Standard Number: DZ 8156

Ambulance New Zealand and AIA Draft Standard for Consultation

Air Sector – Ambulance and SAR Service Standard

EXPLANATORY NOTES FOR REVIEWERS

Credentials This document is a proposed industry standard issue as a draft in this form provides the opportunity for consideration and comment by the bodies and persons having an interest in the standard.

Commenting

Comments are invited, preferably in electronic format, on the technical content, wording and general arrangement of this draft. Please use the comments pages below for your comments.

Editorial matters (i.e. spelling, punctuation, grammar, numbering, references etc) will be corrected before final publication.

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If the draft is acceptable without change, an acknowledgement to this effect would be appreciated.

Normally no acknowledgement of comment is sent. All comments received by the due date will be put before the drafting committee. Where appropriate, changes will be incorporated before the document is formally approved.

Postal address 1: Postal address 2: Ambulance New Zealand Aviation Industry Association of NZ (Inc) P O Box 714 PO Box 2096 Wellington 6140 Wellington 6140

Telephone: (04) 499 2621 (04) 472 2707

Fax: +64 4 499 7223 +64 4 471 1314

Enquiries: David Waters Irene King

Email [email protected] [email protected]

Web site: NA www.aia.org.nz RECOMMENDED CHANGES TO DRAFT STANDARD

To: From: (Your Name and Address) David Waters Ambulance New Zealand P O Box 714 WELLINGTON 6140

Fax: +64 4 499 2621 Email: [email protected] Closing date for Date of your comments comment

30th August 2009

Title: Air Sector – Ambulance and SAR Services Standards

Comment is preferred in electronic format using Microsoft Word, following the layout below.

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of 42 SPECIFIC COMMENT

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Clause/ Recommended Changes and Reason Para/ Figure/ Exact wording of recommended changes should be given Table No

t f Draft V 0.7 a Public Comment Draft r D

Air Sector - Ambulance e and SAR Service

e Standards

t V 0.1 Draft March 2009 V 0.2 Draft May 2009 t V 0.3 Draft June 2009 i V 0.4 Draft June 2009 V 0.5 Draft June 2009 V 0.6 Pre-consultation doc June 15 2009 V 0.7 Consultation draft July 28 2009 m m DO NOT USE THIS DRAFT AS A STANDARD – IT MAY BE ALTERED BEFORE FINAL PUBLICATION

o Aviation Industry Ambulance New Zealand Association of NZ (Inc)

PO Box 714 PO Box 2096 Wellington 6140 Wellington 6140 C

of 42 Air Sector – Ambulance and SAR Service Standards

of 42 Version 0.6 June 2009 – comment draft Committee Representation

The combined Ambulance New Zealand and Aviation Industry Association of NZ (Inc) Expert Committee responsible for the preparation of the Standard and consisted of the following representatives:

NOMINATING ORGANISATIONS

Mark Masters Ambulance New Zealand & Committee Chair David Waters Ambulance New Zealand Rea Wikaira Aviation Industry Association of NZ (Inc) John Funnell Chief Pilot Pete Turnbull Chief Pilot Peter Kidd Chief Pilot Francis Kuriger Chief Pilot Grant Withers Chief Pilot Roger Hortop Chief Pilot Brent Williams Chief Pilot Toby Clark Chief Pilot & AIA Representative Donaleen Shiell NASO Nigel Clifford RCCNZ Shay McGuiness DHBNZ Auckland DHB Troy Browne DHBNZ BOP DHB Karen Hathaway Flight Nurses Association Dianna Keys DHBNZ BOP DHB Henny Nichols DHBNZ Capital and Coast DHB Flt Sgt Russell Clarke NZDF

REVIEW PERIOD

It is intended that this Standard remains a dynamic document reflecting the challenges and changes experienced by the aviation sector.

In order to achieve this, a regular review of the Standard is required to ensure it remains appropriate and applicable. It is intended to review this publication every three years.

COPYRIGHT

It is intended that this Standard is made readily available at no cost and can be obtained from either Ambulance New Zealand or the Aviation Industry Association of NZ (Inc) in hardcopy by request or by electronic means via the organisation’s web sites.

Sections of this document may be duplicated with appropriate reference to the source.

of 42 Version 0.6 June 2009 – comment draft Contents

Foreword 8 Background and intent...... 8 1 GENERAL...... 9 1.1 Scope of application...... 9 1.2 Interpretation and key definitions...... 9 1.3 Referenced documents...... 9 1.4 Exemptions...... 9 2 Pilots...... 10 2.1 Pilot in Command (PIC)...... 10 2.2 Co-pilot...... 10 2.3 Pilot Experience (Rotary) – Minimum Requirements...... 11 2.4 Pilot Experience (Fixed wing) – Minimum Requirements...... 12 3 Crew MEMBER Roles...... 13 3.1 Crew Member - General...... 13 3.2 Winch Operator...... 13 3.3 Air Observer...... 13 3.4 Clinical Support Crew...... 14 4 Risk Management...... 22 4.1 Human Factors and Crew Resource Management (CRM)...... 22 Criteria 4.1.2 Crew Resource Management Training should include but is not limited to:...... 22 4.2 Operational Risk Management...... 22 5 Air Ambulance Operations...... 23 5.1 Availability for Tasking...... 23 5.2 Preparedness and Activation...... 23 5.3 Crew Combinations...... 23 5.4 Equipment...... 23 6 Search and Rescue operations...... 24 6.1 Availability for Tasking...... 24 6.2 Preparedness and Activation...... 24 6.3 Crew Combinations...... 24 6.4 Equipment...... 25 7 CAPABILITY REQUIREMENTS FOR Specialist operations...... 26 7.1 Night Operations – aided and unaided...... 26 7.2 External Load Operations (Ref Civil Aviation Act Part 133)...... 27 7.3 Inshore/Offshore Operations...... 27 7.4 Beacon Search Operations...... 28 8 Ground facilities and Heliports...... 29 8.1 HELIPORTS...... 29 9 COMMUNICATIONS...... 29 9.1 Communication Equipment...... 29 10 Flight Safety enhancement devices...... 29 10.1 Collision Avoidance Systems (TCAS)...... 29 11 Patient Safety...... 30 11.1 Patient Loading and Unloading Procedures...... 30 11.2 Stretcher...... 30 11.3 Assisted Ambulatory...... 30 12 Quality Audit...... 31 12.1 Internal Quality Management Systems...... 31 12.2 Third Party Cerification to this Standard...... 31 Action Plan Checklist...... 37

of 42 Version 0.6 June 2009 – comment draft Foreword

Background and intent

The goal of this Standard is to ensure that quality of service provided by air ambulance/air rescue services in New Zealand promotes safety, consistency and is patient or recipient focused.

The concept of safety and risk minimisation underpins the development of this document and builds upon the excellent safety record experienced in the sector to date. All air providers wishing to provide these services shall meet the standards required within this document.

These standards have been peer reviewed and critiqued not only by the providers of air ambulance/air rescue services, but also key stakeholder organisations such as RCCNZ, ACC, other health providers, search and rescue organisations and medical experts. To ensure ongoing provision of the quality of standards required and ongoing compliance with CAA Rules, independent third party auditing of the service providers is required to demonstrate compliance. This ensures the standards are maintained and that operator Expositions comprise a living document, which can be amended and enhanced to keep in line with ongoing developments in technology and techniques.

