Safety of Emergency Medical Services Flights - Previous NTSB Study

Previous NTSB Study

The Safety Board examined similar safety issues after the occurrence of 59 EMS accidents between May 1978 and December 1986 and concluded in a 1988 safety study5 that many areas of EMS operations needed improvement, including weather forecasting, operations during instrument meteorological conditions (IMC), personnel training requirements, design standards, crashworthiness, and EMS operations management. As a result of its findings, the Board issued 19 safety recommendations to the U.S. Federal Aviation Administration (FAA) and others, which have since been closed (see the report appendix G information about these recommendations and their classifications).

Most of the recommendations to the FAA were closed as a result of the June 20, 1991, issuance of Advisory Circular (AC) 135-14A, "Emergency Medical Services/Helicopter (EMS/H)," which addressed equipment, training, crew resource management (CRM), decision-making, flight-following procedures, weather minimums, and the development of safety programs for EMS helicopter flights operating under 14 Code of Federal Regulations (CFR) Part 135. Although the Safety Board expressed concern at the time that the FAA chose to issue an AC instead of regulations, the number of EMS accidents was decreasing, thus the recommendations were closed.6

Despite the guidance provided in AC 135-14A and AC 135-15, EMS aircraft accidents have continued to occur in significant numbers (as shown in table 1 from the report below) for the 15-year period from 1990 to 2005.

Table 1. EMS Accidents in the U.S. From 1990 to 2005 (source: NTSB/SIR-06/01)
Total Injuries
Year # of accidents # of fatal accidents Fatal Serious Minor
1990 1 0 0 0 0
1991 1 1 4 0 0
1992 3 2 3 4 0
1993 3 2 5 3 3
1994 4 2 6 0 3
1995 5 1 3 0 2
1996 5 3 9 1 0
1997 3 1 4 0 0
1998 11 2 8 5 5
1999 6 0 0 6 0
2000 6 2 7 0 4
2001 13 1 1 2 2
2002 13 6 14 8 4
2003 19 3 3 2 16
2004 19 9 29 7 3
2005 13 6 13 5 5

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