VOLUME 4 AIRCRAFT EQUIPMENT AND OPERATIONAL AUTHORIZATIONS
CHAPTER 5 AIR AMBULANCE OPERATIONS
Section 3 Safety Assurance System: Air Ambulance Service Operational Procedures
4-941 GENERAL. This section contains information and guidance to be used by
inspectors when evaluating a Title 14 of the Code of Federal Regulations (14 CFR) part
special operational procedures for air ambulance
operations (helicopter or airplane). This section covers the evaluation of an
operator’s operational preflight, in-flight, and emergency procedures. To conduct
an air ambulance operation, an operator must comply with all of the pertinent requirements of part
well as meet additional requirements for the issuance of air ambulance
operations specifications (OpSpecs). This section is related to Safety Assurance
System (SAS) Element 2.2.1 (OP), Airmen Duties/Flight Deck Procedures; Element
3.3.1 (OP), Operational Control; Element 2.1.7 (OP), Flight Crewmember Flight/Duty/Rest
Time; Element 2.3.1 (OP), Appropriate Operational Equipment; Element 3.2.2 (OP),
Use of Approved Areas, Routes, and Airports; Element 5.2.1 (OP), Crewmember
Duties/Cabin Procedures; and Element 6.2.1 (AW), Fueling.
4-942 OPERATIONAL PROCEDURES.
A. Operational Control Procedures. Inspectors must evaluate an
operator’s operational control procedures to determine that a pilot may not
initiate a flight when:
· Not authorized by the operator,
· Total risk exceeds the risk limitations established and documented
by the operator.
B. Final Authority to Fly. Inspectors must evaluate the operator’s
policies and procedures to verify that a pilot has the final authority to refuse
a flight request or terminate an assigned flight. The operator’s procedures
must be in compliance with part
The procedures must be adequate with regard to the overall
size and scope of the operations and if applicable, the number of satellite locations.
NOTE: No later than April 22, 2016, all operators authorized to conduct
helicopter air ambulance (HAA) operations with 10 or more HAAs assigned to that
certificate holder’s OpSpecs must have an Operations Control Center (OCC) in
compliance with the specifications established within that section OpSpec.
C. Flight-Locating. An air ambulance operator is required by
regulation to use flight-locating procedures (refer to §
unless a Federal Aviation Administration (FAA) flight plan is filed
and activated. Flight following, conducted by the HAA operator even where it
is not required by regulation, is recommended as an HAA industry best practice
and is a permissible and desirable adjunct to supplement flight locating.
1) An inspector must evaluate an operator’s flight-locating/following
procedures to verify the procedures are followed, are effective in determining
when an aircraft is overdue, and are helpful in providing situational awareness
to the following/locating staff so that appropriate flight information updates
may be shared with the flightcrew.
2) In the event an aircraft becomes overdue, the operator’s procedures
(commonly referred to as post-accident/incident procedures) must document specific
actions that must be accomplished with respect to that overdue aircraft, to
include immediate notification of the local (jurisdictional) FAA Flight Standards
District Office (FSDO), National Transportation Safety Board (NTSB) and FAA
certificate-holding district office (CHDO). The operator should periodically
conduct training exercises with these procedures. These notifications are requirements
shared with other part
(refer to §
HAA industry best practices for flight locating and flight following
are described in the current edition of Advisory Circular (AC)
Helicopter Air Ambulance Operations.
D. Flight Time and Rest Requirements. Inspectors must ensure
that an operator maintains well-defined records logging individual flight time,
and unassigned duty time in accordance with part
135 subpart F,
Flight Crewmember Flight Time Limitations and Rest Requirements.
Air ambulance operators will normally operate under either one of the following regulations:
Flight Time Limitations and Rest Requirements-Unscheduled One-
and Two-Pilot Crews. According to this regulation, the flightcrew members
are allowed to conduct any flight or other duties as assigned, such as training,
testing or routine transport missions, while on duty/assignment. For an assignment
conducted under §
flightcrew members must receive at least 10 consecutive hours of
rest during the 24-hour period that precedes the planned completion of the assignment.
Helicopter Hospital Emergency Medical Evacuation Service (HEMES).
