Helicopters provide a means of transporting people in urgent need of medical assistance. These operations are unique due to the urgent nature of the flight. Each year thousands of patients are transported by helicopter while being attended by medical personnel trained to respond to their needs. Helicopter air ambulances (HAA) are equipped with medical monitoring and support systems to ensure proper care en route.

The HAA industry continues to expand. In response to the dynamic growth of this industry, the Federal Aviation Administration (FAA) has issued this advisory circular (AC) to provide information and guidelines to assist existing HAA operators, other Title 14 of the Code of Federal Regulations (14 CFR) part 135 operators considering becoming an HAA operator and those considering new-startup HAA operations. To address an increase in fatal HAA accidents, the FAA has implemented new operational procedures and additional equipment requirements for HAA operations. The FAA, HAA operators and medical community all play vital roles in applying these changes to ensure safety. Implementing a safety culture will benefit all aspects of HAA operations.

Part 135 subpart L addresses safety improvements for commercial helicopter operations through requirements for equipment, pilot testing, alternate airports and increased weather minimums for all General Aviation (GA) helicopter operations. Many of these requirements also address National Transportation Safety Board (NTSB) safety recommendations directed at improving HAA safety.