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Highlights

Air ambulance transport is widely regarded as improving the chances of survival for trauma victims and other critical patients. However, in recent years, the number of air ambulance accidents has led to increased industry scrutiny by government agencies, the public, the media, and the industry itself. The Federal Aviation Administration (FAA), which provides safety oversight, has been called upon by the National Transportation Safety Board (NTSB) and others to issue more stringent safety requirements for the industry. GAO's study addressed (1) recent trends in the air ambulance industry, (2) FAA's challenges in providing safety oversight, and (3) FAA's efforts to address the challenges and what is known about the effects of these efforts. To address these issues, we analyzed FAA, NTSB, and industry data, interviewed federal and industry officials, and conducted five site visits, among other things.

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Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Transportation To help FAA monitor industry growth trends, accident rates, and operator implementation of FAA guidance, the Secretary of Transportation should direct the Administrator of FAA to identify the data necessary to better understand the air ambulance industry and develop a systematic approach for gathering and using this data. At a minimum, this data should include the number of flights and flight hours, and the number and locations of air ambulance helicopters, and the number and types of FAA violations and enforcement actions related to the air ambulance fleet.
Closed - Implemented

Recommendation status is Closed - Implemented.

In 2007, we reported that the number of air ambulance helicopters and the number of accidents had grown. However, a lack of data about the number of flights or flight hours precluded the calculation of the industry's accident rate, making it difficult to determine whether the industry was becoming more or less safe. Without such data, FAA could not evaluate the effectiveness of its efforts towards safety. We recommended that FAA identify the data necessary to better understand the air ambulance industry and develop a systematic approach for gathering and using this data. We said that this data should include the number of flights and flight hours and the number and locations of air ambulance helicopters. In 2011, we confirmed that FAA now annually surveys all helicopter operators and requests, among other things, the number of helicopters, the state in which they primarily operated, the number of landings, the total flying hours, and the percentage of hours that were flown in air ambulance operations. With these data FAA can gain a better understanding of the air ambulance industry and the impact that its safety efforts are having.
Department of Transportation To help FAA monitor industry growth trends, accident rates, and operator implementation of FAA guidance, the Secretary of Transportation should direct the Administrator of FAA to collect information on the implementation of voluntary FAA guidance by air ambulance operators and evaluate the effectiveness of that guidance.
Closed - Implemented

Recommendation status is Closed - Implemented.

FAA published Notice 8900.63, Validation of Helicopter Emergency Medical Services (HEMS) Safety Initiatives, which required inspectors to validate implementation of the HEMS safety initiatives and to report their findings to FAA Headquarters no later than February 1, 2009. FAA reported the results of this survey in its February 2009 HEMS Fact Sheet.

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