The rest requirements for HEMES (now HAA) differ from the requirements for flights
During operations in accordance with §
provisions must be made for 8 consecutive hours of rest during
any 24-hour period, and the time of that 8-hour rest period must be declared
in advance. If a flightcrew member does not receive the required rest period,
that person must be relieved of the assignment. The operator should establish
recordkeeping to show that only emergency medical evacuation flights are conducted
during these assignments. While a flightcrew member is assigned to duty under §
that person may not be assigned to any other duties. Prohibited
duties during an HAA assignment include, but are not limited to, maintenance,
test flights, public relations flights and administrative duties. Operations under §
in practice, considerably less widespread than operations under §
NOTE: Inspectors must ensure that operators scheduling pilot duty and
flight assignments under
§ 135.271 have
identified those procedures and policies in their operations manual.
NOTE: Both §§
a comprehensive recordkeeping process.
NOTE: An inspector should ensure that company training manuals and OpSpecs
should specify with which of these sections the HAA operator will comply.
E. Flight Data Monitoring. After April 23, 2018, in accordance
all HAAs must be equipped with an FAA-approved Flight Data Monitoring
System (FDMS) capable of recording flight performance data. The regulation intentionally
does not prescribe retention or use of the FDMS recordings. These decisions
are at the discretion of the air ambulance operator. Beyond the minimum flight
performance data stated below, the type and frequency of data recorded is at
the discretion of the operator. The current edition of AC
27-1 MG 6,
Miscellaneous Guidance (MG) for Emergency Medical Service
(EMS) Systems Installations, suggests flight data that should be considered
for recording; however, this is a recommendation, not a requirement. The minimum
· The FDMS must receive electrical power from the bus that provides
the maximum reliability for operation without jeopardizing service to essential
or emergency loads.
· The FDMS must be operated from the application of electrical power
before takeoff until the removal of electrical power after termination of flight.
· FAA approval will be granted to an FDMS which has the capability
of recording flight performance data including, at a minimum, altitude (mean
sea level (MSL)), time/date of sampling with a minimum sampling rate of one
record per second, and sufficient memory to record an entire flight. The FDMS
must also be installed securely and must be powered as stated above in the regulation.
The installation must be approved under the authority of a Supplemental Type
Certificate (STC), an engineering review conducted by the Aircraft Evaluation
Group (AEG), or a field approval.
F. Helicopter Terrain Awareness and Warning System (HTAWS). After
April 24, 2017, in accordance with §
any helicopter approved for air
ambulance operations must be equipped with an HTAWS that meets the requirements
in Technical Standard Order (TSO)-C194, Helicopter Terrain Awareness and Warning
System (HTAWS). Upon implementation, inspectors must evaluate an operator’s
equipment installation and the pilot training curriculum to determine whether
the requirements of §
met. The operator’s Rotorcraft Flight Manual
Supplement (RFMS) and training curriculum must contain appropriate procedures for:
· The use of the HTAWS; and
· Proper flightcrew response to HTAWS audio and visual warnings.
NOTE: Providing HTAWS is operational and the pilot is trained and qualified,
the operator may use HTAWS to qualify for relief against Local Flying Area (LFA)
Class G visual flight rules (VFR) night minimum ceiling and visibility restrictions,
in accordance with §
NOTE: Operators with HTAWS required by §
an approved deviation under 14 CFR part
in compliance with this regulatory mandate. A minimum equipment
list (MEL) deferral procedure may be requested but is subject to Flight Operations
Evaluation Board (FOEB) approval.
G. Situational Awareness. Inspectors should evaluate the operator’s
actions aimed at ensuring the situational awareness of HAA personnel. This includes
their procedures for receiving and filtering information and providing inputs
for or conducting regulatory-required risk assessments, VFR flight planning,
shift-change briefings, and preflight briefings. Procedures must address ensuring
situational awareness of pilots, Operations Control Specialists (OCS) and other
operations support personnel coming on duty, and maintaining of situational
awareness throughout their duty period. Procedures should include methods for
providing information on current operational and flight conditions, with emphasis
placed on hazard updates. Conference calls, shift change briefing documents,
or other technologies to link personnel at remote sites may be applied.
H. Potential Hazard Information. Inspectors should evaluate the
operator’s means at each base and satellite location for depicting hazards to
flight operations. All potential hazards should be annotated. Power lines, towers,
and tall structures in the vicinity of designated Landing Zones (LZ) and newly
erected towers, including temporary construction cranes, are particularly important.
