Research Library
Published research on U.S. air medical safety.
Peer-reviewed journal articles and FAA reports on U.S. air medical transport and helicopter air ambulance operations. Each entry links to the original publication.
Publications
Pressure to Fly and Phase of Flight Analysis in Helicopter Air Ambulance Accidents
Air Medical Journal, 2026, Online ahead of print
When tragedy strikes: from the rush matrix to the deliberate response framework – a narrative review of self-response decision-making in helicopter emergency medical services
Benton, Michael; Griffin, Russell E.
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 2026, Published online 21 September 2026
Human Factors in Helicopter Air Ambulance Accidents, Incidents, and Safety Reports
Baumgartner, Hannah M. ; Durham, Justin; Hu, Peter T.
Air Medical Journal, 44(5), 347-353, 2025
Analysis of Helicopter Air Ambulance Accidents in the United States From 2010 to 2021
Sanchez, Gustavo ; Gupta, Shantanu ; Johnson, Mary E.
Air Medical Journal, 43(6), 499-507, 2024
Human Factors Analysis of Helicopter Air Ambulance Accidents, Incidents, and Events (2013-2023)
Baumgartner, Hannah M. ; Durham, Justin; DiDomenica, Rebecca; Hu, Peter T.
Federal Aviation Administration, Civil Aerospace Medical Institute. Report DOT/FAA/AM-24/22, 2024
Read the abstract
Helicopter Air Ambulance (HAA) operations are subject to unique risks due to their time-sensitive and safety critical nature. The Civil Aerospace Medical Institute (CAMI) completed analyses of the National Transportation Safety Board’s (NTSB) Case Analysis and Reporting Online (CAROL) aviation accident and serious incident database and the National Aeronautics and Space Administration’s (NASA) Aviation Safety Reporting System (ASRS) data over a 10- year span. In total, 102 ASRS reports, 53 final NTSB accident reports, and 3 final NTSB incident reports involving HAA from 2013 to 2023 that occurred within the United States (U.S.) were coded for human factors and organizational risk factors. The analyses identified several human factors risks impacting HAA flight crew related to situation awareness (SA), judgment and decision-making (JDM), adherence to procedures, and experience and training. Further, organizational issues influencing HAA operations, such as communication, safety culture, and those involving operator policy and procedure, were identified. Research recommendations based on the findings broadly involve investigating techniques to improve SA, reevaluating or assessing training needs, and providing additional resources for pilots and flight crews in HAA operations.
Report documentation page. U.S. government work, not subject to copyright.
Using NEMSIS to report annual air medical transport statistics
Reimer, Andrew P. ; Shew, Joshua
Air Medical Journal, 43(3), 226-228, 2024
Fatal Air Medical Accidents in the United States (2000-2020)
Shekhar, Aditya C. ; Blumen, Ira J.
Prehospital and Disaster Medicine, 38(2), 259-263, 2023
Ground Versus Air: Which Mode of Emergency Medical Service Transportation Is More Likely to Crash?
Hartmann, Krista ; Lubin, Jeffrey; Boehmer, Sue; Amin, Sibgha; Flamm, Avram
Air Medical Journal, 42(1), 28-35, 2023
Human Factors in Helicopter Air Ambulance Operations Annotated Bibliography (2014 – 2022)
Baumgartner, Hannah M. ; DiDomenica, Rebecca; Durham, Justin; Hu, Peter T.
Federal Aviation Administration, Civil Aerospace Medical Institute. Report DOT/FAA/AM-23/08, 2023
Read the abstract
Helicopter air ambulance (HAA) operations involve particularly challenging conditions, including landing at unfamiliar, remote, or unimproved sites with terrain and obstacle hazards, and involve urgent or time-sensitive situations. Associated human factors (HF) issues including fatigue, stress, human error, and perceived pressure to fly compound the challenging nature of HAA operations. This report aims to inform the current understanding of HF risks and considerations within HAA operations spanning 2014 – 2022 through a focused review of flight crew fatigue considerations, environmental conditions, areas for increased training opportunities, and other operational risk factors.
Report documentation page. U.S. government work, not subject to copyright.
American Helicopter Emergency Medical Service Pilots Report to Work Despite High Rates of Sleepiness
Kamine, Tovy Haber ; Dhanani, Hiba; Wilcox, Susan ; Kelly, Edward; Alouidor, Reginald; Kramer, Kristina ; et al.
Air Medical Journal, 41(5), 432-434, 2022
Helicopter versus ground ambulance transport for interfacility transfer of critically ill children
Joseph, Allan M.; Horvat, Christopher M.; Evans, Idris V.; Kuch, Bradley A.; Kahn, Jeremy M.
