I am the Pilot In Command of Helicopter Air Ambulance EC-130 helicopter and what I say is ‘Gospel’ inside the aircraft. Or maybe it is I am the Doctor and what I say is ‘Gospel’ in the Operating Room or the Trauma Bay. These are just two examples of how Crew Resource Management does not work.
Crew resource management (CRM) is defined as a set of training procedures for use in environments where human error can have devastating effects. Used primarily for improving air safety, CRM focuses on interpersonal communication, leadership, and decision making in the cockpit. However, CRM is so much more than how pilots interact inside of a cockpit. CRM relates to any occupation where good decision-making, communication and high situational awareness is required.
As a Helicopter Air Ambulance pilot I often witness this extraordinary dance within the back of the helicopter and also within the ER. I often follow the med crews down into the depths of most hospitals trauma centers. Being a Subject Matter Expert in Crew Resource Management I enjoy sitting back and observing the coordination that takes place amongst these professionals.
My First Scene Flight at Night
It was one of my first flights as a pilot going to a scene of a car accident. It was a really bad accident. We left the base after dark on Night Vision Goggles and proceeded to the landing zone. I could see the scene from a good distance away due to all of the flashing lights. On the way to the scene the crew mentioned to me that I might want to follow them down to the ER to truly get a feeling for how things worked in a Level One Trauma Center on a bad scene flight. After we touched down the med crew jumped out of the back of the helicopter and proceeded to the back of the ambulance. A few minutes later the doors opened and the crew was on the way back to the helicopter with the patient. Once inside the aircraft the crew immediately went to work on the patient. Unfortunately, once we took off out of the scene the patient coded and the crew started CPR.
As a pilot I have been in some extreme situation. I was part of the original combat operations in Afghanistan in 2001. I have lead mission where CRM and communication is paramount. I was now witnessing one of the most amazing displays of CRM that I had ever seen. The Flight Nurse and Flight Paramedic worked in unison on this patient. Their decision making, communication, and situational awareness of how to treat this patient was amazing to me. A life hung in the balance of these two professionals hands and the situation was changing second by second.
Upon arrival at the hospital pad I jumped out of the helicopter after shutting down. The crew was working feverishly in order to save this patients life. Communication was a constant stream of information between the crewmembers and now ground crews that were assisting with the patient. The patient was rolled into the trauma bay as the ER staff took over without skipping a beat. The Flight Medic stepped to the foot of the bed and in order to give the patient report. This communication was brief and concise. I was really impressed with the information transfer from the flight crew to the ER Staff. After finishing the report he swiftly stepped away. What I witnessed next seemed to be ‘controlled chaos.’ The amount of Crew Resource Management the transpired in the trauma bay was amazing to me. The doctor took over directing the actions all parties involved. Everyone had a job to do. The Decision Making, Communication and Situational Awareness is so important in order to save a patients life. Without a constant stream of information mistakes can be made.
CRM is not just for pilots. If you are in a job or position where you have to make decisions, communicate and have high situational awareness then Crew Resource Management is a the key to success.
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