VOLUME 4 AIRCRAFT EQUIPMENT AND OPERATIONAL AUTHORIZATIONS
CHAPTER 5 AIR AMBULANCE OPERATIONS
6 Public Helicopter Emergency Medical Services (HEMS) Operations
Introduction. Helicopter Emergency Management Services (HEMS)
operations are conducted using both civil and public helicopters. Civil helicopters
conduct these operations for hire under Title 14 of the Code of Federal Regulations
part 135. Public aircraft also conducts HEMS operations, such as those operated
by a governmental entity, and are not required to hold an FAA air carrier or
operating certificate unless such operations result in compensation.
Preliminary Review of Civil HEMS Accidents. A preliminary
review of the commercial HEMS accidents from January 1998 through December 2004
reveals that controlled flight into terrain (CFIT), night operations, and inadvertent
flight into instrument meteorological conditions (IMC) are predominant factors.
Of the 27 fatal HEMS accidents, 21 occurred during night operations. Of the
21 night accidents, 16 of the operations originated under visual flight rules
(VFR) and inadvertently flew into IMC conditions resulting in CFIT. In addition,
approximately 13 accidents during this timeframe were attributed to maintenance.
See the table below.
Table 4-19, Number of HEMS Accidents
Total Number of
HEMS Accidents (‘98-‘04)
Fatal HEMS Accidents
In 16 of the 27 fatal accidents, the National
Transportation Safety Board (NTSB) lists VFR into IMC and CFIT as contributing
The Types and Circumstances of the Studied Accidents Indicate
the Need for the Following:
Strengthening operational control.
Increasing pilot skill in adverse weather operations, especially in the
avoidance of and recovery from inadvertent IMC.
Applying risk assessment in flight decisions.
Fostering collaborative decisionmaking between ground and flight personnel.
Developing a safety culture in HEMS operations.
Federal Aviation Administration (FAA) Efforts. To meet
these needs, the FAA has accomplished several actions that directly address
the safety concerns revealed in the preliminary review. Specifically, the following
documents were issued:
8000.293, Helicopter Emergency Medical Services (HEMS) Operations, issued
1/28/05 (now more widely distributed by SAFO 06001).
8000.301, Operational Risk Assessment Programs for Helicopter Emergency
Medical Services (HEMS), issued 8/01/05).
8000.307, Special Emphasis Inspection Program for Helicopter Emergency Medical
Services, issued 9/27/05).
HBAT 06-01, Helicopter Emergency Medical Services; OpSpec A021/A002 Revisions,
HBAT 06-02, Helicopter Emergency Medical Services (HEMS) Loss of Control
(LOC) and Controlled Flight into Terrain (CFIT) Accident Avoidance Programs,
The HEMS Task Force. This force consisting of representatives
from the Flight Standards Service, the Aircraft Certification Service, and the
Office of Aircraft Accident Investigation, continues to review accident data
to determine the desired course(s) of action to address accident safety causal
factors in the HEMS operating environment. Additional guidance will be developed
because of this ongoing effort. Such guidance may be in the form of advisory
circulars, notices, handbook bulletins or revisions, and the Aeronautical Information
The safety guidance that has been developed for the civil
HEMS industry has wider application, to include the public HEMS community. While
certain aspects of public HEMS operations are different from the civil sector,
the operational safety considerations are the same.
Accordingly, the FAA will provide the current HEMS guidance
documents to each identified public HEMS operation. Public HEMS operators should
be encouraged to review FAA civil HEMS operations standards, and adopt those
components that have application to their specific operation.
In addition, FAA personnel should be alert to indications
of noncertificated public HEMS providers operating for compensation or hire
contrary to the provisions of 14 CFR
parts 119 and/or
4-993 INSPECTOR RESPONSIBILITIES.
Flight Standards District Offices (FSDOs) will provide copies
of this notice, and the documents cited in paragraph 3(d) to all public aircraft
HEMS operators in their district. Where possible, electronic means should be
used to minimize copying and postage costs.
Each aviation safety inspector (ASI) should be alert for indications
that public HEMS operations are being conducted contrary to the definition of
public aircraft (14 CFR
section 1). Should such indications exist, such as a noted direct or indirect
fee for HEMS service, further investigation should be initiated. Supporting
guidance is contained in:
FAA Order 8900.1, Flight Standards Information Management System,
Volume 3, Chapter 14, Section 1, General Information on Public Aircraft
AC 00-1.1, Government Aircraft Operations.
Public Law 103-411, Independent Safety Board Act Amendments of 1994.
RESERVED. 4‑994 through 4‑1000.