Helicopter Operations 

There are two primary parts to utilizing air transportation for scene calls. The first is the decision to use a helicopter, and the second is coordinating the helicopter landing once you decide that it’s needed.

A LIFE flight helicopter on a landing pad.
Image by Nickolas Oatley, licensed under CC BY-NC 2.0
A LIFE flight helicopter lifting off from a landing pad.
Image by Nickolas Oatley, licensed under CC BY-NC 2.0

There are some general guidelines for deciding if you need a helicopter for your patient(s):

  • If you have a critical/unstable medical or trauma patient and getting to definitive care quickly is critical and the use of air transport will save more than 10 minutes of transport time.
    • Consider the time it takes to establish a landing zone and transfer care.
    • Consider traffic and extended ambulance response times.
  • Mass casualty incidents where you may need additional patient transport capabilities despite the time savings that helicopters may provide.

Coordinating a helicopter to assist patient treatment it starts with a call to the dispatcher. Dispatching air transportation is as simple as requesting the resource from dispatch and confirming what radio channel will be used to communicate with the aircraft. Most EMS departments have predetermined designated landing zones. These may include local fields, parking lots and roadways. Keep in mind that in most cases you will need to transport your patient to a safe and/or designated landing zone instead of directing the aircraft to land at your scene location.

If you are too far away from a predetermined landing zone and need to identify a new and safe landing zone, look for the following criteria:

  • Flat ground which is at least 100ft x 100ft
  • Free of power lines and trees or any other intrusion
  • Free from loose gravel or sand or another surface that may not remain stable in high winds

When communicating with air transportation include a description of the location and any potential hazards they may encounter on their approach to land. Include landmarks and other identifiable information to aid in locating your landing zone. If coordinating a night landing, be sure to ask the flight crew about using your ambulance or fire apparatus lights or not to mark the landing zone as you may inadvertently blind the flight crew who may be using night vision goggles during their landing. Unless your protocols or your local helicopter program advises otherwise there is no need to provide any hand signals to assist the pilot in landing the aircraft.

Prior to helicopter arrival, consider removing loose clothing or items that may be blown in the rotor downwash. Items may include eyewear, gowns, EMS equipment or other nearby items.

Once the helicopter is on the ground, make eye contact with the pilot and wait for their instructions prior to approaching the aircraft. Often, the flight crew will come to you, get a report, examine the patient then give instructions on how the patient will be moved to the helicopter. Some organizations require that rotors be fully powered down prior to loading/unloading. Always follow the flight crew instructions when operating around the aircraft.

In your day-to-day life, take some time to look for landing zones. Identify the hazards and rehearse how you will communicate your location.

Discuss the use of helicopter operations either in a scenario or aside.

Helicopter Operations Skills Verification Table

Air Medical Operations


2 (instructor)


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Oregon EMS Psychomotor Skills Lab Manual Copyright © 2023 by Chris Hamper, BS, NRP; Carmen Curtz, Paramedic, BS; Holly A. Edwins, Paramedic, B.S.; and Jamie Kennel, PhD, MAS, NRP is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.

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