observations, thus increasing the safety of the flight. This rule permits HAAs to depart heliports with a published IAP and departure procedure with no reported weather under IFR, rather than forcing them to depart under VFR, which in low ceiling and visibility conditions is more hazardous.
e. Weather Minimums (refer to § 135.609). Section 135.609 specifies HAA minimums for Class G airspace. HAA operations use higher ceiling and visibility minimums in uncontrolled airspace in uncontrolled airspace than is required for conventional part 135 operations. Each HAA base may establish one or more local flying areas (LFA) where lower minimums may be used. See paragraph 3-5 of this AC on LFAs.
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3-4. PREFLIGHT RISK ANALYSIS (refer to § 135.617). Preflight risk analysis is a key subject of this AC. It is discussed in chapters 3, 6, and Appendix A. This AC provides guidance for implementation of regulatory requirements. Each HAA operator, regardless of size, must design, develop, document and implement an FAA-approved preflight risk analysis process.
Only processes that have been documented and have been the subject of training, meet regulatory requirements. (Refer to § 135.617.)
a. Risk Analysis Steps. Risk analysis includes the following steps:
(1) Risk identification. What are the risks and their importance in quantitative terms?
(2) Mitigation. What changes or approaches reduce the effect of risks?
(3) Calculation of Residual Risks. What risk remains after mitigation?
(4) Management Review. Elevation of higher risk assessment to appropriate management levels for concurrence.
b. Risk Analysis. Risk assessment is a key element of risk analysis. Its process documentation should identify risk factors the HAA operator may consider. This assessment should consider not only the primary intended flight operation but also all contingencies that can reasonably be foreseen. The PIC does not have to perform a new risk assessment prior to a change in destinations. As part of risk assessment, these factors are quantified. The operator should assign to each risk factor an appropriate value reflecting both the likelihood of occurrence and severity of outcome. Combining the value associated with each risk factor will yield a total risk value. An example of this is provided in Appendix A.
c. Flight Authorization. Each HAA operator must document procedures for obtaining and documenting approval by management personnel to authorize a flight when a single or cumulative risk exceeds a level predetermined by the operator. If this value exceeds that predetermined level, it will require management approval or preclude operations. After all risks are identified and risk control strategies and their effects are considered, an informed go/no-go decision can be made. The effect of risk assessment on mitigation strategies and restrictions on acceptable risks must be documented.
d. Risk Assessment Quantifies at Least the Following Risk Factors.
(1) Aircraft Capabilities, Flight Route and Landing Site Considerations. This includes performance, fuel required, resulting useful load, environmental factors and their effect on performance with all engines operating and, as applicable, with one engine inoperative as well as obstacles and terrain along the planned route of flight and LZ conditions. In-flight changes to routes or destinations do not necessarily require a full risk analysis, provided these options or contingencies were considered in the original risk analysis of the flight operation that was conducted prior to the flight operation was initiated. The original risk analysis should be updated, considering factors which have changed, such as: fuel required, fatigue, airworthiness, and dynamic weather conditions, etc.
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(2) Current and Forecast Weather. This includes ceiling, visibility, precipitation, surface winds, winds aloft, potential for ground fog (especially for off-airport scene response operations), and severe weather such as thunderstorms and icing. These factors should be considered for the departure point, en route, and primary destination and contingency routes/diversion landing facilities.
(3) Human Factors. This includes sources of stress such as health, fatigue, circadian effects, flight difficulty, operational complexity and potentially distracting life events. All these are among the many potential contributors to human failure. Human factors considerations should include information such as pilot experience level and operation-specific hazards that also reflect environmental factors.
(4) Declined HAA Flight Requests. The operator must establish a procedure for determining whether another HAA operator has declined the flight request under consideration and if so, for what reason (weather, maintenance, etc.). If applicable, the reason for the declined flight must be factored into the required risk assessment process, i.e., do not include a declined flight due to a maintenance issue or pilot not available. This could be as simple as asking the requestor whether or not this specific flight request has previously been made and declined and why.
