Triage for HEMS

emergency medical services (EMS) aircraft in the United States each year transport about 500,000 seriously ill or injured patients and donor organs to medical facilities. The industry encompasses 1,211 rotary-wing and fixed-wing aircraft, which operate out of 857 bases (Table 1). The recent poor safety record for helicopter EMS (HEMS) operations has prompted the U.S. Federal Aviation Administration (FAA) to issue a notice of proposed rulemaking (NPRM) that, if finalized, would mandate operational and equipment revisions. FAA Administrator Randy Babbitt says the goal is “to protect passengers, patients, medical and flight crews” (Table 2, p. 46). The FAA in previous years has taken numerous non-regulatory actions to address HEMS safety, but in a recent safety review conducted in advance of the NPRM, the agency identified 75 commercial HEMS accidents in the 1994–2008 period that caused 88 fatalities and 29 serious injuries. Further, 127 helicopter air ambulance accidents involving 126 fatalities and 50 serious injuries occurred between 1992 and 2009 — a period in which the industry underwent strong growth (Table 3, p. 46). The U.S. National Transportation Safety Board (NTSB) in October released data showing that U.S.-registered medical helicopters were involved in 188 accidents from March 1990 Growing accident numbers