title: How safe are HEMS-programmes in Germany? A retrospective analysis.
abstract: BACKGROUND
  Recent accidents with helicopter emergency medical service (HEMS) aircraft raise the question how safe HEMS in Germany is and how accidents could be prevented.
  
  
  METHODS
  We surveyed all German HEMS-programmes and reviewed the data of the German Aviation Authority regarding accidents with HEMS.
  
  
  RESULTS
  An average German HEMS-programme encounters one accident leading to at least severe damage or loss of the helicopter in 26 operating years, one accident resulting in casualties in 65 operating years and one fatal accident in 111 operating years. The major causes of accidents were obstacle strikes during landing at the scene. Flying in bad weather conditions and lack of discipline were other factors contributing to HEMS-accidents.
  
  
  CONCLUSIONS
  HEMS-safety could be improved by special training programmes for pilots and HEMS-crewmembers to address the factors listed above. Safety training for doctors is recommended but we did not find support for the notion of changing the doctor's legal position of a passenger to a HEMS-crewmember.
authors.affiliation: Department of Anaesthesia - HEMS, Radboud University Medical Centre, Geert Grooteplein 10, 6500 HB Nijmegen, The Netherlands. k.thies@anes.umcn.nl
authors.forename: Karl-Christian
authors.initials: KC
authors.lastname: Thies
authors.forename: Daan
authors.initials: D
authors.lastname: Sep
authors.forename: Remon
authors.initials: R
authors.lastname: Derksen
mesh_terms: D000060:Accidents, Aviation / Q000706:statistics & numerical data*; D017732:Air Ambulances / Q000706:statistics & numerical data*; D004647:Employee Discipline; D005858:Germany; D006801:Humans; D012189:Retrospective Studies; D012449:Safety; D014887:Weather