(5) Risk Determined Independent of Patient Condition. It should be assumed that HAA operators and personnel are dedicated to making every flight requested, providing the level of risk is acceptable. Best practices in the industry indicate the medical condition of a patient should not be considered in the risk analysis process and that the PIC should not be briefed on this factor in advance of decisionmaking.
e. Mitigation. Identified risks may be mitigated by changing how a proposed HAA flight is conducted. The operator must develop strategies and procedures for controlling risks imposed by identified hazards. For examples of mitigation, refer to Appendix A.
f. Calculation of Residual Risk. After risk is analyzed and quantified and then mitigated, the degree of residual risk is assessed. Residual risk is the safety risk that exists after all controls have been implemented or exhausted and verified.
g. Elevation of Higher Risk Analysis to Appropriate Management. An HAA operator is required to define risk-based flight authorization limits based upon a quantitative assessment of each specific flight operation. Higher risk assessments are referred to an appropriate manager with operations control authority.
h. Reconsideration of Flight Authorization. Material changes in any of the major risk factors considered in the decisionmaking process should trigger reconsideration of flight authorization. This especially applies to deterioration in weather or other environmental conditions or deterioration of patient condition resulting in an unplanned diversion.
3-5. LFAs (refer to § 135.609).
a. Establishing LFAs.
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(1) Each HAA base may establish one or more LFA. A LFA is considered a defined or bounded area within which a HAA pilot has demonstrated detailed local knowledge and within which lower Class G weather minimums may be applicable.
(2) A LFA may be symmetrical, such as an area encompassed by a fixed radius from a point designated by the operator or, alternatively, it may be asymmetrical, using landmarks and geographical features to bound the area. In any case, a designated LFA should not exceed 50 NM in any direction from the designated location.
(3) LFA(s) need not be contiguous. There is no requirement that a LFA for a particular base of operations consist of only one defined area. For example, if an operator that conducts HAA operations in a particular metropolitan area, but often transports patients to a regional trauma center outside that area, may choose to develop an additional LFA for assigned pilots to use when operating near the trauma center. While operating in-between LFAs, cross-country minimums would apply.
FIGURE 3-1. EXAMPLE OF LOCAL FLYING AREA(S) AND WHERE
CROSS-COUNTRY MINIMUMS APPLY
b. References. References to define a LFA may include:
(1) A specific radius from a point (if easily identified using installed operational avionics).
(2) Bounding natural and constructed references (rivers, shorelines, roads, railroads, etc.).
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(3) Governmental boundaries, if easily identified from the air.
(4) By describing an area bounded by natural, constructed or aeronautical reference points (shoreline points, islands, valleys, buildings, airports, very high frequency (VHF) omnidirectional range station (VOR), GPS waypoints, etc.).
(5) Any other reasonable description of an area that may be easily applied by a flightcrew, such as a predetermined route or system of routes.
c. Effects of LFA on Minimum Acceptable Weather Conditions. Establishment of a LFA allows for the use of lower weather minimums as specified in § 135.609. This is only available for use by pilots that have demonstrated LFA familiarity.
d. Demonstration of LFA Familiarity. A pilot must demonstrate a level of familiarity with a LFA by passing an examination given by the certificate holder within the preceding 12 calendar-months prior to using a LFA’s local area weather minimums as specified in § 135.609. This examination may be oral or written and may be part of a line check consisted under § 135.299. The manner of the examination must be described in the operator’s training program. The grace provisions of § 135.301 apply. This examination should include at least the following:
(1) Terrain features and LFA boundaries.
(2) Prominent obstructions including areas of obstruction.
(3) Minimum safe altitudes in the area.
(4) Weather producers (such as industrial areas, fog-prone areas, etc.).
(5) Areas of poor surface lighting and the effects of seasonal and other changes on surface lighting, as applicable to the area.
(6) Airspace control/air traffic facilities.
(7) Radar and communications coverage, including minimum altitudes for radar service and communications with air traffic facilities and company communications facilities.
(8) Airports/heliports/fuel sources, including night availability; available instrument approaches.
(9) Predominant air traffic flows.
(10) Landmarks and constructed features.
(11) Facility-specific information such as flight locating, dispatch and communications.
(12) Any emergency considerations specific to the area.
Par 3-5 Page 24 NOTE: A record of the examination must be kept in accordance with records retention requirements.
3-6. HAZARDS TO OPERATIONS: IDENTIFICATION AND MITIGATION.
a. Hazard Map. One (or more) hazard maps should be developed. While hazard maps should be developed to cover the entirety of each LFA, such maps may be more extensive than a LFA. The map should be reviewed and updated periodically or as new information becomes available. It should be displayed in a conspicuous location for pilots to review. All potential hazards should be annotated. Power lines, towers and tall structures in the vicinity of designated LZs are particularly important. A system to identify and depict newly-added hazards and to ensure pilots are aware of them should be developed. VFR/IFR transition corridors and preferred routes should appear on hazard maps. Recommended practices include treating the hazard map as a living document, updated by the use of grease pencils or map pins with appropriate notes or captions. Transient hazards (including those created by changing light and visibility or recorded in Notices to Airmen (NOTAM)) should appear on the map with their applicable times.
b. Flight Controls. Leaving the flight controls of a helicopter while rotors are turning is a potentially hazardous situation that may be encountered in HAA operations. While current regulations do not prohibit the pilot from leaving the controls while the helicopter is operating, HAA operators are urged to include procedures for accomplishing this safely in their documented operational procedures and training.
c. Magnetic Resonance Imagery (MRI) Systems. Caution should be used in vicinity of MRI systems. Interference from MRI systems may cause fluctuations in compass accuracy and in instruments for up to 30 minutes and render them unusable. MRI systems may also cause interference with full-authority digital electronic control (FADEC)-equipped aircraft.
