Air ambulance

Air medical services is a comprehensive term covering the use of air transportation, airplane or helicopter, to move patients to and from healthcare facilities and accident scenes. Personnel provide comprehensive prehospital and emergency and critical care to all types of patients during aeromedical evacuation or rescue operations aboard helicopter and propeller aircraft or jet aircraft.

The use of air transport of patients dates to World War I, but its role was expanded dramatically during the Korean and Vietnam conflicts. Helicopters are used to transport patients between hospitals and from trauma scenes; fixed-wing aircraft are used for long-distance transports.

The advantages of medical transport by helicopter may include providing a higher level of care at the scene of trauma and improving access to trauma centers. Helicopter-based emergency medical service (EMS) also provides critical care capabilities during interfacility transport from community hospitals to trauma centers.

Effective use of helicopter services for trauma depends on the ground responder's ability to determine whether the patient's condition warrants air medical transport. Protocols and training must be developed to ensure appropriate triage criteria are applied. Excessively stringent criteria can prevent rapid care and transport of trauma victims; relaxed criteria can result in the embarrassing and costly situation of transporting a patient by helicopter only to have the patient discharged in good condition from the emergency department.

Crew and patient safety is the single most important factor to be considered when deciding whether to transport a patient by helicopter. Weather, air traffic patterns, and distances (e.g., from trauma scene to closest level one trauma center) must also be considered. Another reason for cancelling a flight is based on Flight Crew comfort with the flight. The general rule of safety is upon the crew, when there is one pilot and two medical crew is: 3 to go, 1 to say "NO". If one Flight Member is not comfortable with the flight for whatever reason, the flight is cancelled.

Some have questioned the safety of air medical services While the number of crashes may be increasing, the number of programs and use of services has also increased. Factors associated with fatal crashes of medical transport helicopters include flying at night and during bad weather, and postcrash fires.

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