{
  "id": "RL33430",
  "type": "CRS Report",
  "typeId": "REPORTS",
  "number": "RL33430",
  "active": false,
  "source": "EveryCRSReport.com",
  "versions": [
    {
      "source": "EveryCRSReport.com",
      "id": 315198,
      "date": "2006-05-23",
      "retrieved": "2016-04-07T19:02:15.551029",
      "title": "The Safety of Air Ambulances",
      "summary": "The estimated rate of air ambulance accidents has been steadily rising since the early 1990s, and\nhas\nincreased at a rapid rate since 1998 when the industry began to expand more rapidly and shift toward\na model of more independent private air ambulance services that cover larger geographic areas. \nStatistics indicate that the large majority of air ambulance accidents are attributable to operational\nfactors related to pilot situation awareness and decision making when faced with adverse\nenvironmental conditions such as darkness, deteriorating weather, rugged terrain, or some\ncombination of these factors. \n \n Initiatives to improve air ambulance safety to date have consequently focused on additional\npilot training, implementing risk management practices to improve the safety of flight operations,\nand using various technologies to improve pilot situation awareness in restricted visibility conditions. \nHowever, implementation of these safety measures has strictly been voluntary. The National\nTransporation Safety Board (NTSB) and other aviation safety experts are advocating the mandatory\nuse of formal flight dispatch procedures and risk management practices among air ambulance\noperators as well as mandatory installation of terrain warning systems on air ambulance aircraft. The\nNTSB also found that many air ambulance accidents occur when patients are not on board, such as\nen route to an accident scene. Present regulations allow air ambulances to operate under a less\nstringent set of rules with regards to weather minimums and pilot duty times when not carrying\npatients. However, the NTSB believes that air ambulance flights should operate under more\nstringent commercial operating rules at all times that medical personnel are carried on board. \nAlthough maintenance issues have been identified in about 20 percent of all air ambulance accidents,\nneither the Federal Aviation Administration (FAA) nor the NTSB has placed any specific emphasis\non oversight of operators or repair stations that maintain air ambulance aircraft. The present\nemphasis on air ambulance safety has, instead, been dominated by concerns over flight crew\nperformance and weather-related factors. \n \n A variety of options are available to improve safety among air ambulance operators. These\noptions include intensified oversight of air ambulance operators and regulatory changes to bring all\nphases of air ambulance operations under the same set of operational rules regarding weather\nminimums and pilot duty times; possible regulatory changes to provide for sharing and analysis of\nsafety-related data and observations with some degree of impunity; possible aircraft design\nconsiderations to improve crash survivability; expanded application of system safety and formal risk\nmanagement principles to mission planning and flight operations; enhanced training for both pilots\nand support personnel and operational procedures to improve coordination and situation awareness\namong the entire air ambulance crew and ground support team; and the use of various technologies\nto improve pilot situation awareness and augment pilot vision in low visibility conditions.\n \n This report will not be updated.",
      "type": "CRS Report",
      "typeId": "REPORTS",
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}