4.1 Navigation, Maps, GPS, and Night-Vision Goggles
Key Takeaways
- Aeronautical products — sectional charts, helicopter route charts, and a current GPS moving map — show terrain, obstacles, and published heliports that a road map or phone pin will hide
- Read back destination coordinates in the stated format (latitude/longitude, MGRS, or a named pad) and confirm the hospital helipad identifier, not only a street address
- Keep a paper or second-electronic backup; a moving map is the usual picture, not sole-source truth
- Civil aviation NVGs intensify residual light; unfiltered white, many red incandescent lights, phone screens, and strobes can bloom or shut the tubes down
- The flight nurse shares go/no-go weather and NOTAM facts but does not act as pilot in command
A flight nurse is not the pilot in command (PIC), and the Certified Flight Registered Nurse (CFRN) exam does not expect you to file an instrument flight plan. Domain 1.D still expects you to keep the aircraft from landing at the wrong hospital or blooming the night-vision goggles (NVG) with a white flashlight. The PIC owns the path; you own destination truth and cabin lighting.
Charts the road atlas cannot replace
A street map finds a driveway. It is a poor helicopter emergency medical services (HEMS) chart: it hides guy wires, unlit towers, elevation figures, airspace, and many rooftop heliports.
| Chart or product | What it shows well | What it hides |
|---|---|---|
| Highway or phone road map | Street names, mile markers, campus addresses | Towers, wires, elevation figures, airspace, many heliports |
| Sectional chart | Terrain, obstacles, airports, visual checkpoints, airspace | Fine downtown helicopter corridors and some rooftop pads |
| Helicopter route chart | Published metro helicopter routes, recommended altitudes, named heliports | Rural wire fields and temporary cranes |
| Global positioning system (GPS) moving map | Own-ship position and entered waypoints | New wires, a closed pad, a wrong-datum pin |
Use the road map with a landing-zone officer. Use the aeronautical chart with the PIC for terrain, towers, and published heliports.
Coordinates: three languages, one pin
Civilian HEMS lives in latitude and longitude. Disaster, wildland, and many federal scenes speak Military Grid Reference System (MGRS). Ground crews speak street address. Mixing the three without a readback sends the aircraft to the wrong campus.
- Latitude/longitude must name the format: decimal degrees versus degrees and decimal minutes versus degrees-minutes-seconds. A swapped minute and decimal will put you miles off.
- MGRS is a grid (zone, 100-kilometer square, easting, northing). Do not convert in your head. Use the aircraft or dispatch converter and read the result back.
- Street address identifies a building, not a pad. "University Hospital" can mean a downtown rooftop, a north-campus ground pad, or a closed construction pad.
Confirm the helipad identifier, not just the hospital name. Many systems use a Federal Aviation Administration (FAA) landing-facility identifier. Read back hospital, campus, pad, and the coordinates you loaded.
The GPS moving map is the usual picture, not sole-source truth. Databases go stale and antennas fail. Keep a paper sectional or helicopter-route chart and a written copy of the verified pin.
Lost communications and lost visual
Lost communications and lost visual reference are PIC procedures that change your cabin immediately.
If radios fail, the PIC may squawk 7600, continue the last cleared route, or divert on the briefed plan. Keep medical traffic off the dead aviation radio. Use the satellite phone or a dispatch relay.
Lost visual — including inadvertent instrument meteorological conditions (IIMC) — means the PIC is now flying instruments. Sterile cockpit is not optional. Do not ask for a clinical radio patch, a cabin light, or a destination change unless the patient is in cardiac arrest.
Night-vision goggles: image intensification, not heat vision
Civil aviation NVGs are image-intensification devices. Residual photons — moonlight, starlight, cultural lighting — are amplified through a photocathode and microchannel plate onto a phosphor screen. That is not forward-looking infrared (FLIR) thermal imaging. A blacked-out canyon with no moon and no town glow can still be a black hole through the tubes.
Aided vision is the picture through the goggles. Unaided vision is what dark-adapted eyes see around or without them. NVGs give a narrow field of view — often about 40 degrees — and weaker depth perception. The PIC still needs unaided glances for gauges and the landing zone. You need unaided vision for the patient.
Cockpit and cabin lighting discipline
NVG operations assume NVG-compatible lighting: filtered cockpit and cabin lights that do not flood the tubes. Unfiltered white lights, many red incandescent sources, phone screens, and anti-collision strobes can bloom, halo, or shut the goggles down. A monitor at daytime brightness is a searchlight next to the PIC's face.
- Dim or NVG-filter the monitor, ventilator, and pump displays before the PIC calls "goggles on."
- No white flashlight, laryngoscope flood, or phone torch while the aircraft is aided.
- If you must use a bright light for a procedure, tell the PIC first so the crew can look away or transition unaided.
- External strobes and landing lights are PIC-controlled. Do not add a cabin strobe.
Brownout, whiteout, and night wires
Brownout is dust or sand erasing visual references in a hover. Whiteout is the same event in snow. Both produce spatial disorientation. The PIC may abort. Your job is silence and a secured cabin.
Wire-strike risk rises at night, especially on scene flights. Wires are thin, low-contrast, and often missing from charts and GPS databases. NVGs do not paint every cable. Confirm wires, towers, slope, and vehicles with the ground contact. If no one has walked the zone, treat wires as present.
Flight-nurse navigation duties
You do not set legal weather minimums as PIC. You do bring weather and destination facts into the shared go/no-go.
- Confirm destination coordinates and read them back in the stated format.
- Confirm the hospital helipad identifier or named pad, not a street address alone.
- Ask about Notices to Air Missions (NOTAM) that close a pad, raise a crane, or create a temporary flight restriction.
- State weather you can see or have been told — ceiling, visibility, icing, thunderstorms, night unaided versus NVG — as a crew input, not as an order.
If the pin, the pad, or the NOTAM does not match the request, stop the launch.
Dispatch gives only the street address of a multi-campus hospital for a night interfacility flight. What is the flight nurse's priority navigation action?
The pilot calls "goggles on" for a night scene approach. The flight nurse needs to watch the cardiac monitor. Which lighting action is most appropriate?
During cruise the aircraft enters cloud and the pilot states they have lost visual reference. What should the flight nurse do first?