Narrative:

I was the pilot of an EMS helicopter en route from a scene call northwest of ZZZ and underneath the approach paths of runways 18L&right (clt). I was switched to the ZZZ final controller for wy 18L&right and heard my callsign, X acknowledged. Traffic was heavy and the controller was busy so I couldn't get a call in between his traffic calls after my initial call. I stayed at 1300 ft MSL to avoid the 1800 ft floor of the class B airspace around ZZZ and waited for the final controller to call out traffic to me like they normally do. We work with ATC around ZZZ every day. I saw an MD80 approaching from the left and kept my distance and vertical separation (I estimate 1000 ft) from the MD80. I never saw a reason for the MD80 to wave-off, but later I was told by the ATC supervisor at ZZZ that the MD80 had waved off due to a TCASII alert. The controller finally did come up and recommend a switch to tower and said something garbled and unreadable about class B airspace. I switched to tower, called the traffic I saw approaching runway 23 and proceeded to the hospital. Had the controller asked me to turn east for traffic avoidance I was prepared to ask for a direct route to the hospital because of the critical nature of the patient. If I were faced with the same situation again, I would break into the controller's traffic calls to other aircraft, ask for a direct path to the hospital, and explain that the patient onboard was dying. Possible solutions for future incidents like this involving EMS helicopters are to move beyond 'priority handling' and 'lifeguard' prefixes to call signs, and use 'trauma' or 'critical patient' prefixes when the patient is literally dying and every min delayed from a hospital emergency room is critical to the patient's survival. 3 circumstances happened to meet at the same place and time -- an MD80 on final approach, a very busy ATC controller during a 'push,' and am EMS helicopter with a very critical patient on board trying to get to a trauma center.

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Original NASA ASRS Text

Title: EMS HELI EXPERIENCES POTENTIAL CONFLICT AT ZZZ WHILE TRYING TO TRANSIT AREA.

Narrative: I WAS THE PLT OF AN EMS HELI ENRTE FROM A SCENE CALL NW OF ZZZ AND UNDERNEATH THE APCH PATHS OF RWYS 18L&R (CLT). I WAS SWITCHED TO THE ZZZ FINAL CTLR FOR WY 18L&R AND HEARD MY CALLSIGN, X ACKNOWLEDGED. TFC WAS HVY AND THE CTLR WAS BUSY SO I COULDN'T GET A CALL IN BTWN HIS TFC CALLS AFTER MY INITIAL CALL. I STAYED AT 1300 FT MSL TO AVOID THE 1800 FT FLOOR OF THE CLASS B AIRSPACE AROUND ZZZ AND WAITED FOR THE FINAL CTLR TO CALL OUT TFC TO ME LIKE THEY NORMALLY DO. WE WORK WITH ATC AROUND ZZZ EVERY DAY. I SAW AN MD80 APCHING FROM THE L AND KEPT MY DISTANCE AND VERT SEPARATION (I ESTIMATE 1000 FT) FROM THE MD80. I NEVER SAW A REASON FOR THE MD80 TO WAVE-OFF, BUT LATER I WAS TOLD BY THE ATC SUPVR AT ZZZ THAT THE MD80 HAD WAVED OFF DUE TO A TCASII ALERT. THE CTLR FINALLY DID COME UP AND RECOMMEND A SWITCH TO TWR AND SAID SOMETHING GARBLED AND UNREADABLE ABOUT CLASS B AIRSPACE. I SWITCHED TO TWR, CALLED THE TFC I SAW APCHING RWY 23 AND PROCEEDED TO THE HOSPITAL. HAD THE CTLR ASKED ME TO TURN E FOR TFC AVOIDANCE I WAS PREPARED TO ASK FOR A DIRECT RTE TO THE HOSPITAL BECAUSE OF THE CRITICAL NATURE OF THE PATIENT. IF I WERE FACED WITH THE SAME SIT AGAIN, I WOULD BREAK INTO THE CTLR'S TFC CALLS TO OTHER ACFT, ASK FOR A DIRECT PATH TO THE HOSPITAL, AND EXPLAIN THAT THE PATIENT ONBOARD WAS DYING. POSSIBLE SOLUTIONS FOR FUTURE INCIDENTS LIKE THIS INVOLVING EMS HELIS ARE TO MOVE BEYOND 'PRIORITY HANDLING' AND 'LIFEGUARD' PREFIXES TO CALL SIGNS, AND USE 'TRAUMA' OR 'CRITICAL PATIENT' PREFIXES WHEN THE PATIENT IS LITERALLY DYING AND EVERY MIN DELAYED FROM A HOSPITAL EMER ROOM IS CRITICAL TO THE PATIENT'S SURVIVAL. 3 CIRCUMSTANCES HAPPENED TO MEET AT THE SAME PLACE AND TIME -- AN MD80 ON FINAL APCH, A VERY BUSY ATC CTLR DURING A 'PUSH,' AND AM EMS HELI WITH A VERY CRITICAL PATIENT ON BOARD TRYING TO GET TO A TRAUMA CTR.

Data retrieved from NASA's ASRS site as of July 2007 and automatically converted to unabbreviated mixed upper/lowercase text. This report is for informational purposes with no guarantee of accuracy. See NASA's ASRS site for official report.