Yeah the EMS helo mishap rate as been increasing in the past few years. There was an article on it in Air and Space a few months ago. A lot of the problems were coming from crashes in bad weather, when the helo either shouldn't have been flying or on IFR. As far as the "pathfinder", its usually some guy with the fire dept on scene who's been trained in marking an LZ by the EMS helo at a class beforehand. Just enough to mark a spot so the helo can see. At least thats what several of my friends who were EMTs in college tell me.
That's pretty much it.
The problem was almost always a lack of accurate weather reporting enroute and at your destination - and you as a pilot being put between a rock and a hard place.
The EMS program I few in had night VFR mins of 800 and 3. That doesn't seem bad but single pilot, at night (a dark night), sleepy, etc. you get the picture. Generally you got to learn that you really needed 1500/3 in these conditions.
The first responders were generally not effective in LZ prep. Usually they simply marked the first clear 100 x 100 foot area they could find only for you to discover that it was outside your slope landing limits, or surrounded by wires, towers, trees, etc. You learned to recon the LZ like crazy at night with your Nightsun searchlight - (10,000- candlepower). Oh yeah and you are doing this while talking on 2 or 3 different radios, listening to the medical crew chat about what they were missing for dinner, and flying all at the same time. Did I mention this is all single pilot?
Thank god the BK-117 had loads of power. You Basically did a nice slow controlled approach that was a steeper version of the "precision/steep approach" that you learned in the HT's. You took off the same way. Lots of power (smoothly applied of course) to an OGE hover then transition up and out.
In two years I came "too close for comfort" twice when it came flying into terrain and obstacles; even though I always said I woiuld never ever let myslef get sucked in to marginal VFR. Your employer put the fear of god into you to avoid actually going IFR at all costs.The problem is you would push it to maintain visual reference with the ground instead of trusting your IFR skills, climbing into the goo , and getting an approach to an airport and VFR - doing so was labeled irresponsible by management - hence the accident rate in EMS.
At one point I said screw it and climbed, completed an ILS to Lunken Airport (my helo was very very well equipped - so flying the approach was fairly easy). The medical crew (MD and Nurse) thought it was somew sort of miracle that a helicopter coiuld "fly in the clouds" like that.
Lol.