1) The operator should develop hazard maps for each service area
regardless of whether or not an LFA exists. The operator should involve flightcrew
members from each service area when frequently and regularly reviewing and updating
the hazard maps and as new hazard information becomes available. A system to
identify and depict newly-added hazards and to ensure pilots are immediately
aware of them should be developed. VFR/IFR transition corridors and preferred
routes should appear on hazard maps.
2) The operator should display the hazard map in a conspicuous
location at each base for pilots to review. In evaluating the provision of this
information, consider that recommended practices include treating the hazard
map as a living document, updated by the use of grease pencils or map pins with
appropriate notes or captions or other rapid and temporary updating methods.
Transient hazards (including construction cranes or other temporary obstructions,
private heliport equipment outages, repairs, or maintenance operations, as well
as hazards created by seasonal sun angles, and localized high winds or reduced
visibilities due to seasonal meteorological effects, or as recorded in Notices
to Airmen (NOTAM)) should appear on the map with their applicable times.
I. Landing Site Depiction. Inspectors should evaluate the operator’s
means for providing LZ information. Criteria should be established, documented,
and included in training programs to periodically assess each heliport/LZ on
a continuing basis. The operator should document criteria for LZ selection.
These criteria should include size, obstructions, wires, lighting, surfaces,
and methods to determine wind direction, etc. A reporting system for unsatisfactory
or dangerous locations, approach and departure paths, and a continuing LZ evaluation
program should be part of HAA operations. Operators should distill findings
into a simple record of recommendations and precautions regarding each landing
facility regularly used and make this available to flightcrew members.
J. Protection and Control of Infectious Conditions. Inspectors
should evaluate the operator’s procedures for protection against blood-borne
pathogens, biohazard and infection control, and propagation prevention and control
of infectious diseases. Operators should have documented procedures and training,
including disposal and decontamination of equipment and aircraft cleaning (which
could be provided by an associated medical service or hospital or by contract
to a service company). Inspectors should ensure that training in precautions
for the operator’s flight operations and maintenance employees is emphasized
in documentation and in training programs.
4-943 PREFLIGHT PLANNING AND ACTIVITIES. When evaluating an operator’s
preflight planning procedures and activities for an air ambulance service, inspectors
A. General Operations Manual (GOM). In accordance with §§
all HAA operators must document procedures for VFR Flight Planning
and Risk Analysis. If the operator maintains a GOM, these mandatory procedures
should be included and distributed in their GOM system. Regardless, the mandatory
procedure documents and forms must be available at each location where aircraft
are based and flights are initiated, and appropriate sections should be available
in each aircraft. It is recommended but not required that smaller certificate
holders conducting air ambulance operations (including single-pilot and basic
operators) develop a GOM that covers the subject matter contained in §
Voluntarily developed GOMs should be available at each location
where aircraft are based and flights are initiated, and appropriate sections
should be available in each aircraft.
B. Accident Incident Plan/Post-Accident Incident Plan (AIP/PAIP). Per §
air ambulance operators must establish accident and incident
notification procedures. This is a requirement shared with other part
C. Refueling and Servicing Procedures. Refueling with the engine(s)
running, rotors turning, and/or passengers on board can be hazardous and must
be accomplished in accordance with appropriate documented procedures and by
trained personnel. (Refer to AC
the current edition of AC
Safety In and Around Helicopters, for suggested methods and precautions.)
D. Fuel Quality. The inspector must evaluate the operator’s fuel
quality verification procedures. The operator may choose to procure fuel from
commercial fixed base operator sources and/or maintain their own private fuel
storage and delivery system. Due to the nature of HAA operations, many bases
are at locations other than airports. Where these bases have a private fuel
source maintained by the operator, it is recommended that the operator develop
a documentation system for determining and maintaining fuel quality within their
own system throughout the chain of custody from receipt (from the distributor)
to delivery (into the helicopter). If the operator chooses to procure fuel from
commercial fixed base operator sources, they should have a formal audit program
to verify the fixed base operator maintains fuel quality throughout the chain
of custody from receipt (from the distributor) to delivery (into the helicopter).
