Responding by air: HEMS operations: DipIMC practice questions
PHEM curriculum unit A.3 · Cross-cutting theme A: Operational Practice
The DipIMC is blueprinted against phase 1 of the UK Pre-hospital Emergency Medicine (PHEM) curriculum. This page covers unit A.3, Respond to incidents by air.
Below are 2 free practice questions from the DipIMC.Ninja bank, in the Part A single best answer format. Every answer names the textbook page, guideline or statute it was written from, so you can check it rather than take it on trust. The bank holds 7 questions on this unit.
Question 1 · Scene Safety & Extrication · Easy
A helicopter has landed at an incident with rotors running. From which direction should you approach?
AFrom the rear, keeping low and well clear of the main rotor disc
BFrom the front or side, in the pilot's view, once signalled
CFrom the nearest side, moving quickly beneath the rotor disc
DFrom higher ground such as a bank, keeping above the downwash
EFrom the rear quarter, once the rotors have visibly slowed
Show answer
Answer: B
From the front or side, in the pilot's view, once signalled
The Oxford Handbook is explicit that a helicopter should never be approached unless the pilot has given a clear signal to do so, and lists among the ground-safety hazards the danger of walking into the tail rotor and the danger of the main rotor when the aircraft has landed on uneven ground. ABC of Prehospital Emergency Medicine describes leaving the aircraft between the 2 and 10 o'clock positions after the pilot's thumbs-up, which keeps personnel in the pilot's view and away from the main hazard areas, the engine exhausts and rotor blades, and warns that on sloping ground the rotor disc is avoided by moving downhill. Any approach from the rear or rear quarter brings the tail rotor into play, rushing beneath the disc from the nearest side ignores the signal, and approaching from a bank or higher ground brings the head closer to the main rotor. Wait for the signal whatever the rotor speed.
Where this comes from
Oxford Handbook of Pre-Hospital Care
Ch. 13 Patient rescue and transportation · Transport: helicopters, safety regulations · p. 721“should never be approached unless the pilot has given a clear signal”
Ch. 13 Patient rescue and transportation · Transport: helicopters, safety regulations · p. 721“The danger of walking into the tail rotor, if present.”
ABC of Prehospital Emergency Medicine
Ch. 2 Activation and Deployment · Deployment by helicopter · p. 6“exit from the aircraft between the 2 and 10 o’clock position”
Ch. 2 Activation and Deployment · Deployment by helicopter · p. 6“avoid walking into the rotor disc by exiting downhill from the aircraft”
scene-001 · Scene Safety & Extrication · Scene Safety · Easy · v4
Question 2 · Scene Safety & Extrication · Moderate
An air ambulance has landed in a sloping field to collect your patient. You are standing with the trolley at the top of the slope. What is the correct way to approach the aircraft?
AAfter the pilot's thumbs-up, approach from directly behind the helicopter
BAfter the pilot's thumbs-up, approach downslope between 2 and 10 o'clock
CApproach at once without a signal, downslope between 2 and 10 o'clock
DAfter the pilot's thumbs-up, approach upslope between 2 and 10 o'clock
EAfter the pilot's thumbs-up, approach downslope passing the tail rotor
Show answer
Answer: B
After the pilot's thumbs-up, approach downslope between 2 and 10 o'clock
The ABC's helicopter safety guidance is to move between the aircraft and the ground within the forward arc, between the 2 and 10 o'clock positions, and only after gaining the pilot's permission by a thumbs-up signal; this avoids the aircraft's main hazard areas, the engine exhausts and rotor blades. On sloping ground you always approach or leave on the downslope side for maximum rotor clearance, and the ABC warns about walking into the rotor disc on a slope, which is why the upslope approach is wrong even within the forward arc. Approaching from behind, or passing the tail, takes you towards the tail rotor, which the Oxford Handbook lists as a specific ground danger along with the main rotor when the aircraft has landed on uneven ground. Setting off without the pilot's signal abandons the permission step even when the direction is right. Take-off and landing are the most hazardous periods of a helicopter emergency medical service (HEMS) flight, and a landing site should be about twice the rotor diameter, flat, free of debris and clear of wires.
Where this comes from
ABC of Prehospital Emergency Medicine
Ch. 2 Activation and Deployment · Deployment by helicopter: forward arc · p. 6“exit from the aircraft between the 2 and 10 o’clock position”
Ch. 2 Activation and Deployment · Deployment by helicopter: pilot's permission · p. 6“after gaining the pilots permission by a thumb up signal”
Ch. 2 Activation and Deployment · Deployment by helicopter: main hazard areas · p. 6“This ensures avoidance of the aircrafts main hazard areas”
Ch. 2 Activation and Deployment · Figure 2.6 Helicopter safety zones: sloping ground · p. 6“On sloping ground always approach or leave on the downslope side”
Ch. 2 Activation and Deployment · Deployment by helicopter: landing site and hazardous phases · p. 6“Take-off and landing are the most hazardous periods”
Oxford Handbook of Pre-Hospital Care
Ch. 13 Patient rescue and transportation · Helicopters: safety regulations · p. 721“The danger of walking into the tail rotor, if present.”
Ch. 13 Patient rescue and transportation · Helicopters: safety regulations, uneven ground · p. 721“The dangers of the main rotor if the aircraft has landed on uneven ground”
scene-058 · Scene Safety & Extrication · Scene Safety · Moderate · v3