3-7. HAA WEIGHT AND BALANCE (W&B) CONSIDERATIONS. Because of the need for specialized equipment, medical personnel and patients to be carried from a wide range of locations and in a wide range of conditions, W&B considerations for HAA operators differ from those of other part 135 operators. Most HAA helicopters have strictly limited payloads due to installed equipment configurations. This AC identifies requirements and best practices considerations.
a. W&B Requirements of HAA Operators. Certificate holders should develop a W&B program as illustrated in OpSpecs A096/A097, using actual weights for crewmembers, medical personnel and carryon medical equipment (not permanently installed on the aircraft), and only relying on solicited or estimated weights for patients, regardless of the size of the helicopter.
Certain medical equipment (e.g., isolettes and balloon pumps that are removed and replaced as needed) may not technically be installed but rather should be considered similar to carry-on baggage, be properly secured, and counted toward payload.
b. W&B Programs of HAA Operators. An approved W&B program is required to be documented and listed in the certificate holder’s General Operations Manual (GOM), if applicable. It will be approved in the operator’s OpSpecs. See guidance for OpSpecs A096/A097 for more details. A W&B control system may include the following:
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(1) An index-type W&B program that makes use of actual weights for crew members and equipment and average weights for patients may be established in accordance with the appropriate OpSpec (either A096 or A097) and the current edition of AC 120-27, Aircraft Weight and Balance Control. Company manuals should contain procedures for using, managing and updating W&B data. A loading schedule should be prepared composed of graphs and tables based on pertinent data for use in loading that particular helicopter in a rapid manner for HAA operations.
(2) Best practices in the industry are that operators prepare W&B for multiple configurations of each helicopter in terms of differences in occupants and equipment, especially common configurations (e.g., one or two pilots, one or two medical personnel, one or two patients, large carry-on equipment, balloon pumps, fuel in the most critical center of gravity (CG) locations, training configuration, etc.)
(3) Operators must amend individual helicopter W&B documentation when equipment is removed or replaced. If medical equipment is modified or medical supplies are upgraded, the operator must ensure the resulting changes in weight and location inside the helicopter are reflected in the W&B documentation required by the OpSpecs.
3-8. HELIPORTS/LZs. HAA operators should establish procedures for conducting airborne and ground reconnaissance of all types of heliports/landing zones. This is especially important for off-airport LZs or heliports not used on a routine basis.
a. LZ Criteria. Criteria should be established, documented and included in training programs to assess each heliport/LZ on a continuing basis prior to use. The operator should document criteria for LZ selection. These criteria should include size, obstructions, lighting, surfaces, wires and methods to determine wind direction, etc. A reporting system for unsatisfactory or dangerous conditions and a continuing LZ evaluation program should be part of HAA operations
b. Heliports. When part 135 HAA operations are conducted from established heliports, those heliports should meet the criteria established in the current edition of AC 150/5390-2, Heliport Design, to the maximum extent possible.
c. Approach/Departure. For operations over congested areas, ingress/egress routes to heliports or “scene” locations may have to be modified to adhere to best safety practices.
Whenever possible, helicopter operations should include the best practices of “flying neighborly,” as described in the Helicopter Association International (HAI) Fly Neighborly Guide.
d. Ground Security. Best practices suggest that an off-airport or heliport, LZ or “scene” location should be secured against incursions and other hazards by law enforcement or firefighters.
e. LZ Listing. HAA operators should maintain a listing of routinely used off-airport LZs containing pertinent information. This listing should be available to HAA pilots. A system should be established to familiarize pilots with all heliport/LZs serviced by a hospital or certificate holder. A method considered acceptable would be using photographs, drawings and
Par 3-8 Page 26 other descriptive means to identify each heliport/LZs with emphasis on timely recording of any obstructions. The site evaluation should include the following:
(1) Identification and/or removal of obstructions;
(2) Assessment of area lighting/transient light conditions;
(3) Awareness of helicopter ingress/egress limitations; and
(4) A reporting system for unsatisfactory or dangerous conditions.
