Appropriate Utilization of Air Medical Transport in the Out-of-Hospital Setting

 Revised and approved by the ACEP Board of Directors April 2008Originally approved by the ACEP Board of Directors March 1999 

 As an adjunct to this policy statement, the ACEP’s Air Medical Transport Section developed a Policy Resource and Education Paper (PREP) titled,  Guidelines for Air Medical Dispatch . 

The American College of Emergency Physicians (ACEP) recognizes that helicopter air medical care is a crucial component in a tiered response (including all levels of EMS providers, BLS and ALS ground services, rescue, etc) for the expeditious initial care and delivery of the patient to an appropriate health care facility. An air medical helicopter should be an appropriately equipped and licensed ambulance that is staffed with adequate personnel to provide rapid and stabilizing care under various conditions. The air ambulance personnel should provide this care with the supervision of a qualified emergency physician cognizant of the unique features of air evacuation and use approved protocols for direct on-line as well as off-line medical control. Dispatch of the air ambulance should be under the direction of the appropriate emergency medical response entities.

Appropriate reasons to use an air medical helicopter in the out-of-hospital setting include:

  1. Patient has a significant potential to require high level life support available from an air medical helicopter, which is not available by ground transport.
  2. Patient has a significant potential to require a time-critical intervention and an air medical helicopter will deliver the patient to an appropriate facility faster than ground transport.
  3. Patient is located in a geographically isolated area which would make ground transport impossible or greatly delayed.
  4. Local EMS resources are exceeded.

The air ambulance should be recognized as a regional resource that is available to every person needing care, at any time (weather permitting), regardless of the ability to pay. The patient should have initial stabilization and preparation for flight, then be expeditiously transported to the closest appropriate facility.

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