Air Evac Training Requirements: A Comprehensive Guide

In the world of emergency medical services, air evacuation plays a crucial role in transporting critically ill or injured patients to the nearest medical facilities equipped to handle their specific needs. To ensure the highest level of care and safety during such critical missions, air evacuation personnel undergo rigorous qualifications and training. This article explores the essential requirements and expertise necessary for individuals interested in joining the ranks of air evacuation personnel, encompassing both medical personnel and pilots.

Requirements for Air Evacuation Medical Personnel

Minimum Requirements

Before embarking on a career in air evacuation, aspiring individuals must meet certain minimum requirements. These include:

Valid State License: Holding a valid nurse or paramedic state license is essential.
Basic Life Support (BLS) Certification: BLS certification is vital for air evacuation personnel.
Advanced Cardiac Life Support (ACLS) Certification: ACLS certification is vital for air evacuation personnel.
Pediatric Advanced Life Support (PALS) Certification: PALS certification is vital for air evacuation personnel.
Prehospital Trauma Life Support (PHTLS) Training: PHTLS training or equivalent courses are essential for air evacuation personnel. These programs focus on preparing personnel to effectively manage and treat trauma patients during the critical moments before they reach definitive care facilities.
Experience: Prior experience working in emergency departments (ED) or intensive care units (ICU) is highly valued for air evacuation personnel.

Additional Training

Even after meeting the minimum requirements and being hired, air evacuation personnel undergo additional training to enhance their expertise. These training programs cover various critical areas, including:

Flight physiology
Mechanical ventilation
IV pump management
Aircraft indoctrination
Safety protocols
Airway management

Ongoing Competency

Ongoing competency standards are achieved through:

Skills Lab Training
Simulated Patient Care Experiences
Helicopter Safety and Landing Zone Instruction
Medical Director-led Training
Air Medical Resource Management

Air Evac Lifeteam employs more than 600 registered nurses and 600 paramedics who serve on its medical flight crews, with one nurse and one paramedic serving on each flight. Nurses and paramedics must have advanced credentials within two years of being hired. Advanced credentials must include one of the following: Nurses - CEN, CFRN, CCRN; Paramedics - CCP-C, FP-C.

Clinical Internship Program

Flight nurses and flight paramedics selected to work for Air Evac Lifeteam are enrolled in a six-month Clinical Internship Program. This unique program gives Registered Nurses or paramedics with at least two years’ experience the opportunity to participate in several activities designed in preparation for a career with Air Evac Lifeteam. Participants in the Clinical Fellowship program must be sponsored by one of the Air Evac Lifeteam bases. Nurses and paramedics are able to take part in the base skills days, complete the online education modules, learn organizational values and use the patient care equipment in a simulated patient care environment.

Medical Direction

Medical direction for Air Evac Lifeteam is provided by 15 medical directors located in states served by the company. The medical directors work together to develop the company's medical protocols and ensure medical crews are in compliance with the medical regulations in each area.

Simulation Training

Air Evac Lifeteam has taken a leadership position within the air medical industry through its investment in and use of CAE Emergency Care Simulators as part of its initial clinical internship and semi-annual recurrent training. The adult and pediatric Emergency Care Simulators are life-sized computerized mannequins utilized for clinical skill set training from basic airway management to high level advanced procedures, such as chest tube insertion and central line placement. Simulation training provides scenario-based exercises that require critical thinking and hands-on critical patient care.

Requirements for Air Evacuation Pilots

Essential Skills and Considerations

Being an air ambulance paramedic can be an interesting and satisfying job. Not only do you never know what type of situation you’ll be dealing with on any given day, but you’ll also have the opportunity to help people who truly need it. As an air ambulance paramedic, you would be helping people who are in a difficult situation, and who need immediate care. The air evacuation part is where it gets a little more complicated, and there is some added training there, to become an air ambulance paramedic. Paramedics are an essential part of these air ambulance transports. They ride in medical helicopters or ICU configured jets and give emergency medical treatment during the transportation to a hospital or medical facility.

The first step is to become a licensed EMT. These classes are often available at community colleges or vocational school. There is training in basic life support systems, moving patients, assessment, and ambulance operations. After getting EMT certification, the person would need to get certified in the state they want to work in. There is also a National Registry of Emergency Medical Technicians which EMTs can get certification from after written and practical tests.

After you get your EMT certification, you may then enter a paramedic training program. Many programs require a certain number of years’ experience as an EMT before they will admit you to the training. There is a seven-month training process that involves 1,200 hours of training. Classes include things like anatomy, physiology, patient assessment, treatment options, as well as some training involving medications. After becoming a paramedic, you are ready to get a credential to work with an air medical crew. This is normally a 32-hour class that takes four days. There is education about different types of aircraft, landing zone procedures and flight safety. There is also training about how to treat patients while flying, or at altitude. Many air ambulance companies also require training in various pediatric areas, like life support and trauma issues. Basic life support, as well as neonatal resuscitation, may also be required. Cardiac life support is also an essential skill that paramedics need.