The inspector should evaluate the operator’s compliance with standards reflected
in International Civil Aviation Organization (ICAO) Doc 9977 AN/489, Manual
on Civil Aviation Jet Fuel Supply, and the current edition of AC
Aircraft Fuel Storage, Handling, Training, and Dispensing on Airports.
E. Procedures for Medical Equipment Installation and Removal.
Removal and replacement of medical equipment items may have to be performed
on a frequent basis. If the operation is simple, does not require tools, and
can be done in accordance with approved data and procedures contained in the
operator’s manual, any person trained by the certificate holder may be authorized
to remove or replace such equipment. If the operator chooses this option, an
inspector must check that they include this training in their FAA-approved training
and checking program. The inspector must ensure that the operator documents
who is authorized to remove and replace equipment on its aircraft. If personnel
other than certified mechanics will be removing or replacing equipment, they
must do so in accordance with documented instructions and training provided
by the operator and evaluated by an inspector.
F. Flight Authorization, Flight Locating Procedures, and Operations
Control Personnel Duties and Responsibilities. An inspector must check that
these are well considered and are documented in the operations manual. Per §
for those operators with an OCC, a description of the duties and
responsibilities of OCSs should appear in documentation. Inspectors should check
that operators that are not establishing an OCC are documenting procedures for
G. LFA Documentation. Inspectors must evaluate an operator’s
procedures for developing LFAs (where applicable) and ensure these are documented
in accordance with §
If any LFAs are proposed and accepted, a list
of LFAs and a description of the examination that is given to pilots by the
certificate holder enabling the use of alternative minima in these LFAs must
be provided to the principal operations inspector (POI) for acceptance. (Refer to §
OpSpec A021, Air Ambulance OperationsHelicopter.)
H. Instrument Flight Rules (IFR) Operations Procedure. An inspector
should evaluate whether the operator has effectively documented and trained
pilots in procedures for IFR operations at locations without weather reporting.
An inspector should verify that an operator documents approved procedures for
IFR operations using special instrument procedures, point in space (PinS) approach
procedures and departure procedures (DP) (Standard Instrument Departure (SID)
and Obstacle Departure Procedures (ODP)). An inspector should verify that an
operator has documented procedures for transitioning from IFR to VFR on approach
or from VFR to IFR on departure.
I. HAA VFR Flight Planning Procedures. An inspector must evaluate
an operator’s flight planning procedures that must, by regulation, be documented
in the operator’s operations manual system in accordance with §
Inspectors must ensure that HAA operators document their procedures to:
· Determine the minimum safe cruise altitude by evaluating the terrain
and obstacles along the planned route of flight per §
· Identify and document the highest obstacle along the planned route
of flight per §
· Determine the minimum required ceiling and visibility to conduct
the planned flight using the weather minimums appropriate to the class of airspace
for the planned flight per 14 CFR part
§ 91.155 or
§ 135.609(a); and
· Identify the minimum safe en route cruise altitudes per §
as listed in their OpSpecs.
NOTE: When a new request is received when airborne, if this possibility
was considered and documented in the original VFR flight planning as an operational
consideration, the flight may proceed without conducting a full VFR preflight
plan. When the aircraft completes the HAA flight operation, in accordance with §
the PIC must perform a new preflight planning process for the
next flight or series of flights.
NOTE: VFR Flight Planning procedures must be accepted by the POI.
J. FAA-Approved Preflight Risk Analysis Procedures. An inspector
must verify that an HAA operator’s risk analysis procedures comply with §
An inspector must evaluate and approve the certificate holder’s risk analysis
procedures, which must be documented in their operations manual. The preflight
risk analysis procedure must include both the elements identified in subparagraph
4-943I above as required by
§ 135.615(d) and
the following additional elements:
· LZ conditions;
· Fuel requirements;
· Human factors, such as crew fatigue, life events, and other stressors;
· Departure, en route, destination, and forecast weather, including
establishing primary and redundant resources and methods for obtaining current
and forecast weather information for the area of operation at the time of the
planned flight; and
· A procedure for determining whether another HAA operator has refused
or rejected a flight request.
1) Strategies and procedures for mitigating identified risks,
including procedures for obtaining and documenting approval of the certificate
holder’s management personnel to authorize a flight when a risk exceeds a level
predetermined by the certificate holder.