The Standard contains minimum standards for pilots, crew, aircraft and essential equipment in order to promote consistency, quality and risk management practices ensuring that safety remains paramount in all aspects of air ambulance and air rescue service provision.

Important Note

The criteria listed in this standard are deemed to meet or exceed the current requirements of the Civil Aviation Act and associated Rules. No criteria should be interpreted at a level or standard lower than the minimum requirements specified in law. If and when the Civil Aviation Act or any associated Rule are modified these will take precedence over the requirement of this standard if the specified criteria within in document conflict with the law.

of 42 Version 0.6 June 2009 – comment draft 1 GENERAL 1.1 Scope of application

This Standard shall apply to any organisation that provides or operates: a. Air-based primary (emergency) ambulance services; b. Air-based secondary (IHT) ambulance services; c. Air-based search and rescue (SAR) responses; d. NZ registered aircraft for the transport of patients both domestically and internationally; or e. Operators of hospital helipads

1.2 Interpretation and key definitions

For the purposes of this Standard, the word 'shall' refers to practices that are mandatory for compliance with this Standard, while the word 'should' refers to practices that are advised or recommended.

The terms “Normative” and “Informative” have been used in this Standard to define the application of the Appendix to which they apply.

A “Normative” Appendix is an integral part of a Standard, whereas an “Informative” Appendix is only for information and guidance. Informative provisions do not form part of the mandatory requirements of the Standard.

See Appendix A for a list of defined terms and abbreviations used in this Standard.

1.3 Referenced documents

Reference is made in this Standard to the following:

AS/NZS 4360: 2004 Risk management AS/NZS 3551: 2004 Technical management programmes for medical devices NZS 8156: 2008 Ambulance and paramedical services

1.4 Exemptions

It is recognised that in exceptional circumstances services may be unable to fully meet the requirements of this Standard. Examples of this include but not limited to:  Pilot or crew sickness  Scheduled & unscheduled maintenance

Any operator who has a requirement to operate outside of the standard shall submit an application in writing to the administrator of the standard requesting an exemption from the standard.

Any request shall contain at least the following: 1 Area of the standard they seek an exemption from 2 Risk assessment of proposed operations 3 Mitigation or elimination procedures in place or proposed 4 Additional supervision or restrictions to be place on the exemption area requested.

The above requests for an exemption will be submitted by the standard administrator and reviewed by a minimum of two senior pilots with no direct interest in the operation requesting the application. They shall consider the application and make a decision to grant the exemption with or without restrictions or decline the application in writing.

Please refer to Appendix B - Exemption Form (to be developed)

of 42 Version 0.6 June 2009 – comment draft Page 10 of 42 Version 0.6 June 2009 – comment draft 2 PILOTS

2.1 Pilot in Command (PIC)

Outcome 2.1 The pilot in command shall have the required experience, training and currency to provide the safe operation of the aircraft in flight and maintain the safety and wellbeing of all passengers and crew.

Criteria 2.1.1 Experience - All pilots in command shall have acquired the specified minimum flying hours specified in Table 2 – Minimum operating Standards for air ambulance and air-SAR activities – Pilot in Command.

Criteria 2.1.2 Training - All pilots in command shall have acquired the specified minimum training requirements specified in Table 4 – Minimum education and training requirements for air ambulance and air-SAR activities (pilots).

Criteria 2.1.3 Skills maintenance and competency – All pilots in command shall participate in activities that maintain the skills and competencies required to operate as a pilot in command. Up to date documented records shall be maintained to demonstrate the on-going maintenance and acquisition of the required skills and experience.

Criteria 2.1.4 The pilot in command shall ensure that they operate their aircraft in a safe manner with respect to performance and in compliance with the operating limitations specified in the aircraft Flight Manual.

2.2 Co-pilot

Outcome 2.2 The Co-pilot shall have the required experience, training and currency to assist the pilot in command in the safe operation of the aircraft in flight and maintain the safety and wellbeing of all passengers and crew.

Criteria 2.2.1 Experience - All Co-pilots shall have acquired the specified minimum flying hours specified in Table 2 – Minimum operating Standards for air ambulance and air-SAR activities – Co-Pilot

Criteria 2.2.2 Training - All co-pilots shall have acquired the specified minimum training requirements specified in Table 4 – Minimum education and training requirements for air ambulance and air-SAR activities (Co-pilots).

Criteria 2.2.3 Skills maintenance and competency - All Co-pilots shall participate in activities that maintain the skills and competencies required to operate as a Co-pilot. Up to date documented records shall be maintained to demonstrate the on-going maintenance and acquisition of the required skills and experience.

Note: Competency-based approach to training and assessment The development of competency-based training and assessment should be based on a systematic approach whereby competencies and their standards are defined, training is based on the competencies identified, and assessments are developed to determine whether these competencies have been achieved.

of 42 Version 0.6 June 2009 – comment draft 2.3 Pilot Experience (Rotary) – Minimum Requirements

Outcome 2.3 The pilots experience shall be at a level necessary to safely operate a rotary wing aircraft within the potential range of environmental and metrological likely to be experience in an air ambulance or air rescue operation.

Criteria 2.3.1 The following requirements are considered to be the minimum pilot experience necessary to safely operate each of the rotary air ambulance and air rescue categories

2.3.1.1 Helicopter Cat 1, 2 and 3 Pilot in Command

VFR 2000 hours total aviation time. Night 30 hours plus unrestricted night rating ATOPs 75 Hours helicopter NVG Current as per AC and demonstrated IIMC and unusual attitudes recovery to IFR standard.

Up to 1000 hours of fixed wing time may be credited towards the 2000 hour requirement at a conversion rate of 2 fixed wing hours equalling 1 helicopter hour, to a maximum of 1000 hours (the credited hours count towards the helicopter “total aviation time” only, and not to the other individual skill minima i.e. Night (30), ATOPs (75), and NVG).

IFR Meet the above requirements Night 30 hours Multi IFR time 50 hours IMC 20 hours ATOPs 75 hours helicopter

2.3.1.2 Helicopter Cat 1, 2 and 3 Co-pilot

Commercial pilot’s license Night 15 hours IMC 10 hours

2.3.2.3 Helicopter Cat 4 Pilot in Command

Day VFR (only) Pilot in Command to have 1000 hours total aviation time. Up to 500 hours of fixed wing time may be credited towards the requirement at a conversion rate of 2 fixed wing hours equalling 1 helicopter hour, to a maximum of 500 hours. (The credited hours count towards the helicopter “total aviation time” only, and not to the other individual skill minima i.e. Night, ATOPS and NVG).

ATOPs 25 hours helicopter.

Winch and human sling loads Pilot in Command must be trained and current as detailed in CAA Part 133

of 42 Version 0.6 June 2009 – comment draft 2.4 Pilot Experience (Fixed wing) – Minimum Requirements

Outcome 2.4 The pilots experience shall be at a level necessary to safely operate a fixed wing aircraft within the potential range of environmental and metrological likely to be experience in an air ambulance or air rescue operation.

Criteria 2.4.1 The following requirements are considered to be the minimum pilot experience necessary to safely operate each of the fixed wing air ambulance and air rescue categories

2.4.1.1 Fixed wing Cat 1 and 2-Pilot in Command

SPIFR 1000 hours total aviation time as a pilot. IFR Multi time operational 50 hours IMC 50Hrs Night 25 hours ATOPs 50 Hours fixed wing

2.4.1.2 2-Pilot Operation

Where the pilot is operating with a co-pilot, the P in C to have a minimum of 750 hours total aviation time as a pilot.

