Rising Helicopter Crash Deaths Spur Debate Over Proper Use of Air Transport

Abstract

This article considers the recent scrutiny of air medical services, focusing both on the safety of the aircraft and whether they are used too often and for patients who could just as effectively be transported by ground. The author reviews the 9 emergency medical services (EMS) accidents in 2008 that took the lives of 35 people, focusing on the reasons why helicopters crash and issues of appropriate use of helicopter transport. In the first section, topics include helicopter flights in hazardous conditions, the National Transportation Safety Board safety recommendations, the role of the Federal Aviation Administration, the use of automated terrain avoidance systems, and the use of night vision goggles. The section on appropriate use addresses time and cost factors, the allocation of helicopter resources in urban and rural areas, the role of a unified dispatch process for EMS, the tension between aircraft regulations versus medical regulations, adjusting the trauma criteria specifically for helicopter transport, and the need for national guidelines for EMS helicopter use. The author considers the argument that local control of helicopter dispatch, overseen by physicians, as one way to ensure appropriate use of the services.