Alabama Administrative Code
Title 420 - ALABAMA STATE BOARD OF HEALTH
Chapter 420-2-2 - ALABAMA STATEWIDE TRAUMA SYSTEM
Appendix I - Guidelines For Early Activation Of Helicopter Emergency Medical Service

PURPOSE: Helicopter EMS services (HEMS) offer speed of transport and ALS personnel experienced in managing critical patients. These guidelines are to assist EMS responders in determining when early activation of HEMS would likely be in the critical patient's best interest. Early Activation means initiation of a helicopter response prior to arrival of the EMS responders to the scene. Early Activation may be based on pre-arrival information regarding the incident or a suspicion by EMS that specialty care may be needed. Early Activation is initiated at the request of the first responding EMS providers or in conjunction with Dispatch and the EMS service. It is recognized that pre-arrival information may be misleading and the activated HEMS may be cancelled. The HEMS service that can respond to the scene in the shortest time should be called. If a HEMS service cannot answer a call and a second service is requested, the requesting agency must notify the second service that the call has already been refused and why.

Situations in which Early Activation of HEMS may be needed includes, but are not limited to:

1. Report of severe collision involving one or more vehicles

2. Multiple victim incidents with severe illness or injuries

3. Report of person being ejected from a vehicle

4. Pedestrian vs. vehicle with reported injuries

5. MVC with reported death and other injured persons

6. Report of severe burns

7. An unbroken fall of twenty feet or more onto a hard surface

8. Penetrating injury to head, neck, torso, or groin

9. Report of injury with paralysis

10. Sickness with new onset focal weakness or paralysis (suspected stroke)

11. Severe chest pain thought to be of cardiac etiology

12. Near drowning

13. Report of amputation proximal to wrist or ankle

14. Report of serious injury in a patient whose location would be difficult to access by ground ambulance but is more accessible by helicopter

15. Severe shortness of breath or airway problems

16. There is no available ground ambulance to respond

17. Report of patient with symptoms of shock

18. Report of patient with history of trauma and altered mental status

19. Discretion of Medical Direction or responding EMS personnel

HEMS are most appropriately used when their use would SIGNIFICANTLY reduce the time required to get the patient to the appropriate hospital or when potentially lifesaving prehospital interventions may be needed that that cannot be provided by the responding EMS service. The Regional Aeromedical Plan must be followed when approved. Quality Improvement monitoring is important and is best done in partnership with the responding helicopter service.

Authors: John Campbell, M.D., and Choona Lang

Statutory Authority: Alabama Legislature, Act 299, Regular Session, 2007 Code of Ala. 1975, § 22-11D-1, et. seq.