CFRN Aviation Safety and Survival 3 — Questions and Answers
Question 1: In helicopter operations, what is the 'dead man's curve' (height-velocity diagram)?
- A flight path that leads toward mountainous terrain
- A combination of altitude and airspeed from which a safe autorotation is not possible (Correct answer)
- The altitude above which supplemental oxygen is required
- A zone of reduced visibility near the ground during landing
Correct answer: A combination of altitude and airspeed from which a safe autorotation is not possible
The dead man's curve identifies altitude-airspeed combinations where insufficient time or altitude exists for successful autorotation if engine failure occurs.
Question 2: A CFRN is caring for a ventilated patient at 8,000 feet MSL. How should the endotracheal tube cuff be managed during ascent?
- Inflate the cuff more to prevent air leaks at altitude
- Replace air in the cuff with saline or use a pressure-regulated cuff (Correct answer)
- Deflate the cuff slightly to prevent pressure buildup during descent
- No adjustment is needed as cuff pressure is unaffected by altitude
Correct answer: Replace air in the cuff with saline or use a pressure-regulated cuff
Air in the ETT cuff expands at altitude, risking tracheal injury; filling with saline or using a pressure-regulated cuff prevents dangerous over-inflation.
Question 3: When approaching a helicopter in a field landing zone, which path is the safest approach direction?
- From the rear of the aircraft toward the tail rotor
- From the side, within the pilot's field of vision, staying in the 3 o'clock or 9 o'clock position (Correct answer)
- Directly toward the nose of the aircraft
- Any direction is acceptable as long as the rotors are visible
Correct answer: From the side, within the pilot's field of vision, staying in the 3 o'clock or 9 o'clock position
Approaching from the 3 or 9 o'clock position keeps you in the pilot's field of vision and away from the invisible, deadly tail rotor.
Question 4: Which weather condition most commonly contributes to helicopter EMS accidents?
- High winds above 40 knots
- Inadvertent flight into instrument meteorological conditions (IIMC) (Correct answer)
- Thunderstorm proximity within 10 miles
- High-density altitude combined with heavy loads
Correct answer: Inadvertent flight into instrument meteorological conditions (IIMC)
IIMC — where a VFR pilot inadvertently enters clouds or fog — is the most lethal weather-related cause of HEMS accidents.
Question 5: What is the purpose of the crew resource management (CRM) principle of 'assertiveness' in air medical transport?
- To ensure the most senior crew member makes all decisions
- To empower any crew member to voice safety concerns regardless of rank (Correct answer)
- To assign tasks based on crew seniority during emergencies
- To document crew disagreements in the flight record
Correct answer: To empower any crew member to voice safety concerns regardless of rank
CRM assertiveness means any crew member — including the nurse — can and must speak up about safety concerns, regardless of the pilot's authority.
Question 6: A patient on a fixed-wing transport develops a pneumothorax. At altitude, the pneumothorax will:
- Remain the same size due to pressurized cabin compensation
- Decrease in size as cabin pressure increases during cruise
- Expand and worsen due to Boyle's Law as ambient pressure decreases (Correct answer)
- Stabilize within 15 minutes of reaching cruise altitude
Correct answer: Expand and worsen due to Boyle's Law as ambient pressure decreases
Boyle's Law states that gas volume increases as pressure decreases; a pneumothorax will expand at altitude, potentially becoming a tension pneumothorax.
Question 7: In an aircraft ditching scenario, what is the recommended brace position for a rear-facing passenger?
- Lean forward with arms crossed over the chest, feet flat on the floor
- Lean back firmly into the seat with arms crossed over the chest (Correct answer)
- Curl forward placing forehead on knees with hands over head
- Remain upright with seatbelt tightened and hands gripping armrests
Correct answer: Lean back firmly into the seat with arms crossed over the chest
Rear-facing passengers should press firmly back into their seat and cross arms over the chest to minimize injury from deceleration forces.
CFRN Aviation Safety and Survival 3
In helicopter operations, what is the 'dead man's curve' (height-velocity diagram)?