What Are the Criteria for Flying Patients Today? A Look at Position Statements and Best Practices

The appropriate use of Helicopter Emergency Medical Services (HEMS) remains a critical component of modern trauma systems, yet significant variability persists in when and why aircraft are launched. This presentation examines current evidence-based criteria, system considerations, and triage tools that support optimal decision-making for both scene flights and interfacility transfers. Drawing from national position statements by NAEMSP, ACEP, and AMPA, the session highlights three essential pillars—clinical need, safety, and system integration—as foundational elements guiding HEMS activation or cancellation. Emphasis is placed on the importance of objective measures, including the Air Medical Prehospital Triage (AMPT) Score, which identifies trauma patients most likely to benefit from air transport based on paired physiologic and anatomic criteria. The session further explores the real-world challenges influencing HEMS decisions, such as geographic limitations, availability of definitive care and immediately available balanced blood products, variations in provider experience, and the pressures facing rural EMS systems. Participants will analyze when ground transport is equally effective—or superior—based on patient condition, time-to-care, and resource availability. The presentation also discusses the vital role of quality assurance, centralized coordination, and empowering both ground and air crews to make cancellation decisions aligned with patient-centered goals.