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Was reluctant at first, but after years of doing it, it has become a preference and makes me cringe when I see someone on-scene at an (EMS) LZ staying in the aircraft.   They can's see behind them, and rely on others to secure the aircraft for departure when those others are preoccupied with their patient care and in a hurry!

The safety reports are full of incidents of seat belts hanging out, equipment (FOD) laying about, doors and panels unlatched.   And, and security at the LZ is pitiful if you are relying on fire department personnel and police to keep it secure.   Those guys literally have their heads up their butts and are too busy taking pictures or staring at the helicopter to see threats around them entering the LZ (pedestrians, vehicles, bicyclists, etc).   Nearly ever LZ I go into I have to get their attention and point out LZ threats coming my way, many times from behind where you can't see them from the cockpit.   And, even if you saw the threat from the cockpit, trying to get someone's attention outside to point it out is slim to nil.

Getting out has earned my preference to make my LZ a safer place!