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A Look at Helicopter EMS

Mar 16, 2018
Helicopter Emergency Medical Services (HEMS) is a young industry. HEMS lifesaving services require experienced team members. Qualified individuals must be able to withstand a high pressure flight environment. There is some concern within the industry. Administrators are rethinking the way operations are currently managed.

The Helicopter EMS Industry

In 2017, Rotor and Wing International listed the top 10 HEMS by fleet size. Air Methods leads the industry with more than 300 helicopters, Air Evac Lifeteam is second (110), Omniflight is third (90), PHI Air Medical is fourth (82), and Metro Aviation is fifth (62). The other five companies operate fleet sizes with under 50 helicopters.

Consumer Reports examined the growing HEMS industry. U.S. fleet size doubled between 2000 and 2017 to over 1,000 medical-emergency helicopters. However, the industry has some disconcerting faults. For-profit companies will sometimes operate unethically. While they are driving growth, their services are often unnecessary. Medical insurers do not cover HEMS services in full. Patients are subsequently left with substantial medical bills that they cannot afford to pay. Compounding matters is that many did not need air service in the first place. 

Patients receiving unnecessary HEMS is not a new trend. Emergency Medical Services reported on this issue back in 2009. It stated, that in about half of the air transport cases, only ground transport was necessary. The report went on to recommend that closer medical supervision should accompany HEMS.

HEMS Qualifications

Companies operating within the HEMS industry require high qualifications. One reason for this is that it must coordinate with the Federal Aviation Administration and medical community. Team members of HEMS companies are often responsible for the lives of their patients. Operations take place in critical environments while conducting flights that leave no room for error.

According to the top five fleet sizes ranked by Rotor and Wing International, the number one company, Air Methods, operates almost as many helicopters as the other four combined. The company’s hiring requirements are examined in the following sections for EMS Flight Nurses and Paramedics, as well as, Pilots and Mechanics. In addition to the hiring protocols, there are specialized training programs for all fight team members.

Flight Nurses and Paramedics

24-hour shifts are required of Flight Nurses and Paramedics. Candidates with Bachelor’s degrees in health related fields are preferred. Previous flight experience is also preferred. The minimum experience requirement is 3 three years in critical and/or emergency work for Flight Nurses. 3 three years (in a busy 911 system) is also desirable for Flight Paramedics.

Pilots and Mechanics

Becoming a Mechanic for the top HEMS operator requires an FAA A&P license. The preferred experience for a lead position is 5 years working with turbine-engine helicopters and/or planes. A supportive role is expected to have amassed 2 years in this role. Experience in the company’s aircraft model and superior electrical troubleshooting skills are also desirable.

Pilot experience requirements are measured in flight hours. Commercial and Instrument certificates are general requirements for all pilots. For Pilot in Command positions, 2000 hours of Instrument Flight Rules are the minimum requirement on top of accumulated Visual Flight Rules hours. A Second in Command position requires 500 hours of flight time in the appropriate category.

The future of HEMS is bright. It should continue to grow alongside aviation and medicine. Like these associated industries, administration is a complex and arduous undertaking. One asset is that, for a young industry, it appears acutely scrutinized.


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