June 22, 2018
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Federal regulators who are seeking ways to improve the safety of air ambulances can look to Maine as a model. In part because Maine was the last state in the country to create an air ambulance service — LifeFlight of Maine — it learned from others’ mistakes and has built a system that was recently recognized as the best in the country.

Two things set LifeFlight apart from similar services in other states: It is nonprofit run by Eastern Maine Medical Center and Central Maine Medical Center, freeing it from financial pressures, and it has invested in high-tech flight equipment and an on-the-ground network of weather stations to improve safety.

As a result, the service’s two helicopters have transported more than 9,000 patients over the last decade without an accident.

Maine’s early experience with medical helicopters wasn’t so good. In 1993, a private company began medical flights. Six months later, the helicopter crashed into Casco Bay, killing the patient, nurse and paramedic. The crash was attributed to poor weather conditions and low fuel.

When LifeFlight explored re-starting air ambulance service in 1998, the reception was cool. From the beginning, LifeFlight emphasized safety. Its helicopters are equipped with instrument flight technology, navigation and weather radar and satellite tracking, equipment that operators in other states say is too expensive. Night vision technology was recently purchased. A recent bond issue paid for upgrades to weather monitoring systems around the state.

As Tom Judge, executive director, points out, medical helicopters are the only air carriers that transport people who have no choice of airlines or whether they want to fly at all. This makes it especially important that the patients arrive safely. Further, risking the life of pilots and medical personnel to save the life of the patient — however nobly intended — doesn’t make sense.

Because of this ethic, LifeFlight was named the top program of the year by the National Association of Air Medical Services last fall.

Now, it is guiding federal policy. Mr. Judge testified before the National Transportation Safety Board earlier this year as it seeks ways to reduce medical helicopter crashes nationwide. Last year, 13 medical helicopter crashes killed 29 people, prompting the NTSB to put helicopter medical services on its “Most Wanted” reforms list. The board harshly criticized the Federal Aviation Administration for not requiring flight risk evaluation systems or the use of technologies such as terrain awareness and warning systems and night vision imaging systems to enhance flight safety.

Air ambulances fall into an odd regulatory void. Because of the Airline Deregulation Act of 1978, they are regulated by the Federal Aviation Administration, although some medical aspects can be regulated by the states. Because of the rash of crashes, states are seeking more regulatory authority.

A bill introduced earlier this month by Sen. Olympia Snowe would allow states to set requirements for both medical and aircraft equipment for these services. Since the FAA has been too slow in doing this, giving states this authority makes sense, although many are likely to adopt lower standards than Maine’s, so federal rules must also be forthcoming.

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