Appropriate and Safe Utilization of Helicopter Emergency Medical Services

Reaffirmed September 2018

Originally approved April 2011


As an adjunct to this policy, ACEP has prepared a policy resource and education paper (PREP) titled "Appropriate and Safe Utilization of Helicopter Emergency Medical Services" 


We believe: 

That patients benefit from the appropriate utilization of Helicopter Emergency Medical Services (HEMS). 

That EMS and regional healthcare systems must have and follow guidelines for HEMS utilization to facilitate proper patient selection and ensure clinical benefit.   

Clinical benefit may be provided by:

  • Meaningfully shortening the time to delivery of definitive care to patients with time-sensitive medical conditions;
  • Providing necessary specialized medical expertise or equipment to patients before and/or during transport;
  • Providing transport to patients otherwise inaccessible by other means of transport.

That the decision to utilize HEMS is a medical decision, separate from the aviation determination whether a transport can safely be completed.  

  • Physicians with specialized training and experience in EMS and air medical transport must be integral to HEMS utilization decisions, including guideline development and HEMS quality improvement activities.
  • Federal Aviation Administration approved Safety Management Systems must be developed, adopted, and adhered to by air medical operators when making decisions to accept and continue each and every HEMS transport.

That HEMS must be fully integrated within the local, regional, and state emergency healthcare system. 

  • HEMS programs cannot operate independent of the surrounding health care environment.
  • The EMS and health care system must be involved in the determination of the number of HEMS assets necessary to provide appropriate coverage for their region.  Excessive resources may lead to competitive practices that can impact utilization and ultimately affect safety.  Inadequate resources will result in delayed receipt of definitive care.  

We further believe that: 

  • National guidelines for appropriate utilization of HEMS must be developed. These guidelines should be national in scope yet allow for local, regional, and state implementation
  • A National HEMS Agenda for the Future should be developed to address HEMS utilization and availability, and to identify and support a research strategy for ongoing, evidence-based refinement of utilization guidelines.

About this Policy

A joint position statement of the Air Medical Physician Association (AMPA), the American College of Emergency Physicians (ACEP), the National Association of EMS Physicians (NAEMSP), and the American Academy of Emergency Medicine (AAEM)

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