2) Prior to the first leg of each HAA flight operation, the pilot
in command (PIC) must conduct a preflight risk analysis and complete a preflight
risk analysis worksheet in accordance with §§
and 135.617 and the certificate
holder’s FAA-approved operations manual.
a) The PIC must sign (manually, digitally, or via any equivalent FAA-approved
technique) the preflight risk analysis worksheet and specify the date and time
it was completed. The pilot may sign this form manually, digitally, or may authenticate
the form via an FAA-approved technique tying the PIC to this completed risk analysis.
b) In the event a new request is received when airborne, and if this reassignment
possibility was considered and documented in the original preflight risk analysis,
a new preflight risk analysis is not required. In accordance with §
when the aircraft completes this HAA flight operation, the PIC must perform
a new preflight planning process and risk analysis for the next HAA flight operation.
3) When a new request is received when airborne (e.g., a new
diversion to a nearby hospital for a patient transport while on repositioning
flight), if this possibility was considered and documented in the original risk
analysis as an operational consideration, and weather, fuel requirements, crewmember
stress, etc., is not adversely affected or has not materially changed, the flight
may proceed on the diversion without conducting a full risk analysis. The inspector
should evaluate the operator’s procedures regarding how the pilot would confer
with the OCS or with the individual who maintains operational control over the
current flight to address any risks which may have changed, and proceed with
or refuse the diversion flight accordingly. When the aircraft completes the
amended HAA flight operation, the PIC must perform a risk analysis for the next
flight or series of flights.
4) If the operator has an OCC, the inspector must evaluate the procedures defining
how the OCS will acknowledge the risk analysis in accordance with §
This acknowledgement, in its simplest form, may be a separate record, must be
directly linked to the risk analysis worksheet, and it may be digitally or manually generated.
5) The air ambulance operator must retain the original or a copy
of each completed preflight risk analysis worksheet at the location specified
in the operations manual for at least 90 days from the date of the operation.
An inspector must evaluate the retention method to determine whether this regulatory
requirement has been met.
4-944 FLIGHT PROCEDURES. When evaluating an operator’s in-flight
procedures for an air ambulance service, inspectors must consider the following.
A. Passenger Briefing Procedures. A person designated and trained
by the operator and approved by the FAA Administrator may conduct the passenger
briefing required by §
If passenger safety briefing duties are delegated to
medical personnel, the procedure must be covered in the operator’s operations
and training manuals. As in all part
operations, passenger-briefing cards are required
for air ambulance operations.
B. Medical Personnel Serving As Crewmembers. Medical personnel
are considered passengers. However, in some cases, particularly in the case
of an emergency, the medical personnel may be requested to perform some duty
in an aircraft that relates to the operation of that aircraft, such as assisting
the flightcrew in seeing and avoiding other aircraft, evaluating an LZ, coordinating
with ground personnel at an LZ, and emergency shutdown of aircraft systems in
an accident. For safe performance of such tasks, the operator must provide medical
personnel with appropriate and documented training and checking including Crew
Resource Management (CRM) as applicable, which the POI should evaluate. All
legs of a HAA flight operation, including the “tail-end ferry” flight for return
to base, must be conducted under part
C. Medical Personnel Safety Briefing Procedures. Prior to each
HAA operation, each PIC, or other flightcrew member designated by the certificate
holder, must ensure that all flight medical personnel have been briefed on the
· Passenger briefing requirements;
· Physiological aspects of flight;
· Patient loading and unloading;
· Safety in and around the helicopter;
· In-flight emergency procedures;
· Emergency landing procedures;
· Emergency evacuation procedures;
· Efficient and safe communications with the pilot; and
· Operational differences between day and night operations, if appropriate.
NOTE: With the exception of the briefing required by §
this preflight medical personnel briefing may be omitted
if all medical personnel on board have satisfactorily completed the certificate
holder’s FAA-approved medical personnel safety training program within the preceding
24 calendar-months in accordance with §
D. Passenger Restraint Procedures. Inspectors should evaluate
the operator’s method for normal and specialized passenger restraint before
takeoff. Passengers and patients who may pose a hazard to the aircraft or to
its occupants (such as hysterical or combative patients) may require special
restraint methods. Operators should be encouraged to establish adequate written
procedures for the proper restraint of all flight personnel and the proper use
of seat belts and should harnesses during air ambulance operations. In addition,
it is the responsibility of the PIC to ensure that passengers who may pose a
hazard to the aircraft or to its occupants are properly restrained before takeoff.
