Medevac

[ATC Jesus]

Preach it! Some of the posts from our west coast brethren imply that all medevacs should get direct all the time.

They should! Nobody is going to die if those air carriers are stopped for a few minutes, or vectored. Nobody dies if you miss your connecting flight, or get to the airport 10 minutes late. You don't cut 10 minutes off a medevac flight's route, and the potential is certainly there.

Those aircraft would certainly be stopped for an emergency, and the coordination between the 7 or 8 sectors would magically happen. In fact, it would be overly coordinated between the sectors, supe-to-supe, between facilities, etc. Nobody would ever think twice about it. A medevac is one step down on the priority handling chain, it's a life critical flight (that's how they are defined by the FAA), yet a supe wouldn't lift a finger to coordinate that aircraft being direct. Nobody would coordinate sector-to-sector, because there is no way air carriers and business jets are going to be moved to accommodate this life critical flight. No way are departures going to be stopped. No way are air carriers going to be vectored.

Maybe the mentality isn't just a west coast thing.

 

[ATC Jesus]

...and this "Crusty level 7 controller on his way out" (you couldn't be farther from the truth)

I would have gone with Level 5, but I don't think there are any 5 TRACONs left anymore.

Obviously you're cowboys. I mean absolutely John Wayne...

Cowboys? Just two controllers who actually give a damn about this profession, and aviation as a whole. We're not okay with just coming in to work every day, collecting our paychecks, and going home. We want to improve the system for the better. It's a shame more people don't. When we see something that seems wrong, we fix it. When we see procedures that make no sense, we question them. We're apparently the only two people on the west coast who see a medevac going 100+ miles out of its way, and ask the question, "Why the hell are we adding 45 minutes to this medevac flight???" Nobody else did. The flight passed through at least 6 controllers and nobody did a thing to fix it. We're standing up for the people, and hearts, and livers, and kidneys, and eyeballs in the back of the plane who can't speak up for themselves.

If that makes us cowboys, giddy up!

 

[ATC Jesus]

Not directly in response to ATC delays, but this is certainly a powerful quote from a Canadian doctor:

“Time is tissue, and the longer you delay that patient getting to that lab, the greater the chance of disability or death,” he said. “By adding an extra 35 or 45 minutes, this person instead of being a high-functioning individual that can dig trenches, is now going to be a cardiac cripple sitting at home on multiple medications — or worse yet he might die on route.”

Because we didn't want to coordinate with a few other controllers, stop a few departures, or vector a few air carriers? Really?

 

[N90-EWR]

They should! Nobody is going to die if those air carriers are stopped for a few minutes, or vectored. Nobody dies if you miss your connecting flight, or get to the airport 10 minutes late. You don't cut 10 minutes off a medevac flight's route, and the potential is certainly there.

Those aircraft would certainly be stopped for an emergency, and the coordination between the 7 or 8 sectors would magically happen. In fact, it would be overly coordinated between the sectors, supe-to-supe, between facilities, etc. Nobody would ever think twice about it. A medevac is one step down on the priority handling chain, it's a life critical flight (that's how they are defined by the FAA), yet a supe wouldn't lift a finger to coordinate that aircraft being direct. Nobody would coordinate sector-to-sector, because there is no way air carriers and business jets are going to be moved to accommodate this life critical flight. No way are departures going to be stopped. No way are air carriers going to be vectored.

Maybe the mentality isn't just a west coast thing.

Stay on the west coast then, because you truly have no clue about what goes on over here, and you'd be banging your head against a very thick reinforced concrete wall here.

Not directly in response to ATC delays, but this is certainly a powerful quote from a Canadian doctor:

“Time is tissue, and the longer you delay that patient getting to that lab, the greater the chance of disability or death,” he said. “By adding an extra 35 or 45 minutes, this person instead of being a high-functioning individual that can dig trenches, is now going to be a cardiac cripple sitting at home on multiple medications — or worse yet he might die on route.”

Because we didn't want to coordinate with a few other controllers, stop a few departures, or vector a few air carriers? Really?