IFR Multi 50 hours IMC 50 hours Night 20 hours ATOPs 50 Hours fixed wing

Co-pilot CPL IMC 40Hrs Night 15 hours fixed wing

2.4.1.3 Fixed wing Cat 3 and 4-Pilot in Command

VFR (only) 750 hours total aviation time as a pilot. On Type 40 Hours X Country 50 Hours

2.4.1.4 2-Pilot Operation

P in C to have a minimum of 500 hours total aviation time

On Type 40 Hours X Country 50 Hours

Co-pilot. CPL On Type Current X Country 20 Hours

of 42 Version 0.6 June 2009 – comment draft 3 CREW MEMBER ROLES 3.1 Crew Member - General

Outcome 3.1 The Crew Member shall have the required experience, training and currency in their specific roles to assist the pilot in command in the safe operation of the aircraft in flight and maintain the safety and wellbeing of all passengers and crew

Criteria 3.1.1 Experience and Training – All Crew Members shall meet the minimum training requirements for their specific roles specified in Table 3 – Minimum education and training requirements for air ambulance and air-SAR activities (non-pilot personnel). An Operator shall ensure that each Crew Member is competent to perform his/her duties in accordance with procedures specified in the Operations Manual.

Criteria 3.1.2 Skills maintenance and competency – All Crew Members shall participate in activities that maintain the skills and competencies for their specific roles required to operate as a Crew Member, as prescribed in the Operations Manual. Up to date documented records shall be maintained by the Operator to demonstrate the on-going maintenance and acquisition of the required skills and experience.

3.2 Winch Operator

Outcome 3.2 The Winch Operator shall have the required experience, training and currency to assist the pilot-in-command in the safe operation of the aircraft in flight whilst conducting winch operations.

Criteria 3.2.1 Experience – No person may act as a Winch Operator on a helicopter engaged in winching unless they have satisfactorily completed a course of training that meets current accepted practice, and be certified by an approved person. An approved person is an operator’s check and training pilot or winch operator as designated within the Operator’s Operations Manual procedures.

Criteria 3.2.2 Training – All Winch Operators will meet the minimum training requirements specified in Table 3 – Minimum education and training requirements for air ambulance and air-SAR activities (non-pilot personnel) for Rotary wing operations.

Criteria 3.2.3 Skills maintenance and competency – All Winch Operators shall participate in activities that maintain the skills and competencies required to operate as a Winch Operator, as prescribed in the Operations Manual. Up to date documented records shall be maintained by the Operator to demonstrate the on-going maintenance and acquisition of the required skills and experience.

3.3 Air Observer

Outcome 3.3 The Air Observer(s should have the required experience, training and currency to safely and effectively conduct visual observation duties during the flight

Criteria 3.3.1 Experience - All Air Observers should have participated regularly in air operations that enable them to maintain the skills required to be an effective Air Observer.

of 42 Version 0.6 June 2009 – comment draft Criteria 3.3.2 Training – All Air Observers should complete the Police/RCCNZ Air Observers recognised training course or an equivalent course.

Criteria 3.3.3 All Air Observers shall meet the minimum training requirements specified in Table 3 – Minimum education and training requirements for air ambulance and air-SAR activities (non-pilot personnel). An Operator shall ensure that each air observer is competent to perform his/her duties in accordance with procedures specified in the Operations Manual.

Criteria 3.3.4 Prior to any Search flight, or series of flights, Air Observers shall be briefed on the following (as per table 3):  Familiarisation with the helicopter/aeroplane type operated  Entry and exit under normal and emergency conditions both for self and patients  Use of the relevant equipment to ensure security of the individual  The use of aircraft intercommunication system  Location and use of onboard fire extinguishers.

Criteria 3.3.5 Skill maintenance and competency. All Air observers shall participate in activities that maintain the skills and competencies required to be an effective Air Observer. Up to date records shall be maintained to record the on-going practice of the skills and attitudes required to demonstrate proficiency in the role.

3.4 Clinical Support Crew

Outcome 3.4 A Clinical Support Crew member carried in an aircraft (including but not limited to doctors, nurses, paramedics and ambulance officers) who has the required experience, training and skills to care for the patients on board. Medical Passengers may perform this role infrequently or as a one-off.

Criteria 3.4.1 Experience and Training – All Clinical Support Crew members shall meet the minimum training requirements for their specific roles specified in NZS 8156: 2008 and Table 3 – Minimum education and training requirements for air ambulance and air-SAR activities (non-pilot personnel). An Operator shall ensure that each Crew Member is competent to perform his/her duties in accordance with procedures specified in the Operations Manual.

Criteria 3.4.2 Medical Passenger - Prior to any flight, or series of flights, Medical Passengers shall be briefed on the following by the most appropriate crewmember: 1. Familiarisation with the helicopter/aeroplane type operated 2. Entry and exit under normal and emergency conditions both for self and patients 3. Use of the relevant onboard specialist medical equipment 4. Method of supervision of other medical staff 5. The use of aircraft intercommunication system 6. Location and use of onboard fire extinguishers.

Criteria 3.4.3 Skills maintenance and competency – All Clinical Support Crew members shall participate in activities that maintain the skills and competencies for their specific roles required to operate as a Crew Member, as prescribed in NZS 8156: 2008 and the Operations Manual. Up to date documented records shall be maintained by the Operator to demonstrate the on-going maintenance and acquisition of the required skills and experience.

Crew Member is defined as anyone apart from the pilot or co-pilot who is required as part of their role to assist the pilot or co-pilot in the execution of their duties. Page 15 of 42 Version 0.6 June 2009 – comment draft Clinical Support Crew is defined as anyone apart from the pilot or co-pilot who is required as part of their role to assist or care for patients whilst in transport and is expected to perform this clinical role regularly as required by their position specification.

Medical Passenger is defined as anyone apart from the pilot or co-pilot who is required as part of their role to assist or care for patients whilst in transport on a non-regular or one-off basis.

of 42 Version 0.6 June 2009 – comment draft Table 1 - Aircraft categorisation and mission capability For the benefit of this standard, aircraft have been grouped in the following manner: Emergency (Primary) Level 1 Level 2 Search and Search and Search Search Aircraft Category response (full ICU) transfer (non-ICU) transfer Rescue Rescue only only usually dispatched by Daylight the EACCs) (usually step-up care) (usually step-down 24 hrs only Daylight care) 24 hrs only Fixed Wing Cat 1 – Air Ambulance/Search and Rescue NA YES YES NA NA YES NA

Fixed Wing Cat 2a – Yes Air Ambulance/Search and Rescue NA Limited as unpressurised YES NA NA YES NA

Fixed Wing Cat 2b – Air Ambulance/Search and Rescue Yes NA YES NA NA YES NA

Fixed Wing Cat 3 – Air Ambulance/Search and Rescue NA NO YES Yes NA yes YES

Fixed Wing Cat 4 – Search Only NA NA NO NO NA NO YES

Rotary Wing Cat 1 – Air Ambulance/Search and Rescue YES YES YES YES NA YES NA

Rotary Wing Cat 2 – YES Air Ambulance/Search and Rescue YES YES Limited YES NA YES NA as not IFR Rotary Wing Cat 3 – Air Ambulance/Search and Rescue YES YES YES YES Limited as NA YES NA not IFR Rotary Wing Cat 4 – Search Only NO NO NO NO YES NO no