The American Journal of Emergency Medicine, 61, 44-51, 2022
Out-of-pocket payments made by patients transported by Helicopter Emergency Medical Services (HEMS)
Gooley, Brian; Sherr, Sela; Lenz, Timothy J.
The American Journal of Emergency Medicine, 58, 192-196, 2022
Overutilization of Helicopter Emergency Medical Services in Central Gulf Coast Region Results in Unnecessary Expenditure
Miles, M. Victoria P. ; Beasley, Justin R.; Reed, Haylie E.; Miles, Daniel T. ; Haiflich, Andrew; Beckett, Allison R.; et al.
Journal of Surgical Research, 273, 211-217, 2022
A Bayesian Approach on Investigating Helicopter Emergency Medical Fatal Accidents
Simonson, Richard J.; Keebler, Joseph R.; Chaparro, Alex
Aerospace Medicine and Human Performance, 92(7), 563-569, 2021
Appropriate Air Medical Services Utilization and Recommendations for Integration of Air Medical Services Resources into the EMS System of Care: A Joint Position Statement and Resource Document of NAEMSP, ACEP, and AMPA
Lyng, John W. ; Braithwaite, Sabina ; Abraham, Heidi; Brent, Christine M.; Meurer, David A.; Torres, Alexander; et al.
Prehospital Emergency Care, 25(6), 854-873, 2021
Helicopter Transport of Trauma Patients Improves Survival Irrespective of Transport Time
Schneider, Andrew M.; Ewing, Joseph A.; Cull, John D.
The American Surgeon, 87(4), 538-542, 2021
Medical Helicopter Accident Review: Causes and Contributing Factors
Greenhaw, Richard; Jamali, Mehdi
Federal Aviation Administration, Civil Aerospace Medical Institute. Report DOT/FAA/AM-21/19, 2021
Read the abstract
The purpose of this study was to determine the quantitative differences in Emergency Medical Service (EMS) and non-EMS helicopter accident rates and trends by examining accident reports of both fatal and non-fatal accidents. The study also aimed to identify contributing factors or conditions that result in either fatal or non-fatal helicopter accidents. This was a retrospective, longitudinal observational study that examined more than 3,000 EMS and non-EMS helicopter accident records covering 20 years beginning in 1999 provided by the National Transport Safety Board and analyzed their data using linear and multivariate logistic regression models along with statistical hypothesis tests to predict trends and associations. This study found that fatal accidents accounted for a much higher proportion of EMS helicopter accidents than non-EMS accidents (rates for non-EMS helicopter accidents were essentially twice that for EMS accidents), and the rates for fatal helicopter accidents did not differ between EMS and non-EMS. Additionally, the study found two prevalent factors that determined EMS accident fatality: visibility/darkness and pilot decision making/judgment. Additional factors highly associated with fatal EMS accidents were pilots with a second-class medical certificate rather than first-class and the lack of a second pilot. Exploring the reasons for the much higher proportion of fatal EMS vs. non-EMS accidents is outside the scope of this study. Such questions could be the subject of further research. Detailed analyses focusing on this research could lead to a reduction in fatal EMS accident rates.
Report documentation page. U.S. government work, not subject to copyright.
Predictors of Inappropriate Helicopter Transport
Brown, Christopher; Irfan, Wajeeh; Schoen, Jonathan E.; Marr, Alan B.; Stuke, Lance E.; Cavalea, Alexander C.; et al.
The American Surgeon, 87(2), 248-252, 2021
Establishing Transport Statistics: Results From the Medevac Transport Statistics Survey
Reimer, Andrew P. ; Hobensack, Mollie
Air Medical Journal, 38(3), 174-177, 2019
Evaluation of a New Helicopter Crew Transport Fatigue Assessment
Bushmaker, Ryan; Corey, Katherine; Dunn, Julie ; Lalonde, Trent; Estrada, Samantha
Air Medical Journal, 38(3), 198-201, 2019
Responsible “Helicopter Shopping” Through Selective Resource Management
Good, Nikole Regina
Air Medical Journal, 38(3), 143-146, 2019
Systems Safety Risk Analysis of Fatal Night Helicopter Emergency Medical Service Accidents
Aherne, Bryan B.; Zhang, Chrystal; Chen, Won Sun; Newman, David G.
Aerospace Medicine and Human Performance, 90(4), 396-404, 2019
Human Error Analysis of Helicopter Emergency Medical Services (HEMS) Accidents Using the Human Factors Analysis and Classification System (HFACS)
Cline, Paul
Journal of Aviation/Aerospace Education & Research, 2018
Operational Impact of a Critical Care Transport Duty Time Tool Implementation: A Quality Improvement Project to Enhance Crew and Patient Safety
Sorensen, Megan; Chaplin, Robert
Air Medical Journal, 37(6), 352-356, 2018
Pilot Decision Making in Weather-Related Night Fatal Helicopter Emergency Medical Service Accidents
Aherne, Bryan B.; Zhang, Chrystal; Chen, Won Sun; Newman, David G.
