Streamlined, standardized communication is essential for high-risk search-and-rescue operations.

Operating procedures in emergency medical services (EMS) and search-and-rescue (SAR) helicopter operation should be standardized as much as possible to reduce confusion and improve mission effectiveness. The streamlining of communications between different crews should be part of this standardization effort, especially when the result of misinterpretation could be catastrophic. 

The International Civil Aviation Organization (ICAO), the International Maritime Organization (IMO) and, in the United States, the Federal Aviation Administration (FAA) and Federal Emergency Management Agency (FEMA) through the National Incident Management System (NIMS) have developed various policies and techniques for standard communications in EMS and SAR helicopter operations, together with the development of internationally recognized EMS/SAR signals to overcome language barriers.

Creating standards

The U.S. Coast Guard follows FAA, ICAO, and other published standards when appropriate, depending on the airspace, mission, phase of flight, and other variables. The Coast Guard has developed standard phraseology promulgated through its Air Operations Manual, specific airframe flight manuals and the required use of checklists. Specific Coast Guard communications procedures are developed in coordination by different offices and directorates of the Coast Guard.

“Any crewmember recognizing an unsafe condition that requires the jettison of the hoist cable during rescue swimmer operations can vocalize the command ‘SHEAR SHEAR SHEAR’ to direct all crewmembers to activate the emergency hoist jettison system,” a spokesperson for the U.S. Coast Guard told Valor. “This command is designed to be distinct and cannot be confused with other vocalized commands in the aircraft.”

The Royal Canadian Air Force (RCAF) has no documented history of the process by which the terms used today in standard helicopter communications came about. 

“In general, the terminology used by the RCAF rotary-wing SAR community in operations has been an evolution over many years,” an RCAF spokesperson told Valor. “Some terminology is intrinsic to helicopter aviation, while other terms have been ported over from other communities (such as tactical aviation) as air crewmembers moved into the SAR world.” 

Some of the terminology used today can be found in the standard maneuver manuals for the aircraft in RCAF SAR fleets, which list all the standardized activities for a particular airframe (such as circuits, hoisting, instrument procedures). Manual annexes often provide examples of scenarios in which certain terms are used to provide context for proper usage.

The phraseologies used in EMS/SAR rotorcraft communications are specific to the operators based on approved operations manuals. There are, however, a core group of aligned principles that are common throughout the world. 

“These international principles are centered around safety, standards, competency, equipment and training. The language across the industry has evolved into a basic standardized set of phraseologies, which is great for consistency,” said Brian Guthrie, director of rotary-wing operations at Australia’s RACQ LifeFlight Rescue. “Nevertheless, there will always be a need for individual operators to have the flexibility to adapt phraseologies to their own unique environments. Operators need to be able to use what works for their needs and not be dictated to. There is verbal and non-verbal language used in EMS/SAR and above all else it must be understood by all crews.”

The Norwegian Air Ambulance Service conducts mainly EMS operations, and the phraseology it uses is derived from the big picture defined in ICAO standards and EASA regulations, but some operations and/or procedures require phraseology that is customized to specific tasks, said flight operations manager Lars Erik Bragstad. 

“In these cases, known phraseology derived from other operators conducting similar tasks is usually adopted,” Bragstad said. “Then these phrases are defined in the handbooks which then in turn are approved by our civil aviation authority.”

Consistency is key

“At RACQ LifeFlight Rescue, we certainly believe it needs to be up to individual operators to determine the most appropriate phraseology for their specific operations, however the need for consistency must be considered for operators that interact across multiple agencies, which is the case for most EMS/SAR operations,” Guthrie said. “An example of this consistency would be in relation to the nonverbal communication, such as hand signals which are an essential primary and secondary form of communication.”

U.S. Coast Guard SAR procedures are standardized and outlined in the flight manual of the particular aircraft type, its Helicopter Rescue Swimmer Manual, the Addendum to the U.S. National SAR Supplement, and other publications. 

“In addition, checklists are required to be used in all aspects of Coast Guard aviation and are developed in a challenge-response format to ensure continual, standardized communications between pilots and aircrew,” according to a Coast Guard spokesperson. “All Coast Guard standard communications have been developed using the tenets of crew resource management (CRM), a flight safety system used throughout commercial and military aviation to reduce human error, increase effective crew communications, and lower the frequency and severity of aviation mishaps.”