E. Air-to-Ground Communications. Inspectors should evaluate the
operator’s method of air‑to‑ground communication systems that ensure the flightcrew
can coordinate with emergency personnel, first responders and communication
specialists or OCSs/operations control personnel.
F. Scene Response Operations. Inspectors and operators normally
associate the term “scene response” with helicopter operations; however, scene
response operations are not limited to helicopters. Scene response flights may
be served by airplanes as well as helicopters; these may be conducted during
airplane operations in remote locations. Inspectors should consider the following
operational procedures regarding scene response operations:
1) Inspectors should evaluate the operator’s procedures for determining
the suitability of the landing area. Suitability considerations should include
· Surface condition (e.g., loose snow, soil and dust, spongy, muddy,
or soft soil);
· Crowd control;
· Wind direction and velocity;
· Restrictions to visibility; and
· Illumination of obstacles by ground personnel at night.
2) Final responsibility for the determination of the suitability
of the LZ remains with the PIC.
3) The operations manual should contain specific policy guidance
for coordination procedures between flightcrew and medical personnel.
4-945 EMERGENCY PROCEDURES. When evaluating an operator’s emergency
procedures for an air ambulance service, inspectors must consider the following:
A. Inadvertent Instrument Meteorological Conditions (IIMC). Inspectors
will evaluate emergency operations procedures for recovery from IIMC. These
procedures must be presented in the operator’s GOM and initial and recurrent
training manual(s). The GOM must also include procedures for aircraft handling
in flat-light, whiteout, and brownout conditions, including methods for recognizing
and avoiding those conditions. All pilots must be checked in compliance with §
B. In-Flight Medical Emergencies. Inspectors should evaluate
procedures for flightcrew coordination with medical personnel resulting from
in-flight medical emergencies. Such procedures must exclude the PIC from the
nature of the medical emergency yet ensure the pilot is aware of and can act
upon any desired diversion to a different hospital other than the original intended
destination, providing risks associated with diverting from the original planned
flight are not worse than the planned flight. The PIC should use the Medevac
prefix or discrete company call sign when communicating with air traffic control (ATC).
C. Emergency Evacuation Procedures. Inspectors should evaluate
emergency evacuation procedures for each make and model of aircraft and aircraft
configuration. This should include any additional duties assigned to the medical personnel.
4-946 IFR OPERATIONS. Inspectors should verify that all pilots meet
the requirements of §
April 24, 2017. After that date, no certificate
holder may usenor may any person serve as PIC ofan HAA operation, unless that
person meets the requirements of §
holds a helicopter instrument rating or an Airline Transport
Pilot Certificate (ATPC) with a category and class rating for the aircraft that
is not limited to VFR.
A. Transitions Between a PinS Instrument Approach Procedure (IAP)
Missed Approach Point (MAP) and the Landing Area. Such transitions may be
depicted as “proceed visually” or “proceed VFR,” depending upon the results
of obstruction analysis and approach design criteria. The inspector should evaluate
the operator’s understanding of the terms used and the manner in which flightcrews
are trained to execute the transitions accordingly.
B. Transitions from other Published Approaches from an Airport Runway
Environment to a Discrete Landing Area not on the Airport. Inspectors should
ensure that operators’ manuals either prohibit or properly address executing
an instrument approach to an airport and thence proceeding VFR to an LZ someplace
other than on the airport to which the approach was conducted. Procedures should
incorporate determining the weather at the location to which the approach is
executed and along the entire route to the LZ. Weather must meet or exceed VFR
weather minimums for the class of airspace to which the VFR transition will
be conducted, as expressed in §
at the intended landing area and along
the intended route of flight.
C. Transitions Between a Landing Site and Controlled Airspace.
When a DP containing obstacle avoidance procedures (ODP or SID) is published
for a site and takeoff minimums are depicted on the DP, the pilot may depart
in accordance with the published minimum visibility. This is not considered
a VFR departure. If takeoff minimums are not published, the departure is considered
VFR and must conform to §
4-947 LFA FOR HAA OPERATIONS. The LFA is considered that area within
which the pilot has detailed local knowledge.