Aerospace Medicine and Human Performance, 89(9), 830-836, 2018
Crew Resource Management in Helicopter Air Ambulance Operations: A Literature Review
Rowley, Crystal; Bryant, Michelle R.
Federal Aviation Administration, Civil Aerospace Medical Institute. Report DOT/FAA/AM-17/13, 2017
Read the abstract
Crew resource management (CRM) training has evolved from an aviation-specific practice to a much broader-scoped practice involving other industries with team oriented objectives. Combined objective industries such as helicopter air ambulance (HAA) operations have the unique requirement to combine ground (dispatch) and air (flight crew) with traditional medical and aviation operations in ad hoc situations adding another dimension to the CRM implementation process. Despite the requirements for such training in HAA operations, evidence suggests that CRM training does not reach all team members equally. Thus, there are gaps in the current research both in theory and practice
Report documentation page. U.S. government work, not subject to copyright.
2015 Air Medical Safety Survey
Coons, Joe; Zalar, Christine
Air Medical Journal, 35(3), 120-125, 2016
Occupant Injury Severity and Accident Causes in Helicopter Emergency Medical Services (1983-2014)
Boyd, Douglas D.; Macchiarella, Nickolas D.
Aerospace Medicine and Human Performance, 87(1), 26-31, 2016
Pilot Domain Task Experience in Night Fatal Helicopter Emergency Medical Service Accidents
Aherne, Bryan B.; Zhang, Chrystal; Newman, David G.
Aerospace Medicine and Human Performance, 87(6), 550-556, 2016
A Review of Risk Analysis and Helicopter Air Ambulance Accidents
Nix, Sam; Buckner, Steven; Cercone, Richard
Air Medical Journal, 33(5), 218-221, 2014
Helicopter Emergency Medical Services and Weather-Related Accidents
Butler, Bryan
Air Medical Journal, 33(3), 84-85, 2014
Probable cause in helicopter emergency medical services crashes
Habib, Fahim A.; Shatz, David; Habib, Aliya I.; Bukur, Marko; Puente, Ivan; Catino, Joe; et al.
Journal of Trauma and Acute Care Surgery, 77(6), 989-993, 2014
Strategies to Reduce US HEMS Accidents
Winn, William; Thomas, Frank; Johnson, Kent
Air Medical Journal, 31(2), 78-83, 2012
Analyzing Communication Errors in an Air Medical Transport Service
Dalto, J.; Thomas, F.; Weir, C.
Air Medical Journal, 30(5), 254, 2011
Fixed-Wing Medical Transport Crashes: Characteristics Associated with Fatal Outcomes
Handel, Daniel A.; Yackel, Thomas R.
Air Medical Journal, 30(3), 149-152, 2011
Pilot Fatigue Survey: Exploring Fatigue Factors in Air Medical Operations
Gregory, Kevin B.; Winn, William; Johnson, Kent; Rosekind, Mark R.
Air Medical Journal, 29(6), 309-319, 2010
Formal testing and utilization of streaming media to improve flight crew safety knowledge
Bellazzini, Marc A.; Rankin, Peter M.; Quisling, Jason; Gangnon, Ronald; Kohrs, Mike
Air Medical Journal, 27(2), 84-98, 2008
Assessment of air medical coverage using the Atlas and database of air medical services and correlations with reduced highway fatality rates
Flanigan, Marie; Blatt, Alan; Lombardo, Louis; Mancuso, Dawn; Miller, Maile; Wiles, Dale; et al.
Air Medical Journal, 24(4), 151-163, 2005
Critical issues facing the air medical transport community the 2003 Air Medical Leadership Congress survey
Thomas, Frank; Romig, Laurie; Durand, John; Hutton, Kevin; Handrahan, Diana
Air Medical Journal, 24(3), 106-111, 2005
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About this library. Entries are drawn from the working group's reference collection. Each one is either an article in a peer-reviewed journal or a report from the FAA Civil Aerospace Medical Institute, and each one studies U.S. air medical transport. The library lists bibliographic details only. Full text is available from each publisher.
Inclusion is not endorsement of a study's methods or conclusions. Topic tags are AMSARC's, not the authors'.
Author profile links appear only where the publisher's record lists the author's ORCID iD and the public ORCID record matches the author's name, or where an author has provided the link.
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Last updated October 21, 2026.