A full description of the requirements for each Category follows in Table 2.

of 42 Version 0.6 June 2009 – comment draft Table 2 – Minimum operating standards for air ambulance and air-SAR activities (applies to unrestricted pilots)

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t o C l I i P p - o C Fixed Wing Aircraft Cat 1 Yes NA NA Yes NA Yes No 1000 25 50 NA Yes 24 hrs R* NA Yes Single pilot hrs hrs Two pilots 1000 750 Cat 2a Yes NA NA Yes NA No Yes 1000 25 50 NA Yes 24 hrs R* NA Yes Single pilot hrs hrs Two pilots 1000 750 Cat 2b (e.g.PC12) NA Yes NA Yes NA Yes No 1000 25 50 500 Yes 24 hrs R* NA Yes Single pilot hrs Hrs Two pilots 1000 750 Cat 3 Yes Yes No No Yes No Yes 1000 25 NA NA Yes Daylight R* NA Yes Single pilot hrs only Two pilots 1000 750 SAR Cat 4 NA NA Yes No Yes No Yes 750 NA NA NA Yes Daylight NA NA Yes Single pilot only Rotary Wing Aircraft Cat 1 Yes NA No Yes No NA NA 2000 50- 50 NA 10 hrs 10 hrs Yes 24 hrs R* Yes Yes

Single pilot Rotary XC

Hrs hrs Two pilots 2000 500 Cat 2 Yes NA No No Yes NA NA 2000 15- NA NA 10 hrs 10 hrs Yes 24 hrs R* Yes Yes

Hrs hrs Two pilots 2000 500 Cat 3 NA Yes No No Yes NA NA 2000 15- NA NA 10 hrs 10 hrs Yes 24 hrs R* Yes Yes

Hrs hrs Two pilots 2000 500

of 42 Version 0.6 June 2009 – comment draft SAR Cat 4 No No Yes No Yes NA NA 750 NA NA NA 10 hrs 10 hrs R Daylight NA NA Yes

Single pilot Rotary or GPS only - R

Hrs Legend: R = Recommended, R* = Recommended in congested air-traffic areas, XC = Cross country, IMC – experience can be gained from either FW or RW Table 3 – Minimum education and training requirements for air ambulance and air-SAR activities (non-pilot personnel who as part of their employment or contract requirements fulfil a crew or clinical role) t t e s s s s s s s y s s s s g n n g n g d n g f l M l l h r e e e e e e d n n g n o o n o a n o n o o o r r i i r i i i r i i i g R a r s u u o o o i t t t c c c i l s t l u u u n u d i n c o s w C c q i a a i t i f r o o s i o o a t d d t d t d n b e / i a o t a t a a t l f

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t o t h d h m t t s d i t s n e a o v h a f y s V i n g i t n g f n c g r r l s n n h t i c i m e c a c y a e o n l a e N l a a r e u l r a r i o i a g r n f o o i i n f i i r t F l a f c f r l m S t d p s e d t a d e g t C a r f e e e a e i p n p p - y

S n g i d n t l i h u h m s l i l r a S c t o o n a A v a c n l u g i l I a u r e d o i n t a M u a q c A g r c n H y a w m i n e i i t s v m o u E n f E c o g g i i r , n e s s e l s d y r n i c o t s h g e o t u t t l n e e f r e e V c d c o h n a o f d a g u

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U d - g n n n I a i l l m e u u f H e R

Fixed Wing operations Crew member                      Clinical Support Crew                     Air Observer                     

Rotary wing operations Crew member                          Clinical Support Crew                         Air Observer                   Page 19 of 42 Version 0.6 June 2009 – comment draft Page 20 of 42 Version 0.6 June 2009 – comment draft Table 4 – Minimum education and training requirements for air ambulance and air-SAR activities (Pilots)

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Fixed Wing operations Pilot in Command                     Co- Pilot                    

Rotary wing operations Pilot in Command                        

Co- Pilot                        

of 42 Version 0.6 June 2009 – comment draft Table 5 – Minimum equipment requirements for air ambulance and air-SAR activities l ) ) ) y e k s k s s g

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m i v u c D i m e i q D m v v n A i r e o t u u C c n S m e o t i t m o a r o c P i C n u m m o C Fixed Wing Cat 1 Air Ambulance Search and   *  *      * p* *  Rescue Fixed Wing Cat 2a Air Ambulance Search and   *  *      * p* *  Rescue Fixed Wing Cat 2b Air Ambulance Search and   *  *      * p* *  Rescue Fixed Wing Cat 3 Air Ambulance Search and   *  *      * p* *  Rescue Fixed Wing Cat 4 Search and Rescue   *  * N/A N/A N/A N/A N/A * p* * 

* = if aircraft used for SAR activities. p* = preferred if aircraft used for SAR activities (nor mandatory)

of 42 Version 0.6 June 2009 – comment draft oay Wn a – 4 Cat Search Rescueand Wing Rotary and Rescue Search –Air Ambulance 3 Cat Wing Rotary and Rescue Search –Air Ambulance 2 Cat Wing Rotary and Rescue Search Air Ambulance - 1 Cat Wing Rotary  Page Page * = if aircraft used for SAR activities. SAR for aircraftused activities. if = 23 of 42 Version June 0.6 – comment2009 draft

    Survival gear (adequate and appropriate)    Ambient temperature / climate control      p* Communication equipment - radio = preferred if aircraft used for SAR activities (norSAR for aircraftusedmandatory) activities if preferred =

    Communications equipment – intercrew     Communications equipment – Satellite phone * N/A    Stretchers N/A    Medical securing system or rack N/A    Power supply 12, 24v Dc / 240v AC N/A    Overhead hooks

   Lighting – task/patient lighting

   Lighting – crew torches

   Storage space -    

p* p* p* p* Direction finding/homing (406 MHz )     Direction finding/homing (121.5 MHz)

    Protective clothing / helmets suitable for task 4 RISK MANAGEMENT 4.1 Human Factors and Crew Resource Management (CRM)

Outcome 4.1 The service shall have a fully implemented CRM Programme that ensures professional and proficient crew communication and participation in order to achieve safe flying and operational practices.

Criteria 4.1.1 Crew Resource Management - Each operator shall have a program that all operational staff are familiar with that clover the following:

4.1.1.1 Improving communication and leadership skills among all team members. 4.1.1.2 Integrating checklists and error traps into everyday practice, reducing the risk of error. 4.1.1.3 Promoting a culture supporting professional development. 4.1.1.4 Improving employee performance and staff retention. 4.1.1.5 Assisting to make facilities and operations safer and more efficient.

Criteria 4.1.2 Crew Resource Management Training should include, but is not limited to:

4.1.2.1 What is CRM? 4.1.2.2 Human error 4.1.2.3 Human Factors – fatigue, stress etc 4.1.2.4 Communication - Barriers To Communication, Advocacy/ Assertiveness 4.1.2.5 How Assertive Should You Be, Listening, Conflict Resolution etc 4.1.2.6 Team work – command and leadership, briefings, debriefings 4.1.2.7 Decision making – decision-making styles 4.1.2.8 Threats To Effective Decision Making, Good Decision Making 4.1.2.9 Attitudes- Anti-authority, Impulsiveness, Invulnerability, Macho, Resignation 4.1.2.10 Situational awareness- What is it, Relationship to Information 4.1.2.11 Processing, Loss of situational awareness, Preventing and minimizing, CFIT Cause Factors.