You are way off. Even going with the extreme example that you give of adding 100 miles (which I truly doubt) the typical medevac aircraft is not going to take 35 to 45 minutes extra to fly that distance unless they're in a C172, and if you're flying Medevacs in such a slow aircraft...then the issue maybe in their choice of aircraft for the mission. The typical Medevacs we get over here is usually a learjet of some sort, and they get to stay fast all the way in, and we do shortcut them as much as possible. You are talking of maybe 5 minutes extra in the most extreme cases.

Anyway, since it seems like almost every single hour we have multiple Medevacs going to one of the gazillion airports we have, the decision to stop departures, and hold arrivals for each Medevac would mean shutting down all NY traffic so often, it would create an even bigger backlog than we already have. There is a reason why in most instances, the decision to run them with the normal flow is not up to the line controller behind the scope, but all the way from the top.

There is no "one size fits all" solution for this issue. Even if you do succeed in getting some changes over there, things are likely to stay there same on this side.

 

[deadstick]

135.4 and the relevant opspec... if you have 2 pilots.

Not an eligible on demand op.

 

[ATC Jesus]

Stay on the west coast then, because you truly have no clue about what goes on over here, and you'd be banging your head against a very thick reinforced concrete wall here.

I do know what goes on over there. I have plenty of friends who work on the east coast, controllers in our building who have come from the east coast, etc. Everything is so proceduralized that nobody is willing to change anything, the vectoring aircraft over Missouri to get 40 miles in trail to IAD, for example, on a normal day with no weather, the leaving EWR/JFK aircraft on course every day, so Cleveland Center can get them 60 MIT. It's silly. I know you guys are busy, I know you guys have a lot to do. But you'd bust your ass for an emergency aircraft. The same should be afforded for medevac flights.

You are way off. Even going with the extreme example that you give of adding 100 miles (which I truly doubt) the typical medevac aircraft is not going to take 35 to 45 minutes extra to fly that distance unless they're in a C172, and if you're flying Medevacs in such a slow aircraft...then the issue maybe in their choice of aircraft for the mission.

Nobody is way off. It was a king air doing barely 200kts ground speed due to the headwinds. The route of flight added about 105 miles to the flight (doubt all you want). You're talking ~30 minutes at that ground speed, plus they aren't going to maintain that speed all the way in to the airport, obviously. So nobody is way off. It's 3rd grade math.

And you make the same silly argument people make out here. If it was important, they'd be flying a decent plane. Apparently there is no difference at all between the west coast and east coast. I knew we were going to get to that eventually. It's not a regional issue at all. Sometimes another plane isn't available. Sometimes another plane can't make it into the airport...i.e. runway lengths, etc. If you were dying, I'm sure you would rather be on a direct route flight in a King Air doing 200kts, than in an ambulance. That's still 4 times faster than most ambulances will get you there, just in speed alone. That argument doesn't stand with me, I'm afraid.

 

[N90-EWR]

Good luck with that crusade. I guess you'll be going into management someday? cause as a controller...you're not going to get the culture change you want. That has to come from the top.

 

[Ozelot]

I can't figure out who has the bigger wiener

 

[ATC Jesus]

Good luck with that crusade. I guess you'll be going into management someday? cause as a controller...you're not going to get the culture change you want. That has to come from the top.

That's exactly why we're taking it through ATSAP and a few other folk "up top". As I already mentioned, they have escalated the issue to "urgent". I don't know exactly what that means, but the executive movement ATSAPs I submitted a couple months ago were escalated to urgent, and we had directives at our facility within a few weeks. It is absolutely going to take a culture change, and I'd say it's about time for that change to take place. The ATSAP people seemed very angry that this was taking place, and very motivated to get it resolved. Of course, it's hard to sense emotion through an email, but it's only the 2nd time the ERC has personally written back to me, the first time they provided me statistics and said it was a widespread problem, and the first time they really seemed outraged over an issue. They asked me to work with them, NASA, and a few other folks, so there is obviously some motivation to get this issue resolved.

 

[N90-EWR]

The problem I see is this....You may get the change you want at places where you have everyone on the same page, like there where you work, because you are putting pressure to get change, but that culture change is going to be more difficult to deal with Nationwide than you can imagine. Its not that I don't share your views on Medevac's priority status, but at the end of the day, I have to work within the system I'm given, and if I am told "no, you are not stopping departures for that medevac" by the first line supe, and the TMS in charge, then...well, that's not going to last.