3-9. OPERATIONS UNDER SPECIAL CONDITIONS.
a. Inadvertent Instrument Meteorological Conditions (IIMC).
(1) Operators should develop and document operational procedures for avoiding flight into IIMC along with procedures to be followed after IIMC is encountered. Both of these sets of procedures should include operations in an ATC radar environment as well as IIMC in isolated areas or a non-radar environment.
(2) Avoidance of entry into IIMC should be emphasized in HAA training and operations. A thorough weather briefing, proper analysis of weather (especially that potentially affecting in-flight route changes) and incorporation of adverse weather conditions into risk analysis should help prevent encounters with IIMC. HAA-appropriate training for IIMC flight is discussed in paragraph 4-3 of this AC.
(3) Some best practices for avoiding flight into IIMC include procedures that specify HAA pilots execute a contingency plan whenever speed or course adjustment is required due to deteriorating weather conditions. This contingency plan could be to execute a course reversal to leave the area of deteriorating weather or the execution of a precautionary landing to avoid entering IIMC.
(4) Procedures to be followed by a HAA pilot after entering IIMC should be developed and documented. These procedures should be tailored to each HAA base or operating area. For example, a HAA base that routinely operates near airports with an ATC control facility might establish procedures for contacting ATC and receiving radar vectors to visual meteorological conditions (VMC) or for an instrument approach. A base that operates in areas without local approach control or radar services might pre-designate airports in their service area where IAPs are available. Approach procedure information for those airports could then be kept in the cockpit, readily available should the need arise.
(5) HAA operators may request the use of a discrete transponder code from a local air traffic facility for use when conducting HAA operations in its area of responsibility. This would provide positive identification during an HAA flight.
(6) Operators are also encouraged to meet with local ATC facility personnel to formulate and coordinate instrument meteorological conditions (IMC) “emergency escape plans
Par 3-9 Page 27 and procedures” for participating HAA aircraft. These plans and procedures may be established with a letter of agreement (LOA) between an operator and its local air traffic facility.
(7) In the event IMC is inadvertently encountered, weather observations and forecasts assessed during the timely performance of preflight planning and the risk analysis process did not, in the pilot’s judgment, indicate that an IIMC event was likely, and the pilot subsequently performs an FAA accepted IIMC emergency recovery procedure, FAA personnel are discouraged from conducting enforcement against the pilot or the operator.
NOTE: IIMC avoidance and recovery training should in no way be construed as authorizing or condoning actual IMC flights without meeting IFR requirements.
b. Night Operations.
(1) A PIC must meet the requirements of 14 CFR part 61 and should complete the certificate holder’s night training before conducting any night operations. A certificate holder should develop and document procedures for maintaining night proficiency in HAA operations.
Pilots must be capable of meeting night recency of flight requirements to fly with or without night vision goggles (NVG). NVG recency of flight experience is defined in part 61, § 61.57(f).
(2) Night landings at unimproved sites, authorized by OpSpec A021, are permitted with adequate and appropriate lighting for the pilot to identify the landing site and surrounding hazards. Such lighting must be compatible with the Night Vision Imaging System (NVIS) if authorized and used.
NOTE: “Adequate” lighting allows a helicopter pilot to conduct a safe approach and landing during conditions of darkness while avoiding terrain and obstacles. The source of this lighting may be on the helicopter or on the surface and includes the possibility of vehicle-mounted lights being used to illuminate a landing site. Pyrotechnic road hazard flares are not recommended for illumination or marking a landing site.
c. Overwater Operations.
(1) Preflight passenger briefings for overwater flight must instruct on use of regulationcompliant life preservers and emergency exits. See the definitions in paragraph 1-6 for autorotational distance, shoreline, or suitable offshore heliport structure. (Refer to §§ 135.117,
135.167, and 135.168.)
(2) Best practices suggest that passengers be briefed anytime there is overwater flight although the regulations address only flights beyond autorotational distance.
d. Flat Light, Whiteout and Brownout. After April 22, 2015, in accordance with the requirements of § 135.293(h), all rotorcraft pilots must be tested on procedures for aircraft handling in flat light, whiteout and brownout conditions, including methods for recognizing and avoiding those conditions. HAA operators are susceptible to all of these conditions due to the nature of off-airport landings and operating in remote environments. These following are not
Par 3-9 Page 28 intended to be scientific explanations, but serve as operational definitions suitable for use by HAA operators. These terms should not be used interchangeably.