4.2 Operational Risk Management

Outcome 4.2 A fully implemented operational risk management program maximises aviation safety.

Criteria 4.2.1 The operator shall have a fully implemented risk management program which utilises the principles of risk assessment - acceptable, acceptable with mitigation and unacceptable. AS/NZS 4360 provides an example of this

Note: The minimum standard or requirement is the CARs however, the CAA Act allows for in certain circumstances a lesser of these rules where there is a threat to life or property. Operators/Pilots must use risk assessment, taking into account items on the Action Plan checklist prior to conducting operations. . An example of this is provide in Appendix C

of 42 Version 0.6 June 2009 – comment draft 5 AIR AMBULANCE OPERATIONS 5.1 Availability for Tasking

Outcome 5.1 The air ambulance asset shall be available for tasking for the date and time periods as agreed in formal contract or Service Level Agreements concluded with the tasking agency or contracting authority.

Criteria 5.1.1 The response aircraft or helicopter is available for tasking.

Criteria 5.1.2 Specialist role equipment necessary to ensure the required ambulance capability is fitted or available to be fitted to the aircraft or helicopter.

Criteria 5.1.3 Appropriate personnel are available to crew and operate the aircraft or helicopter for the air ambulance incident.

5.2 Preparedness and Activation

Outcome 5.2 The air ambulance asset shall meet the preparedness requirements as agreed in formal contract or Service Level Agreements concluded with the tasking agency or contracting authority.

Criteria 5.2.1 Air ambulance assets are to respond to requests for dispatch in a timely manner with due consideration for all safety planning and preparation necessary to ensure a safe response. Air ambulance assets shall inform the tasking authority of the anticipated time to get airborne following a request to dispatch in light of the requirement above.

Note: It is the primary goal for air ambulance assets to respond in as short a time period as possible, but this should never be to the detriment to flight safety. Therefore while there will be no stated response time requirements all operators undertake to respond as soon as operational requirements allow.

5.3 Crew Combinations

Outcome 5.3 The air ambulance asset provides the appropriate crewing capabilities for the known patients status and any specialised skills necessary to retrieve the patient safely.

Criteria 5.3.1 The combination of crew roles shall be determined by the requirements of each specific mission.

Criteria 5.3.2 Minimum clinical crewing requirements as specified in NZS 8156 shall be met. Safety of the operation and the crew is however the top priority

5.4 Equipment

Outcome 5.4 The air ambulance asset provides the appropriate equipment for the known patients status and any specialised requirements necessary to retrieve the patient safely.

of 42 Version 0.6 June 2009 – comment draft Criteria 5.4.1 The requirements of each specific mission shall be based on the clinical needs of the patient and this shall determine the selection of air ambulance assets, general and specialised medical equipment and recovery equipment.

5.4.2 Medical equipment, stretchers, and associated restraint systems shall meet any required Standard and be maintained in compliance with the manufactures specifications.

5.4.3 Oxygen supplies shall be maintained in order to assure an adequate supply is available.

5.4.4 Equipment power supplies shall ensure an uninterrupted supply at the appropriate voltage.

6 SEARCH AND RESCUE OPERATIONS 6.1 Availability for Tasking

Outcome 6.1 The response asset is available for tasking for the date and time periods as agreed in formal contract or Service Level Agreements concluded with the tasking agency or authority.

Criteria 6.1.1 The response aircraft or helicopter is available for tasking.

Criteria 6.1.2 Specialist role equipment necessary to ensure the required SAR capability is fitted or available to be fitted to the aircraft or helicopter.

Criteria 6.1.3 Appropriate personnel are available to crew and operate the aircraft or helicopter for the SAR operation.

6.2 Preparedness and Activation

Outcome 6.2 The response asset will meet the preparedness requirements as agreed in formal contract or Service Level Agreements concluded with the tasking agency or authority.

Criteria 6.2.1 SAR assets are to respond to requests for dispatch in a timely manner with due consideration for all safety planning and preparation necessary to ensure a safe response. Following a request to dispatch, SAR assets shall inform the tasking authority of the anticipated time to get airborne in light of the requirement above.

Note: It is a primary goal for SAR assets to respond in as short a time period as possible, but this should never be to the detriment to flight safety. Therefore while there will be no stated response time requirements all operators undertake to respond as soon as operational requirements allow.

6.3 Crew Combinations

Outcome 6.3 The response asset crewing provides the appropriate capabilities for the SAR operation tasking.

Criteria 6.3.1 For a SAROP that is expected to involve a search element and a rescue

of 42 Version 0.6 June 2009 – comment draft element the following criteria should be met:

6.3.1.1 Safe and effective support of the operation of the aircraft or helicopter in the prevailing and forecast conditions; 6.3.1.2 Safe and effective operation of the search equipment deployed on the aircraft or helicopter;

6.3.1.3 Safe and effective operation of the human recovery system(s) fitted to the aircraft or helicopter;

6.3.1.1 Safe and effective air observation capability;

6.3.1.2 Safe and effective clinical support for person(s) in distress; 6.3.1.6 Safe and effective operation and survival if deployed from the aircraft given the prevailing and forecast environmental conditions in the operating area.

Criteria 6.3.2 For a SAR operation that is expected to involve only a search element the following criteria should be met:

6.3.2.1 Safe and effective support of the operation of the aircraft or helicopter in the prevailing and forecast conditions; 6.3.2.2 Safe and effective operation of the search equipment deployed on the aircraft or helicopter. 6.3.2.3 Safe and effective air observation capability.

6.4 Equipment

Outcome 6.4 The SAR asset provides the appropriate equipment for the known patients status and any specialised requirements necessary to retrieve the patient safely . Criteria 6.4.1 The equipment requirements of each specific mission shall be based on the clinical needs of the patient and this shall determine the selection of SAR assets, general and specialised recovery equipment.

6.4.2 Rescue equipment, search equipment, and recovery systems shall meet any required Standard and be maintained in compliance with the manufactures specifications.

of 42 Version 0.6 June 2009 – comment draft 7 CAPABILITY REQUIREMENTS FOR SPECIALIST OPERATIONS 7.1 Night Operations – aided and unaided

Outcome 7.1 The following requirements are for all helicopter night VFR air ambulance and search and rescue operations.

Criteria 7.1.1 All helicopter night VFR air ambulance and search and rescue operations shall be conducted utilising Night Vision Imaging Systems (NVIS) in accordance with CAA Advisory Circular AC 91-13 and the applicable RFM Supplement, or under instrument flight rules (IFR). Note, AC 91-13 states that safe night vision goggle (NVG) flight operation is based on the assumption that the pilot can maintain VFR flight unaided in the event that NVG imagery is lost or degraded.

7.1.2 Weather - Pilots undertaking VFR night flying operations shall maintain a minimum visibility of 8 kilometres at all times, a cloud base no lower than the minimum of 2000 feet above ground level (AGL) in uncontrolled airspace and 1500 feet AGL in controlled airspace, provided that:

If it is necessary to undertake a VFR night flying operation in order to preserve life; and the cloud base is below the aforementioned minima, the pilot-in- command shall immediately inform the relevant Air traffic Control tower of the action and notify the Director of the Civil Aviation Authority via a Section 13A report as soon as practicable.

This being the case it is recommended that no VFR night flying operations are undertaken where cloud base is below the minimum of 1000 feet above the terrain over which the helicopter is travelling. .

