Safety of Air Ambulances (CRS Report for Congress)
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| Release Date |
May 23, 2006 |
| Report Number |
RL33430 |
| Report Type |
Report |
| Authors |
Bart Elias, Resources, Science, and Industry Division |
| Source Agency |
Congressional Research Service |
Summary:
The estimated rate of air ambulance accidents has been steadily rising since the early 1990s, and
has
increased at a rapid rate since 1998 when the industry began to expand more rapidly and shift toward
a model of more independent private air ambulance services that cover larger geographic areas.
Statistics indicate that the large majority of air ambulance accidents are attributable to operational
factors related to pilot situation awareness and decision making when faced with adverse
environmental conditions such as darkness, deteriorating weather, rugged terrain, or some
combination of these factors.
Initiatives to improve air ambulance safety to date have consequently focused on additional
pilot training, implementing risk management practices to improve the safety of flight operations,
and using various technologies to improve pilot situation awareness in restricted visibility conditions.
However, implementation of these safety measures has strictly been voluntary. The National
Transporation Safety Board (NTSB) and other aviation safety experts are advocating the mandatory
use of formal flight dispatch procedures and risk management practices among air ambulance
operators as well as mandatory installation of terrain warning systems on air ambulance aircraft. The
NTSB also found that many air ambulance accidents occur when patients are not on board, such as
en route to an accident scene. Present regulations allow air ambulances to operate under a less
stringent set of rules with regards to weather minimums and pilot duty times when not carrying
patients. However, the NTSB believes that air ambulance flights should operate under more
stringent commercial operating rules at all times that medical personnel are carried on board.
Although maintenance issues have been identified in about 20 percent of all air ambulance accidents,
neither the Federal Aviation Administration (FAA) nor the NTSB has placed any specific emphasis
on oversight of operators or repair stations that maintain air ambulance aircraft. The present
emphasis on air ambulance safety has, instead, been dominated by concerns over flight crew
performance and weather-related factors.
A variety of options are available to improve safety among air ambulance operators. These
options include intensified oversight of air ambulance operators and regulatory changes to bring all
phases of air ambulance operations under the same set of operational rules regarding weather
minimums and pilot duty times; possible regulatory changes to provide for sharing and analysis of
safety-related data and observations with some degree of impunity; possible aircraft design
considerations to improve crash survivability; expanded application of system safety and formal risk
management principles to mission planning and flight operations; enhanced training for both pilots
and support personnel and operational procedures to improve coordination and situation awareness
among the entire air ambulance crew and ground support team; and the use of various technologies
to improve pilot situation awareness and augment pilot vision in low visibility conditions.
This report will not be updated.
