• John W Lyng, Sabina Braithwaite, Heidi Abraham, Christine M Brent, David A Meurer, Alexander Torres, Peter V Bui, Douglas J Floccare, Andrew N Hogan, Justin Fairless, and Ashley Larrimore.
• Department of Emergency Medicine (NAEMSP), University of Minnesota School of Medicine (JWL); Department of Emergency Medicine (NAEMSP), Washington University in Saint Louis School of Medicine (SB); Austin/Travis County EMS (NAEMSP) (HA); Department of Emergency Medicine (NAEMSP, AMPA), University of Michigan (CMB); Department of Emergency Medicine (NAEMSP), University of Florida College of Medicine (DAM); Department of Emergency Medicine (NAEMSP), Cleveland Clinic Florida (AT); Department of Emergency Medicine (NAEMSP), Augusta University (PVB); Department of Emergency Medicine (AMPA), Maryland Institute for EMS Systems (MIEMSS), Maryland State Police Aviation Command, University of Maryland (DJF); UT Southwestern Medical Center Department of Emergency Medicine (AMPA) (ANH); Department of Emergency Medicine (ACEP), Texas Christian University and University of North Texas Health Science Center School of Medicine (JF); Department of Emergency Medicine (NAEMSP), The Ohio State University (AL).
• Prehosp Emerg Care. 2021 Nov 1; 25 (6): 854-873.

AbstractThis update to the 2013 joint position statement, Appropriate and Safe Utilization of Helicopter Emergency Medical Services, provides guidance for air medical services utilization based on currently available evidence. Air medical services utilization considerations fall into three major categories: clinical considerations, safety considerations, and system integration and quality assurance.Clinically, air medical services should accomplish one or more of three primary patient-centered goals: initiation or continuation of locally unavailable advanced or specialty care; expedited delivery to definitive care for time-sensitive interventions; and/or extraction from physically remote or otherwise inaccessible locations that limit timely access to necessary care. Ground-EMS (GEMS) transport is preferred when it is able to provide the necessary level of care and timely transport to definitive care.Risk identification and safety of both the patient and crew must be uniformly balanced against the anticipated degree of patient medical benefit. While auto-ready and auto-launch practices may increase access to air medical services, they also risk over-use, and so must be rigorously reviewed. Safety is enhanced during multi-agency emergency responses by coordinated interagency communication, ideally through centralized communication centers. Helicopter shopping and reverse helicopter shopping both create significant safety risks and their use is discouraged.Regional EMS systems must integrate air medical services to facilitate appropriate utilization in alignment with the primary patient goals while being cognizant of local indications, resources, and needs. To maximize consistent, informed air medical services utilization decisions, specific indications for and limitations to air medical services utilization that align with local and regional system and patient needs should be identified, and requests routed through centralized coordinating centers supported by EMS physicians.To limit risk and promote appropriate utilization of air medical services, GEMS clinicians should be encouraged to cancel an air medical services response if it is not aligned with at least one of the three primary patient-centered goals. Similarly, air medical services clinicians should be empowered to redirect patient transport to GEMS. Air medical services should not routinely be used solely to allow GEMS to remain in their primary service area.

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