7.1.3 Equipment – Further to the requirements of CAA Advisory Circular AC 91-13 and the applicable RFM Supplement (for NVIS operations), the helicopter utilised for night VFR operations shall be equipped with the following:  A radar altimeter equipped with a pilot programmable warning bug (an audio and/or visual warning device)  A second artificial horizon  A nitesun or pilot directionally controlled flood light  Terrain awareness warning – either a GPS moving map with terrain warning information or EGPWS.

7.1.4 Experience & Training – all pilots to have the required experience and training as specified in Table 2 – Minimum operating Standards for air ambulance and air-SAR activities – Pilot in Command, and Table 4 – Minimum education and training requirements for air ambulance and air-SAR activities (pilots).

7.1.5 Operational Procedures:

7.1.5.1 Inadvertent Instrument Meteorological Conditions (IIMC) – All flight crew shall be familiar with the procedures that should be adopted in the event of IIMC conditions being experienced. Each operator is required to adopt and implement procedures, dependent on the equipment contained in the helicopter, and on the experience of the flight crew. The pilot flying the helicopter should be the holder of an Instrument Rating.

of 42 Version 0.6 June 2009 – comment draft 7.1.5.2 Crew Composition – If a Crew Member is being utilised in a single pilot operation at night, they should be trained in the use GPS and other navigation equipment. This will enable the crewmember to enter waypoints, assist the pilot in night operations and consequently reduce the workload on the flying pilot. The Crew Member should have reasonable access to the radio and navigation equipment. 7.1.5.3 Landings to unprepared sites, or if operating at low level (below 500 feet AGL) requires two trained members on NVGs or use of an autopilot and at least one crew member on NVGs.

7.2 External Load Operations (Ref Civil Aviation Act Part 133)

Outcome 7.2 The service shall have an approved section in their expositions or operations manuals with standard operating procedures appropriate to the type of Part 133 operation they conduct.

Criteria 7.2.1 Human Static line/ Strop - All Pilots, crewmembers and rescue personnel who conduct static line / Strop operations shall complete a training course comprising of equipment familiarisation, normal and emergency operations.

7.2.2 Winch - All Pilots, crewmembers and rescue personnel who conduct winch operations shall complete a training course comprising of equipment familiarisation, normal and emergency operations.

7.2.3 All equipment shall meet CAA requirements as well as the AS/NZ 1891.1 for testing/checking and lifetime criteria.

7.2.4 All pilots and crewmembers shall complete annual external load operation proficiency training.

7.2.5 Due to the reduced risk and efficiencies provided by winching operations compared to human static-line operations, wherever possible preference should always be given to carrying out the required task using the winch method. Use of a winch or long line shall be decided by the pilot in command in connection with the crew as to the best method to recover the person/s

7.2.6 Human static-line operations shall not be performed at night. 7.3 Inshore/Offshore Operations

Outcome 7.3 The operator has a safe and consistent level of standards and equipment for over water operations

Criteria 7.3.1 Lifejackets 7.3.1.1 Up to 10 nautical miles from shore - All aircraft - Life jackets must be carried and readily accessible to all occupants. 7.3.1.2 Beyond 10 nautical miles from shore - All helicopters - Lifejackets must be worn.

Criteria 7.3.2 Life rafts 7.3.2.1 Up to 10 nautical miles from shore - All aircraft - Life rafts not required. 7.3.2.2 Beyond 10 nautical miles from shore - All Helicopters - Life rafts sufficient to accommodate all occupants must be carried. Life rafts to be equipped to CAR 91.525 (b).

Criteria 7.3.3 Aircraft floats 7.3.3.1 Up to 10 nautical miles from shore - All aircraft - not required.

of 42 Version 0.6 June 2009 – comment draft 7.3.3.2 Beyond 10 nautical miles from shore - Single engine helicopters - shall be float equipped, or occupants must have available survival suits. All other aircraft - Floats not required.

Criteria 7.3.4 Survival suits 7.3.4.1 Up to 10 nautical miles from shore - All aircraft - not required. 7.3.4.2 Beyond 10 nautical miles from shore - Single engine helicopters - occupants must have available survival suits. All other aircraft - occupants must have available survival suits.

Criteria 7.3.5 Top Cover 7.3.5.1 Up to 100 nautical miles from shore - All aircraft - Top cover is recommended. 7.3.5.2 Beyond 100 nautical miles from shore - All helicopters - Top cover should be provided at the discretion of the operator and in consultation with the tasking authority.

Criteria 7.3.6 Fuel Requirements 7.3.6.1 All aircraft -  CAR 91.305 for VFR operations – Helicopters - 30 minutes Air planes – 45 minutes  CAR 91.403 for IFR operations – Helicopters - 30 minutes Air planes as per CAA requirements

Criteria 7.3.7 Helicopter Underwater Emergency Training (HUET) 7.3.7.1 Regular Crewmembers (Crewmembers participating in offshore operations greater than 3 times) - Should/Shall have received HUET training. 7.3.7.2 Non-regular crewmembers shall be briefed on all aspects of offshore operations, emergency and non-emergency. 7.4 Beacon Search Operations

Outcome 7.4 Safe, effective and efficient location of distress beacons transmitting location and homing signals.

Criteria 7.4.1 Tasking. The Coordinating Authority that tasks the search asset will provide all available information concerning the task.

7.4.2 Direction finders. Search assets: 7.4.2.1 Should have the capability (equipment, training, experience, and currency) to detect and locate transmissions made on 406 MHz. 7.4.2.2 Shall have capability (equipment, training, experience, and currency) to detect and locate transmissions made on 121.5 MHz.

7.4.3 Search techniques. Search assets shall have the capability (equipment, training, experience and currency) to employ standard search techniques and complete standard search patterns as passed to them by the Coordinating Authority. 7.4.4 Specialized training. Search assets should, undertake any specialized training necessary to ensure that the search capability is available when tasked.

7.4.5 Crew and equipment. Search assets shall be crewed and equipped so as to ensure safe and effective operation of the search equipment deployed.

of 42 Version 0.6 June 2009 – comment draft 8 GROUND FACILITIES AND HELIPORTS

8.1 HELIPORTS

Outcome 8.1 All hospital heliports operators should meet the standards of heliports as recommended in CAA Advisory Circular AC 139-8 Aerodrome design, heliports.

Criteria 8.1.1 Any alterations or infringements that affect existing hospital helipads / landing areas shall be notified to their service provider prior to change, renovation or

8.1.2 Any new Hospital helipads shall meet the requirements of AC 139-8 and the local or Air Ambulance service provider to be consulted prior to implementation

8.1.3 Hospital Heliports should have facilities to access hospitals without an ambulance required as well as access via pathways to allow for stretcher trolleys and equipment.

9 COMMUNICATIONS 9.1 Communication Equipment

Outcome 9.1 The service shall have a range of communication devices approved for the aviation environment that provides two-way communication with the tasking agency in the expected operational environment.

Criteria 9.1.2 In addition to the aviation radios and navigation equipment required to meet the CAA rules for IFR or VFR as appropriate, each aircraft shall have the following;

Criteria 9.1.3 The service has a GPS device suitable for the aviation environment that provides in-flight programming of a search pattern, with recording and up- loading of the tracks flown to the tasking agency provided by the GPS or Tracking tool.

Criteria 9.1.4 The service has an in-flight position reporting device approved for the aviation environment that provides position reporting at a minimum of 5 minute intervals to the tasking and flight following agency.

