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m.  Emergency Situations 


In the event of a helicopter accident in the 

vicinity of the LZ, consider the following: 

(a)  Emergency Exits: 


Doors and emergency exits are typical-

ly prominently marked. If possible, operators should 
familiarize ground responders with the door system 
on their helicopter in preparation for an emergency 


In the event of an accident during the LZ 

operation, be cautious of hazards such as sharp and 
jagged metal, plastic windows, glass, any rotating 
components, such as the rotors, and fire sources, such 
as the fuel tank(s) and the engine. 

(b)  Fire Suppression: 

Helicopters used in HEMS operations are usually 
powered by turboshaft engines, which use jet fuel. 
Civil HEMS aircraft typically carry between 50 and 
250 gallons of fuel, depending upon the size of the 
helicopter, and planned flight duration, and the fuel 
remaining after flying to the scene. Use water to 
control heat and use foam over fuel to keep vapors 
from ignition sources. 



4.  Emergency Medical Service (EMS) 

Multiple Helicopter Operations 

a.  Background.

 EMS helicopter operators often 

overlap other EMS operator areas. Standardized 
procedures can enhance the safety of operating 
multiple helicopters to landing zones (LZs) and to 
hospital heliports. Communication is the key to 
successful operations and in maintaining organiza-
tion between helicopters, ground units and 
communication centers. EMS helicopter operators 
which operate in the same areas should establish joint 
operating procedures and provide them to related 

b.  Recommended Procedures. 

1.  Landing Zone Operations.

 The first heli-

copter to arrive on

scene should establish 

communications with the ground unit at least 10 NMs 
from the LZ to receive a LZ briefing and to provide 
ground control the number of helicopters that can be 
expected. An attempt should be made to contact other 
helicopters on 123.025 to pass on to them pertinent 
LZ information and the ground unit’s frequency. 
Subsequent helicopters arriving on scene should 

establish communications on 123.025 at least 10 
NMs from the LZ. After establishing contact on 
123.025, they should contact the ground unit for 
additional information. All helicopters should 
monitor 123.025 at all times. 


If the landing zone is not established by 

the ground unit when the first helicopter arrives, 
then the first helicopter should establish altitude 
and orbit location requirements for the other 
arriving helicopters. Recommended altitude separa-
tion between helicopters is 500 feet (weather and 
airspace permitting). Helicopters can orbit on 
cardinal headings from the scene coordinates. (See 
FIG 10




Upon landing in the LZ, the first 

helicopter should update the other helicopters on the 
LZ conditions, i.e., space, hazards and terrain. 


Before initiating any helicopter move-

ment to leave the LZ, all operators should attempt to 
contact other helicopters on 123.025, and state their 
position and route of flight intentions for departing 
the LZ. 

2. Hospital Operations.

 Because many 

hospitals require landing permission and have 
established procedures (frequencies to monitor, 
primary and secondary routes for approaches and 
departures, and orbiting areas if the heliport is 
occupied) pilots should always receive a briefing 
from the appropriate facility (communication center, 
flight following, etc.) before proceeding to the 


In the event of multiple helicopters 

coming into the hospital heliport, the helicopter 
nearest to the heliport should contact other inbound 
helicopters on 123.025 and establish intentions. 
Follow the guidelines established in the LZ 


To facilitate approach times, the pilot



command of the helicopter occupying the hospital 
heliport should advise any other operators whether 
the patient will be off loaded with the rotor blades 
turning or stopped, and the approximate time to do so. 


Before making any helicopter movement 

to leave the hospital heliport, all operators should 
attempt to contact other helicopters on 123.025 and 
state their position and route of flight intentions for 
departing the heliport. 




Special Operations