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Category: EMS Operations

Topic: Air Medical

Level: Critical Care

9 minute read

Medical Crew Standards

The Commission on Accreditation of Medical Transport Services (CAMTS, pronounced "KAYMS") has specific standards for the makeup, training, and equipment of medical flight crews. These standards are intended to keep you and your partners safe in an environment that is extremely unforgiving of mistakes!

Staffing Standards

There are two primary designations for an air ambulance's level of care to the patient: critical care and specialty care transport. Each has unique standards for staffing and training.

Critical Care - the MOST common level of care in helicopter emergency medical services (HEMS)

  • Two critical care clinicians are required at all times with most air medical agencies. A small handful of agencies operate with two paramedics (ALS care) or 2 flight nurses versus the common configuration mentioned below.
  • The most common air medical crew configuration throughout the industry is 1 flight paramedic and 1 flight nurse. Other configurations can include a flight physician, flight nurse practitioner, and a flight respiratory therapist in conjunction with a flight nurse or flight paramedic. 

Specialty Care Transport

  • A minimum of one flight-trained air medical professional at any level in addition to the specialty-trained professionals required for the individual situation.
  • All specialty personnel must complete the same safety and emergency training as a regular flight crew member but are not required to have specialty training in medical care.

Training Standards

The training standards to prepare an EMS professional for work in a flight environment can vary based on the agency, and some states also place requirements on this. The most consistent experience requirement air medical employers require for a paramedic is 3-5 years in a busy 911 EMS system. However, now that many large health systems are employing paramedics and critical care paramedics in areas like the emergency department, ICU, and even the cath lab, that experience can be derived from the facility and will go well with you as the provider for your career in air medical. Nurses have similar time requirements within a hospital ICU (cardiac and trauma ICUs are preferred) and a high volume emergency department. The most common certification by exam as required by CAMTS is the FP-C (Flight Paramedic-Certified) for paramedics and the CFRN (Certified Flight Registered Nurse) for nurses. Most services require this certification within one year of hire, although it is a lot less stressful for you to have it PRIOR to employment and will also aid you in obtaining a position versus those who do not yet have it. 

The vital areas of education identified for air medical providers are:

  • Airway management
  • Ventilation management
  • Flight physiology
  • Flight safety
  • High-risk obstetrics
  • Infection control
  • Trauma
  • Pharmacology
  • Management of emergency situations

Uniforms and Protective Equipment

As with all things in air medicine, safety comes first. The uniform requirements for EMS flight crew and pilots are focused on the prevention of injury. While some of the guidelines may seem restrictive or unnecessary, they were created in response to injuries or situations encountered by other air medical professionals and/or the military while on the job and have been adopted as industry standards in the name of improved safety strategies and tactics.

Some of the universal requirements for flight uniforms include:

  • Leather Boots
  • Flame-resistant flight suit that fits appropriately, 1/4 of an inch of room between the body and the material. 
  • Reflective outerwear for low visibility situations and motor vehicle scenes 
  • Hearing protection during flight operations
  • Flight helmets that are in place anytime the aircraft is in operation.