Standard phrases used by SAR personnel might have to be rendered in English and other languages spoken by pilots and crew. The Norwegian Air Ambulance uses both English and Norwegian. 

“The main thing is to have the phraseology standardized, so the message is easy to understand and interpret,” Bragstad said. “For air traffic communication this is all done in English [because] crews of other aircraft might not speak our native language. Within the cockpit Norwegian is spoken since the crews speak this as their native language.” 

Communication regarding aircraft systems, checklists, emergency procedures, instrument procedures, etc. are all done in English to eliminate the risk of incorrect translation. Medical communication with other assets is done in Norwegian.

“Our specific procedures like static rope rescue have a combination of native and English, both are standardized,” Bragstad said.

An important feature of phraseology development is repetition when clarity of communication is essential, compounded by the urgency of the command. The U.S. Coast Guard’s standard “SHEAR SHEAR SHEAR” is a good example.

“Using the example of ‘CUT CUT CUT’ to cut a hoist cable, this is usually required in a context in which the cable is snagged or otherwise compromised and could pose a danger, so repeating the order to ‘CUT’ communicates the urgent need to do it quickly while being clear, so that everyone listening understands,” the RCAF spokesperson said. “The same would be true for ‘UP UP UP’ to avoid an obstacle in a confined area.”

Non-standard comms

While standard phraseology is preferred to reduce confusion and create efficiency, particular missions or phases of flight may call for a departure from standard phraseology due to the specific on-scene details or aircraft emergency. 

“Aircrews are empowered to depart from standard procedures when required for flight safety, and aircrews are trained to maintain flight discipline at all times to ensure communications are accurate, bold, and concise,” according to the U.S. Coast Guard. 

At Australia’s RACQ LifeFlight, non-standard phraseology is most often used in uniquely challenging environments, when using non-standard or specialized equipment, and during certain types of operations. 

“Since no two organizations operate in identical environments, with identical gear, there will always need to be some variations,” Guthrie said.

Standard phraseology is developed to prevent miscommunication, while non-standard phraseology may be used to fill any agency specific requirements or gaps in standard phraseology. 

“For example, when preparing to conduct a rescue hoist, the aircrew follows the rescue checklist, and the pilot conducts a rescue briefing,” according to the U.S. Coast Guard spokesperson. “While the format of the brief is standardized, the pilot is encouraged to add additional details, as necessary. Upon completion, crewmembers seek any required clarification before beginning the rescue operations.”

Talk training

As with all high-risk operations, training and competency in EMS/SAR communications is key for mission success. 

“As an operator of 11 helicopters, we run a comprehensive and exhaustive initial and ongoing training program that is standardized across the operation and enables crew to know everyone’s roles and what to anticipate in each other’s behavior,” Guthrie said. “Communication and phraseology are assessed in training and throughout crewmembers’ careers. It is a key aspect and requirement of any initial and ongoing EMS/SAR training.” 

“One needs to know what each person in the crew is going to do next and understand what ‘may’ or ‘could’ happen,” Guthrie added. “A proactive operator and crew will identify and address an issue prior to it even occurring. This can only come through quality training and ongoing practice. Regardless of previous experience, we always need to keep evolving. Standardized phraseologies are particularly important in training for high-stress environments like emergencies.”

Familiarization on standard operating procedures, communication and terminology should be an integral portion of any operator’s training for new recruits and existing personnel, as well.  

“We also have a CRM training course for our crewmembers. This training is delivered by several contributors,” Bragstad said. “We have our own approved training organization (ATO) delivering the type rating, then the crew training department conducting the conversion training and the line training. Dedicated training on communications is a major part of the training we conduct.”

U.S. Coast Guard pilots and aircrews receive communication training throughout all aspects of their aviation career and practice those techniques throughout the course of routine flight training and aviation operations. In addition, pilots and aircrew receive initial CRM training followed by annual refresher training focused on crew communication, cockpit leadership, and aviation decision-making.

All aviation check-rides evaluate individuals on standard communications and CRM, and instructors provide verbal and written feedback on the use of standard communications, according to the Coast Guard. Overall, Coast Guard aircrews receive communications training from numerous sources periodically throughout their aviation career, thus ensuring continual exposure to standard communication techniques and procedures.