(1) Flat Light. Flat light is an optical condition, also known as sector or partial whiteout. It is not as severe as whiteout but this condition causes pilots to lose depth-of-field and vertical orientation. Flat light conditions are usually the result of overcast skies over snow or ice fields, inhibiting visual reference. Such conditions can occur anywhere in the world, primarily in snow-covered areas but they can also occur in dust, sand, mud flats or on glassy water. Flat light can completely obscure features of the terrain, creating an inability to distinguish distances and closure rates. As a result of this reflected light, it can give pilots the illusion of ascending or descending when actually flying level. However, with good judgment and proper training and planning, it is possible to safely operate aircraft in flat light conditions.
(2) Self-Induced Whiteout/Brownout. This effect typically occurs when a helicopter takes off or lands on a dusty or snow-covered area. The rotor downwash picks up particles and re-circulates them through the rotor system. The effect can vary in intensity depending upon the amount of light on the surface. This phenomenon can happen on the sunniest, brightest day with good contrast everywhere. However, when it happens, there can be a complete loss of visual clues. If the pilot has not prepared for this immediate loss of visibility, the results can be disastrous.
(3) Some resources that HAA operators have available to assist with training in these conditions include:
• Airman’s Information Manual, paragraph 7-5-13; and
• FAA FAASTeam Library, Flying in Flat Light and White Out Conditions.
e. Operations Involving Multiple Aircraft—General. HAA operator service areas often overlap other HAA operator service areas. Standardized procedures can enhance the safety of operating multiple helicopters at heliports, LZs and hospitals. Communication is critical to successful operations and maintaining orderly separation and coordination between helicopters, ground units and communication centers. HAA operators should establish joint operating procedures and provide them to related agencies.
f. Recommended Multi-Aircraft Landing Zone Procedures. Based on existing industry conventions and material in the AIM, best practices identified include: The first helicopter to arrive on−scene should establish communications with an on-scene ground unit when at least 10 NMs from the LZ to receive a LZ briefing and to provide incident command with the number of helicopters that can be expected. An attempt should be made to contact other helicopters on VHF communications frequency 123.025 megahertz (MHz) 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 MHz at least 10 NMs from the LZ. After establishing contact on 123.025 MHz, they should contact the ground unit for additional information. All helicopters should monitor 123.025 MHz at all times.
(1) If an LZ 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
Par 3-9 Page 29 helicopters. Recommended altitude separation between helicopters is 500 feet (weather and airspace permitting). Helicopters can orbit on cardinal headings from the scene coordinates.
(2) Upon landing in the LZ, the first helicopter should update the other helicopters on the LZ conditions, i.e., space, hazards and terrain.
(3) Before initiating any helicopter movement to leave the LZ, all operators should attempt to contact other helicopters on 123.025 MHz, and state their position and route of flight intentions for departing the LZ.
g. Recommended Multi-Aircraft Hospital Operations. 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 (if required, making contact through the use of the HAA operators’ communication center, flight following, etc.) before proceeding to the hospital.
(1) In the event of multiple helicopters arriving at a hospital heliport, each arriving helicopter should contact other inbound helicopters on 123.025 MHz and establish intentions.
(2) To facilitate approach times, the PIC of a helicopter occupying a hospital heliport should advise any other operators whether the patient will be off-loaded with the rotor blades turning or stopped, and the approximate time to do so.
(3) Before making any helicopter movement to leave the hospital heliport, all operators should attempt to contact other helicopters on 123.025 MHz and state their position and route of flight intentions for departing the heliport.
3-10. PATIENT/PASSENGER HANDLING/SAFETY.
a. Documentation of Procedures. Restraint of all personnel in flight is required by § 135.117. As in all part 135 passenger-carrying operations, passenger briefing cards are required in HAA operations. Operators are encouraged to document procedures for the proper restraint of all flight personnel and passengers and the proper use of seatbelts and shoulder harnesses during HAA operations. In addition, it is the responsibility of the PIC to insure passengers (such as hysterical or combative patients) who may pose a hazard to the aircraft or occupants are properly restrained before takeoff. Procedures detailing the proper restraint of patients/passengers should be detailed and documented, taking into account local law and applicable regulations.
b. Training in Procedures. A person designated and trained by the operator may conduct the passenger briefing required by § 135.117. If passenger briefing duties are delegated to non-flightcrew member, the procedure must be covered in the operator’s operations and training manual or other appropriate documentation.
3-11. BIOHAZARD CONTROL. HAA operators are encouraged to educate pilots, medical crewmembers, and maintenance personnel in mitigating exposure to blood borne pathogens and biohazards. They should observe universal precautions and receive appropriate vaccinations