Criteria 9.1.5 For Search and Rescue missions in the marine environment assets shall be equipped with marine radios able to communicate with surface vessels.

10 FLIGHT SAFETY ENHANCEMENT DEVICES

10.1 Collision Avoidance Systems (TCAS)

Outcome 10.1 It is recommended each service, that operates continually in an airspace where there is heavy traffic and the majority of other traffic have transponders operating, should have a TCAS/TAS/TPAS Traffic Advisory System approved for the aviation environment that provides a backup to the "SEE and AVOID" concept in areas of high traffic density.

Criteria 10.1.1 The system should have an audible advisory of traffic threat.

of 42 Version 0.6 June 2009 – comment draft 10.1.2 The system should have a visual display to show location and bearing of traffic threat.

of 42 Version 0.6 June 2009 – comment draft 11 PATIENT SAFETY 11.1 Patient Loading and Unloading Procedures

Outcome 11.1 Patient loading and unloading device shall meet OSH guidelines for safe staff lifting requirements (16.6 kg for women and 25 kg for males).

Criteria 11.1.1 The lifting device is lightweight and configured to be operated by one person, not lifting more than recommended weight

11.1.2 The loading device can be stored at airport locations or carried on the aircraft

11.1.3 That lifting devices are maintained according to manufactures instructions

11.1.4 The weight safety limit is documented on the device

11.1.5 Special considerations for bariatric patients

11.2 Stretcher

Outcome 11.2 The stretcher used in the aircraft meets all service and safety requirements Refer to CAA FAR 23.785, FAR 23.561. To work towards using standardized equipment .

Criteria 11.2.1 Medical equipment is secured to the stretcher and meets safety requirement

11.2.2 The stretcher is light and easy to secure and load in the aircraft

11.2.3 That lifting risks have been minimised by the service

11.2.4 The stretcher has the appropriate occupant restraints that have met load tests as per CAA FAR 23.561

11.2.5 Stretchers are compatible with all interfacing services e.g. ambulance

11.3 Assisted Ambulatory

Outcome 11.3 Patients are safely assisted onto the aircraft

Criteria 11.3.1 That all staff are aware of the weight limitation on the stairs

11.3.2 That patients/relative are assessed to comply with limitation of space and weight

11.3.3 That infants and children are secured in the appropriate restraining device.

of 42 Version 0.6 June 2009 – comment draft 12 QUALITY AUDIT

12.1 Internal Quality Management Systems

Outcome 12.1 The service shall have a Internal quality system which supports safety and provides all personnel with a safe and healthy working environment.

Criteria 12.1.1 Air Ambulance services shall have a fully implemented quality management system that either complies with, CAA Rule Part 119 or is equivalent to ISO 9000.

12.1.2 Air Ambulance Services should be certified to NZS 8156.

12.1.3 The Air Ambulance Services develops and implements policies and procedures that are aligned with current good practice and service delivery, meet the requirements of legislation and are reviewed at regular intervals.

12.1.4 There is a document control system to manage the policies and procedures. This system shall ensure documents are approved, up to date, available to staff and managed to preclude the use of obsolete documents.

12.1.5 A process to measure ongoing achievement against the quality and risk management system is implemented.

12.1.6 A corrective action plan addressing areas requiring improvement in order to meet the specified Standard or requirements is developed and implemented. 12.2 Third Party Cerification to this Standard

Outcome 12.2 The service is independently certified to this Standard

Criteria 12.2.1 The service shall contract an independent third party audit agency to confirm compliance with this standard.

12.2.2 The service shall ensure the third party audit agency utilises the appropriate mix of auditor competency and specific industry and technical knowledge to audit the service against this Standard

12.2.3 The third party audit agency shall be endorsed by either Ambulance New Zealand or the Aviation Industry Association.

of 42 Version 0.6 June 2009 – comment draft Appendix A (these need to be reviewed and deleted/added to) Explanation of terms (Normative)

For the purpose of this Standard, the following abbreviations shall apply:

Abbreviation Description

ACC Accident Compensation Corporation.

ACEM Australasian College of Emergency Medicine.

AIA Aviation Industry Association of New Zealand Inc.

ALS Advanced Life Support.

AMPLANZ Ambulance National Major Incident Plan for New Zealand

ANZCA Australian and New Zealand College of Anaesthetists.

AVL Automatic Vehicle Location system. A system that can track ambulances or vehicles and display them on a digital map.

BLS Basic Life Support.

CAA Civil Aviation Authority of New Zealand.

CAD Computer Aided Dispatch. System that provides decision support for dispatchers.

CIMS Co-ordinated Incident Management System.

CLI Caller Line Identification. Automatically provides call taker with telephone number and address details where available.

CCSOPS Communications Centre Standard Operating Procedures.

DHB District Health Board.

EMD Emergency Medical Dispatcher. A member of the EACC who is registered through the International Academy Emergency Medical Dispatchers.

IHT Inter-hospital transfer.

JFICM Joint Faculty of Intensive Care Medicine.

ILS Intermediate Life Support.

LTNZ Land Transport New Zealand.

MNZ Maritime New Zealand.

MPDS Medical Priority Dispatch System. Non-computerised version of the triage system used by the EACC.

of 42 Version 0.6 June 2009 – comment draft NZRC New Zealand Resuscitation Council

PSAP Public Safety Answering Point. Examples include Ambulance, Police, and the Fire service.

PTS Patient Transport Service. Non urgent, non emergency ambulance.

SAR Search and Rescue.

SMS Safety Management System.

For the purposes of this Standard the following definitions apply:

Term Description

Accountability A clinical provider’s responsibility to account for, or be liable for, fulfilling an action – whether or not that action is carried out by that service.

Ambulance Any conveyance that is either designed or equipped for the transport of sick or injured person(s), and or the transport of clinical personnel to such person(s).

Authority to Refers to the right to provide a healthcare service within the constraints and according Practice to the conditions of a scope of practice and terms of appointment to an organisation.

Clinical A system of accountability participated in by clinical staff in an organisation, and at all governance levels in an organisation, to assure quality, safety and efficacy.

Clinical Individuals who are responsible for performing the service on behalf of an organisation. personnel This includes the provision of care and treatment to the patient by all staff that are responsible or accountable to the organisation when providing care and treatment to the patient.

Continuing Evidence of ongoing professional development through reading, participation in Clinical professional affairs, and contribution to or attendance at courses/conference etc. Education

Co-ordinated The system is designed to improve the management of the response phase to Incident emergency incidents through better co-ordination between the major emergency Management organisation (e.g. fire, rural fire, police, ambulance, civil defence) and between the System many other organisations, which also have a role in mounting an emergency response.

Coordinating Th A Coordinating Authority is the agency or body responsible for the overall conduct of a Authority Search and Rescue Operation. The Coordinating Authority will lead and manage the operation. The New Zealand Police and the Rescue Coordination Centre New Zealand are the recognised Coordinating Authorities in New Zealand.

Credentialing The formal process used to verify the qualifications, experience and other relevant attributes for the purpose of forming a view about the competence and performance of an individual to provide safe healthcare within specific environments.

of 42 Version 0.6 June 2009 – comment draft Current accepted Involves the current accepted range of safe and reasonable practice included to oversee practice efficient and effective use of available resources to achieve quality outcomes for patients. Current accepted practice should also reflect standards for service delivery where these exist. This may include but is not limited to: (a) Codes of practice; (b) Research (c) Evidence based practice; (d) Professional standards; (e) Best practice guidelines; (f) Recognised/approved guidelines; and (g) Benchmarking.