 

[deadstick]

I can't figure out who has the bigger wiener

King Air pilots, of course. Glad I could help out. Y juevos también.

 

[DvLzArchAngL]

Clearly neither of you have been in this profession long enough or have diverse experience enough to know that despite all that you know, you aren't certified in the facility you're complaining about ... but yeah driving traffic deep into someone else's airspace without a point out or handoff, that'll show em.

Why follow 2-1-1 when 2-1-2 is there? I mean worst case scenario a few hundred die in a mid air right? I've never personally done anything other than direct the airport with an LN unless extreme situations warranted it. You're advocating just driving them is like an ambulance driver just plowing through a clogged intersection at high speed. The patient won't live if they never see the hospital and how many did they kill in the process?

This from the guy complaining about the controllers in the facility he's not certified in? Hypocrite?

Driving deep without an "Accepted" p/o or handoff isn't going to "show them" anything. I'm going to look and go to provide the service just like you've "broken every rule". At least step out of your glass house when your throwin' rocks.

There's several reasons why its just not feasible to send Medevacs from the southeast direct TEB, or HPN. Those big airports called EWR, LGA, and JFK kinda get in the way, and the problem is...its not one, not 2, not 3, not 4, not 5, but usually 6 or 7 different sectors, and controllers, working different streams of traffic, and the sheer volume of traffic, complexity, and coordination required makes it extremely impractical. You would have to stop EWR and TEB departures, as well as make a gap to both the LGA and EWR flow to cut you right through. We do what we can, when we can, and as soon as the situation allows, we do send them direct, and we do keep them speed up, and we do make a hole in the sequence, but you have to come over and see it for yourself to understand the degree of difficulty involved with coming from the southeast, specially when we're landing the southwest flow.

Go tell the families it wasn't "feasible". Tell them you do "what you can, when you can". The degree of difficulty doesn't matter when someone's in need of priority. Didn't you guys work the "Miracle on the Hudson"? If he coulda maintained altitude you woulda done everything you just said wasn't "feasible". I clearly heard him say "stop your departures". Didn't sound that hard.

Nobody's talking about putting them IN harms way and causing accidents. If you can't vector to avoid a MedEvac you shouldn't be in this field. You've completely missed sight of the fact that the life is worth more than the money you're going to cost everyone to get out of the way.

Shut the airliners off, move the departures, work your ass off for that level whatever paycheck cause that's what you signed up to do.

You'd do it for the emergency or the potus, do it for the person who's burning to death waiting for the helicopter or for the kid who's cozy in bed waiting for his new "eyeballs".

 

[N90-EWR]

This from the guy complaining about the controllers in the facility he's no certified in? Hypocrit?

Driving deep without an "Accepted" p/o or handoff isn't going to "show them" anything. I'm going to look and go to provide the service just like you've "broken every rule". At least step out of your glass house when your throwin' rocks.



Go tell the families it wasn't "feasable". Tell them you do "what you can, when you can". The degree of difficulty doesn't matter when someone's in need of priority. Didn't you guys work the "Miracle on the Hudson"? If he coulda maintained altitude you woulda done everything you just said wasn't "feasable". I clearly heard him say "stop your departures". Didn't sound that hard.

Nobody's talking about putting them IN harms way and causing accidents. If you can't vector to avoid a MedEvac you shouldn't be in this field. You've completely missed sight of the fact that the life is worth more than the money you're going to cost everyone to get out of the way.

Shut the airliners off, move the departures, work your ass off for that level whatever paycheck cause that's what you signed up to do.

You'd do it for the emergency or the potus, do it for the person who's burning to death waiting for the helicopter or for the kid who's cosy in bed waiting for his new "eyeballs".

Get off your high horse. The call is not mine to make if it gets shutdown and countermanded from the top. Its not a matter if I am god's gift to ATC and the best in the planet....I'm not the one working every plane out there, and if the other sectors say unable, and are not getting out of the way, I am not driving into their airspace just to prove a point.

 

[DvLzArchAngL]

The problem I see is this....You may get the change you want at places where you have everyone on the same page, like there where you work, because you are putting pressure to get change, but that culture change is going to be more difficult to deal with Nationwide than you can imagine. Its not that I don't share your views on Medevac's priority status, but at the end of the day, I have to work within the system I'm given, and if I am told "no, you are not stopping departures for that medevac" by the first line supe, and the TMS in charge, then...well, that's not going to last.