A. LFA. The LFA may be a symmetrical area, such as an area encompassed
by a designated size radius, or an irregular area defined by landmarks and geographical
features; however, visually distinct geographical features defining the irregular
area must be individually identified.
1) An acceptable LFA is an area that the pilot can identify the
borders of in flight, and for which the pilot’s operational knowledge can be
evaluated through an oral or written test.
2) If an identified LFA is outside of the geographical boundaries
of the CHDO, the CHDO may coordinate review of the proposed LFA with the FSDO
having jurisdiction over the area.
3) An LFA may overlap more than one FSDO’s area, in which case,
coordination may be desired with all affected FSDOs.
4) Exceptions can be approved when the LFA has limited complexity,
however, in no case should an LFA exceed 50 nautical miles (NM) in any direction
from the operator-designated center location.
B. Any Number of References May Define the LFA:
· A specified radius from a point (if easily identified using installed,
· Bounding natural and cultural references (rivers, shorelines,
· Governmental boundaries, if easily identified in flight;
· By describing a polygon between natural, cultural, or aeronautical
reference points (shoreline points, islands, valleys, buildings, airports, VHF
omnidirectional range stations (VOR), global positioning system (GPS) waypoints);
· Any other reasonable description of an area that may be easily
applied by a flightcrew, such as a predetermined route or system of routes; and
· Limitations to any of the above (e.g., 25-NM radius of the John
Doe Hospital, except that portion west of Muddy River).
C. Contiguous. A base of operations may have more than one LFA,
and multiple LFAs are not required to be contiguous, that is, there is no requirement
that the LFA for a particular base of operations be only one defined area. For
example, if the operator conducts HAA operations in a particular metropolitan
area, but often transports patients to a regional trauma center outside that
area, the operator may choose to develop an additional LFA for the assigned
pilots to use when operating near the trauma center. While operating in between
the LFAs, the cross-country minimums would apply. (See Figure 4-56, Local and
Cross-Country Flying Minimums.)
Figure 4-56. Local and Cross-Country Flying Minimums
D. Flying Area Minimums. In order to use the LFA minimums provided
in OpSpec A021, an HAA pilot must have completed an examination on the features
of the LFA within the previous 12 calendar-months. This examination should include,
but is not limited to the following:
· Terrain features;
· Prominent obstructions, including areas of obstructions;
· Minimum safe altitudes in the area;
· Weather producers (such as industrial areas, fog prone areas, etc.);
· Areas of poor surface lighting, and the effects of seasonal and
other changes on surface lighting, as applicable to the LFA in question;
· Airspace/air traffic facilities;
· Radar and communications coverage, including minimum altitudes
for radar service and communications with air traffic facilities and company dispatch/communications facilities;
· Airports/heliports/fuel sources, including night availability;
· Available instrument approaches;
· Predominant air traffic flows;
· Landmarks and cultural features;
· Noise sensitive areas;
· Facility-specific information, such as flight locating, dispatch,
and communications; and
· Any emergency considerations appropriate to the area.
1) This examination may be an oral or written examination, or
combination, and may be conducted as a part of the line check conducted under §
The manner in which the examination is conducted must be described
in the operator’s approved training program.
2) If a pilot has not satisfactorily passed an examination on
the applicable LFA, he/she must use the cross-country area weather minimums.
3) Additionally, OpSpec A021 provides different minimums for
mountainous and non-mountainous areas. To ensure commonality with IFR requirements,
mountainous areas are identified as those designated as mountainous areas in 14 CFR part
4-948 SERVICING OF AIRCRAFT WITH PATIENTS ON BOARD. Before conducting
rapid refueling with the engine(s) running or replenishment of oxygen with passengers
on board, the certificate holder must develop procedures acceptable to the POI.
These procedures must be published in the certificate holder’s GOM (see
Volume 3, Chapter 32, Section 4).
These policies and procedures should include any
special considerations for the evacuation of patients in case of emergencies.
The certificate holder must train and qualify all applicable personnel in these
procedures before conducting such operations. (Refer to AC
135-14 and AC
suggested methods and precautions.)
RESERVED. Paragraphs 4-949 through 4-960.