Delegated Scope The extent of an clinical provider’s practice as authorised for that individual by the Medical of Practice Director.

Educate Includes teaching theory and practice, simulating practice by rehearsal of scenarios, training on specific skills and developing rationale for actions and mentoring in aviation standard practice.

ICU Level Inter- The transport of a patient who requires or has the potential to require assisted ventilation hospital transfer and/or other organ support.

Night Vision NVIS is defined as the integration of all elements required to successfully operate an Imaging System aircraft with NVGs (NVIS)

Organisation Includes companies, associations, statutory bodies, agencies, trusts, groups, incorporated societies, independent practitioners and individuals accountable for the delivery of the service to the consumer.

Patient The recipient of the service. Where appropriate this may include the family/whānau or other representatives.

PRIME Primary Response in a Medical Emergency – A system using rural doctors and nurses who are funded under contracts between those providers and ACC and the Emergency Ambulance Providers.

RCCNZ Rescue Coordination Centre New Zealand

SAR Search and Rescue.

SAROP Search and Rescue Operation - A Search and Rescue Operation (SAROP) is an operation undertaken by a Coordinating Authority to locate and retrieve persons missing or in distress. The intention of the operation is to save lives, prevent or minimise injuries and remove persons from situations of peril by locating the persons, providing for initial medical care or other needs and then delivering them to a place of safety.

Rapid Response Any conveyance whose primary purpose is to provide rapid response to the scene. vehicle

Re-validation The formal process used to reconfirm authority to practice.

Response A travel priority assigned to a dispatch in response to a call. priorities

of 42 Version 0.6 June 2009 – comment draft Review A formal process of updating, amending or re planning based on the evaluation of outcomes as part of a quality assurance process.

Risk A formal process of minimising the likelihood of adverse events within the context of the management overall management of an individual, group or community, to achieve the best possible outcome, and deliver a safe and appropriate service.

Patient transfer Secondary ambulance services include the transport of patients to and from out-patient ambulance appointments, planned healthcare facility admissions, discharges home and inter- services hospital transfers. It also includes the transfer of specialist hospital clinical teams and equipment, without an accompanying patient, as part of an inter-hospital transfer.

of 42 Version 0.6 June 2009 – comment draft Appendix B - Exemption Form (to be developed)

of 42 Version 0.6 June 2009 – comment draft Appendix C - Action plan checklist (Informative)

Action Plan Checklist

1. Details of the Mission:

2. Pilot/ Crew requirements

3. Weather Information - Departure - En route - Destination - Significant Weather, fog, turb, cloud base - Weather forecasts METARs TAFs etc - Sea state - Mountain conditions

4. Helicopter / Role equipment Serviceability - Known Defects (use of MEL?)

5. .Flight Plan with Alternative - VFR /IFR

6. Fuel Required with Res. - Fuel dump/ refuel

7..Area Charts - Topographical - Aeronautical - Marine

8. Communication / Navaid Information - RCC - Marine - Police/Fire - Ambulance/DHB - Airways

11. Mission Equipment - Long Range Fuel Tank - Floats - Off shore equipment -Life rafts/ life jackets - Mountain/ Alpine equipment - Winch Equipment - Medical Equipment - Special Equipment/Personnel - Night Equipment - NVIS - Nite-sun (night scanner-) - TAWS

Patient/ Medical details -Pressurised - Non pressurised – height limitations - Medical equipment required

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Appendix D (Normative) Extract from CAA Review - September 1996 In-flight and Non-in-flight Emergencies

Since 1990 there has been confusion in some quarters as to whether section 13 of the Civil Aviation Act or regulation 35 of the Regulations applied to the operation of aircraft in emergency situations. Following submissions to the Transport Select Committee on behalf of the Aviation Industry Association, Parliament has moved to clarify the position.

In-flight emergency Under a new section 13A(1) of the Civil Aviation Amendment Act 1996, a pilot in command faced with an in-flight emergency is now able to breach any requirement of the Act, regulations or rules if he or she is satisfied that; • the emergency involves a danger to life or property; • the prescribed requirement is only breached as far as necessary to deal with the emergency; • there is no other way of alleviating, avoiding or assisting with the emergency; and • the degree of danger involved in complying is clearly greater that the degree of danger involved in deviating from the requirement.

Non-in-flight emergency Subsection 13A(3) now provides for a non-in-flight emergency which necessitates the urgent transportation of persons or medical or other supplies for the protection of life or property (such as a flight to pick up the victim of a shark attack at a remote location).

In this situation a pilot-in-command may also breach certain requirements based on the same criteria as above. However requirements that cannot be breached are those relating to; • registration of the aircraft; • its airworthiness; and • the lawful entitlement to operate the aircraft. This includes the lawful entitlement to possession as well as the need to hold appropriate qualifications.

N o t i f i c a t i o n For both in-flight and non-in-flight emergencies the pilot in command or the operator must immediately notify the relevant air traffic control service of the action and, as soon as possible, notify the Director of the action and the circumstances that necessitated it.

Section 13A should be used when notifying any breach of the legislation to air traffic control and to the Director.

The full extract of CAA Act 1990 Section 13A follows:

Civil Aviation Act 1990 as amended to 11 April 2008

13A Duties of pilot-in-command and operator during emergencies

(1) Subject to subsections (2) and (6) of this section, in an emergency that arises in flight, the pilot-in-command may breach the provisions of this Act or of regulations or rules made under this Act.

(2) For the purposes of subsection (1) of this section, a breach of any prescribed requirement is permitted only if the pilot-in-command is satisfied that— (a) The emergency involves a danger to life or property; and (b) The extent of the breach of the prescribed requirement goes only as far as is necessary to deal with the emergency; and (c) There is no other reasonable means of alleviating, avoiding, or assisting with the emergency; and (d) The degree of danger involved in complying with the prescribed requirement is clearly greater than the degree of danger involved in deviating from it.

of 42 Version 0.6 June 2009 – comment draft (3) Subject to subsections (4) to (6) of this section, where an emergency (not being an emergency that arises in flight) necessitates the urgent transportation of persons or medical or other supplies for the protection of life or property, the pilot-in-command of the aircraft or the operator of the aircraft may breach the provisions of this Act or of regulations or rules made under this Act.

(4) For the purposes of subsection (3) of this section, a breach of any prescribed requirement is permitted only if— (a) The emergency involves a danger to life or property; and (b) The extent of the breach of the prescribed requirement goes only as far as is necessary to deal with the emergency; and (c) There is no other reasonable means of alleviating, avoiding, or assisting with the emergency; and (d) The degree of danger involved in deviating from the prescribed requirement is clearly less than the degree of risk in failing to attend to the emergency.

(5) Nothing in subsection (3) of this section permits— (a) The operation of an aircraft that is not registered in New Zealand or elsewhere; or (b) The breach of any prescribed requirement as to the airworthiness of an aircraft; or (c) The operation of an aircraft by a person who is not lawfully entitled to operate that aircraft.

(6) Where, in any emergency described in this section, a pilot-in-command or an operator breaches this Act or regulations or rules made under this Act in accordance with the provisions of this section, the pilot-in-command or the operator, as the case may be, shall— (a) Immediately notify the relevant air traffic control service of the action; and (b) As soon as practicable, notify the Director of the action and the circumstances that necessitated it, and, if requested by the Director, provide to the Director a written report in respect of the action.

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