Get off your high horse. The call is not mine to make if it gets shutdown and countermanded from the top. Its not a matter if I am god's gift to ATC and the best in the planet....I'm not the one working every plane out there, and if the other sectors say unable, and are not getting out of the way, I am not driving into their airspace just to prove a point.

If everyone continued to work within the system they're given then we'd all still be living in caves. Nothing gets countermanded from the top till you stand up and try. If they unable you they have to give a reason. Let's hear it? A valid one... that countermands providing life saving priority. Then tell that to a judge when youre in court because the "worst case" happened, SOMEBODY DIED.

The call is yours to make. They gave you a duty priority to make that call. Stand for something more than a paycheck and a NATCA logo.

I'll be on my high horse standing for mine.

 

[N90-EWR]

If everyone continued to work within the system they're given then we'd all still be living in caves. Nothing gets countermanded from the top till you stand up and try. If they unable you they have to give a reason. Let's hear it? A valid one... that countermands providing life saving priority. Then tell that to a judge when youre in court because the "worst case" happened, SOMEBODY DIED.

The call is yours to make. They gave you a duty priority to make that call. Stand for something more than a paycheck and a NATCA logo.

I'll be on my high horse standing for mine.

View attachment 24658

Since you like using the Patco name, remind me exactly how it ended for them after standing for something more than a paycheck and a logo? yeah...that's right. no more paychecks for them. I don't disagree with your cause, but I've been in the agency way longer than you, and I know how the machine operates. I tried rocking the boat back when I was younger, but learned through the decades that changes come very slowly, if they come at all, and it has to come from the top. BTW, although a bit dramatic, I loved the line about the judge and court. Good luck getting any case related to a medevac routing to court to begin with.

 

[DvLzArchAngL]

Patco standing for what they believed in no matter how it ended led to you having a job working under the pretty little conditions you work under. Read your history before you pipe up.

"The strike and defeat of PATCO has been called "one of the most important events in late twentieth century U.S. labor history". This led officials to recognize that the ATC system was operating nearly at capacity. To alleviate some of this, Congress accelerated the installation of automated systems, reopened the air traffic controller training academy in Oklahoma City, began hiring air traffic controllers at an increasing rate, and raised salaries to help attract and retain controllers."

What did Natca do when faced with the white book? They took it like a cheap date and took years to enact your slow change. Try not to forget those who sacrificed so much to "prove their point". I'd only hope that if NATCA raised a call to arms like PATCO did, you stand and be counted.

And guess what, when a family sues cause ATC were found to have been a cause of a wrongful death, guess who's going to be standing in a court room explaining how "BUSY" they were?

I don't disagree with your point that change takes time. But policy happens real quick when things hit the fan. We're just doing everything we can to throw issues at it. I hope you never have to be in the position to be hoping they "shut the departures off" and "vector their way out of a wet paper bag" to save your or your loved ones some pain or at "worst case" their life.

 

[N90-EWR]

I know the PATCO and NATCA history better than you do. I was there, and still here, even if not for much longer. There was not much NATCA could do during the white book, since after PATCO no federal workers union is ever going to strike again.

Now, even through all the animosity of these exchanges on this internet forum, I want you to know that I am not against what you guys are crusading for. I think its a worthy, and noble cause, and I understand and agree that Medevacs should be handled better. All I'm saying is, that is not a fight for individuals to bring on against the FAA machine. There is a lot of special interest lobby pressure on keeping those airliners moving. You need NATCA national behind this, and you'll need to get the top hats on central flow to buy off on it too. I don't know about how things are done on your side of the country, but over here, more often than not there is piss poor coordination between ZNY and N90, and medevac flights get dumped on the wrong sector, without a proper handoff or verbal coordination, because automation can't figure out what sector is the right one to handoff. There's been several instances of medevacs entering a busy sector's airspace and frequency without a proper handoff. There's a few ATSAP's on file on that. We do what we can to handle them as best we can, and deal with what we're given, but its a more complex issue than you can possibly imagine..at least here where you can have 7 different controllers own different blocks of altitude over the same piece of real estate.

