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INTRODUCTION
Air medical transport has become a well-established part of the emergency medical services (EMS) system. Through the use of aircraft, patients are moved swiftly and safely throughout the world. However, for a number of reasons, the use of air medical transport remains somewhat controversial. One reason for this controversy is that debate continues to surround appropriate utilization of air medical transport. Since the topics of triage to air transport were last addressed by the National Association of EMS Physicians' (NAEMSP's) Air Medical Task Force (hereafter abbreviated as "the Task Force"), there has been significant evolution of thought concerning appropriateness of air medical dispatch. Therefore, the goal of this position paper is to outline current recommendations guiding utilization of air medical transport.
This position statement builds on earlier work by the Task Force and replaces two previous position statements.1,2 The first NAEMSP position statement on the subject was published in Prehospital and Disaster Medicine in January-March 1992 as a contribution of the 1992 Task Force.1 The 1994 Task Force published a follow-up paper addressing non-trauma and pediatric considerations.2 The current Task Force members gratefully acknowledge the work of the previous documents' authors: Drs. Nicholas Benson, Catherine Carruba, Dan Hankins, Richard Hunt, and David Wilcox. The current authors have also drawn upon the work of other organizations, including the Association of Air Medical Services (AAMS)3 and the American Academy of Pediatrics (AAP),4 which have produced similar documents.
This position statement has also been endorsed by the Air Medical Physician Association (AMPA), by approval of its Board of Directors.
DISCUSSION
Air medical transport has grown to the point where we commonly speak of people being "life-flighted." As of this writing, the AAMS, which represents the vast majority of U.S. air medical providers, reports 271 air medical program members, 193 of which have a helicopter EMS component.5 The growth of air medical transport is, at least in part, due to a perception that provision of such a service results in benefits to the patients and/or regions where air transport exists. In some cases, the benefit results from the increased level of care provided by the air medical crew; these individuals are generally trained to a higher level of care than available ground EMS providers. In other cases,...