There's no wrongful death lawsuit that would stand the test of public safety. You can argue until the cows go home about this, but at the end of the day, the needs of the many outweight the needs of the few, and if a medevac is delayed a few minutes, because the controller is trying to avoid a collision, you got nothing. Unless somebody intentionally takes a medevac way out of the way (which nobody ever does), and there is no traffic in the way, you got no case. The second you play a replay with the typical mess we got around here, there goes that theory.

 

[GolfChuck]

"

What did Natca do when faced with the white book? They took it like a cheap date and took years to enact your slow change. Try not to forget those who sacrificed so much to "prove their point". I'd only hope that if NATCA raised a call to arms like PATCO did, you stand and be counted.

The white book was a ploy to get NATCA decertified. NATCA had the discipline to take it and work it out through the proper channels. They tried to get us to work-to-rule and sick-out so that they had a case against us at the the NLRB. It failed.

I could give my medevacs direct TEB and then they would end up stuck at F200 over the field, or crossing 100NM out at 070 or below. Maybe you can shut down EWR and LGA, but you couldn't predict with any accuracy the PHL-BOS overflights that would also be a factor. Bottom line is keeping them on the pref routing is better service.

Edit: Never mind that the next sector isn't going to accept the handoff direct anyway

 

[ATC Jesus]

I could give my medevacs direct TEB and then they would end up stuck at F200 over the field, or crossing 100NM out at 070 or below. Maybe you can shut down EWR and LGA, but you couldn't predict with any accuracy the PHL-BOS overflights that would also be a factor. Bottom line is keeping them on the pref routing is better service.

The point I have been trying to make for several pages now, if that was an emergency, would it be stuck up at FL200 or crossing 100NM out at 7000 or below? Of course not. You can't vector the PHL/BOS overflights and get them out of the way? You know as well as I do that you (and your co-workers, and supes) would work your behind off to give the emergency expeditious handling and get that aircraft down on the field.

How is a medevac any different? It's a life critical flight where literally every second counts. You would bust your ass for the emergency. You would vector people to make it happen. You would stop departures, you would spin air carriers. But for a medevac, nobody wants to lift a finger to do any of that. Nobody gives a damn.

I posted a quote from a well-known doctor a few pages back, and nobody commented on it...not a single person. Everyone knows it's true. Everyone knows that giving a medevac expeditous handling can be the difference between life and death; the difference between somebody living a normal life or living in a crippled state forever. But nobody cares, because nobody wants to work hard if they don't have to. An emergency, and every action would be scrutinized. Every tape would be pulled. QARs would be written. You better have hoped you did the right thing or you're going to be in an office somewhere (or in a courtroom) getting your ass chewed out.

But with a medevac, nobody gives a damn. N90-EWR is absolutely right...it needs to start from the top. Perhaps we should start to be scrutinized over the service we provide these folks, but then again, some of us don't need that. Some of us are willing to provide that service (per our 7110.65 requirements) without being told to do it, without needing the supes to tell us what to do, without the QARs being written. We're willing to work a little harder to help ensure lives are being saved. Are you?

 

[GolfChuck]

2-1-2. DUTY PRIORITY
a. Give first priority to separating aircraft and issuing safety alerts as required in this order. Good judgment must be used in prioritizing all other provisions of this order based on the requirements of the situation at hand.

2-1-4. OPERATIONAL PRIORITY

b. Provide priority to civilian air ambulance flights “LIFEGUARD.” Air carrier/taxi usage of the “LIFEGUARD” call sign, indicates that operational priority is requested. When verbally requested, provide priority to military air evacuation flights (AIR EVAC, MED EVAC) and scheduled air carrier/air taxi flights. Assist the pilots of air ambulance/evacuation aircraft to avoid areas of significant weather and turbulent conditions. When requested by a pilot, provide notifications to expedite ground handling of patients, vital organs, or urgently needed medical materials.
NOTE-
It is recognized that heavy traffic flow may affect the controller's ability to provide priority handling. However, without compromising safety, good judgment must be used in each situation to facilitate the most expeditious movement of a lifeguard aircraft.

do you see anything about direct destination in there? Maybe I need my eyes checked. And yes this was copied from FAA.gov today, LIFEGUARD and all.