An air evac pilot or air ambulance pilot is simply the pilot who flies an air ambulance. This can mean piloting a helicopter or small plane. You cannot begin your piloting career just training for medical evacuations. There are around 150,000 medical flights via plane and another 400,000 on rescue helicopters throughout the country annually. After all, as an air evac pilot, every single day at work is meaningful, and life impacting. Your job will literally make the difference between life and death for many. What could be more fulfilling?

Not everyone is cut out to be an air evac pilot. Sometimes, these flights will simply involve transporting a patient from one location to another for additional treatment when the patient is fairly stable. Other times, the flights are lifesaving in nature. This means as an air evac pilot, you will be responsible for someone’s life. You will see traumatic injuries and witness harrowing events. Consequently, this job will have moments of high-level stress and pressure. Of course, on the other hand, it is intensely rewarding as well when you help save someone’s life. Therefore, just as working in and emergency center or trauma bay at a hospital isn’t for everyone, neither is medical evac piloting.

Steps to Becoming a Medivac Air Pilot

Here's how to go about becoming a medivac air pilot once you have determined this is a career you want to attempt:

Check Out The Specific Company You Want to Work For: Each air ambulance company varies slightly on their requirements, meaning they will desire certain education levels, certifications and flight hours.
Earn a Degree: Virtually all air ambulance companies require you have a degree of either two to four years, four years being preferable.
Become Medically Certified: The next step to take is to pass the Federal Aviation Administration’s (FAA) Aviation Medical Examiner (AME) certification. This will give you a medical certificate, meaning you can then start flight training.
Attend a Flight School: You can attend any university or college that is FAA certified and offers aviation degrees or pilot training. If you don’t want to go this route, you can opt to take lessons with an FAA certified instructor. The one caveat to this requirement is military flight training.
Get Instrument Training: Since you will be flying in all types of weather conditions impacting visibility as a medical pilot, you need to be able to fly, using your instruments alone. Therefore, it’s a requirement to have instrument training and at least 40 hours of flight experience using only instruments to fly.
Log Your Flight Time Hours: Many air ambulance companies have tough requirements when it comes to flight hours, requiring their pilots have a minimum of 1,000 hours.
Apply: The final step is to apply to the air ambulance organization of your choice. Often, you can submit your resume online. If you get called in for an interview, be prepared to undergo a full background check as well as pass a drug screening test.

Air Evac Lifeteam Pilot Requirements and Training

Only pilots who meet or exceed CAMTS requirements and their respective state requirements are considered by Air Evac Lifeteam. Before a pilot can fly for Air Evac Lifeteam, the candidates must demonstrate instrument proficiency in a dedicated Level 7 flight training simulator. Air Evac Lifeteam is among the few air medical companies with this stringent practice.

Read also: Becoming a Neonatal Nurse

Pilots must also achieve standards established in Air Evac Lifeteam's proprietary, FAA-approved training program. The 18 to 21-day course delivers operational and procedural instruction, as well as aircraft and transport-specific training in the Bell 206, Bell 407, and Airbus AS350, EC130, or EC135 helicopters.

As part of their continuous improvement program, all pilots are required to complete recurrent training, which includes a Part 135/NVG check-ride, on an annual basis. Training is oriented around the air ambulance operational flight profile, including flying at night and landing on hospital rooftop helipads, and unimproved rural terrain, such as pastures and fields. Base assignment requires rigorous, base-specific flight orientation training to become an authority on local hospitals and landmarks and location of obstacles such as towers.

Air Evac Lifeteam's instrument-rated pilots are skilled aviators who become proficient air medical pilots by training under the company’s proprietary and Federal Aviation Administration-approved program.

All of our pilots must meet the following minimums:

2000 hours total flight time
1500 hours helicopter time
1000 hours helicopter Pilot-in-Command time (PIC)
500 hours turbine time
100 hours unaided night time
Maximum weight of 230 lbs.

Air Evac Lifeteam Pilot Compensation and Benefits

Air Evac Lifeteam’s Pilot Starting Salary range (effective July 1, 2021) is $73,775 to $96,923 based on experience and available geographical modifiers. Air Evac Lifeteam’s compensation package, in addition to the base salary, includes components such as geographic modifiers, stipends for advancement, a 3% annual merit increase, and work-over at the rate of time-and-a-half. A “Pilot Experience Worksheet” (PEW) determines initial base salary, taking into consideration total flight time, rotorcraft time, ratings held, night unaided and aided time, turbine time, prior HAA experience, etc.

Many AEL locations have a geographic modifier, adding a percentage to the base salary ranging from 2% to 25%. The percentage amount depends on the assigned base location.

Work-over Opportunities - Work-over is paid at 1.5 times the base salary hourly rate. It includes the geographic modifier where applicable, whether at your home base or away. Per Diem and travel expenses are provided when working away from your home base.

Relocation Bonus - You will be eligible for a $5,000 bonus if you move your permanent residence to within 60 miles of your assigned base and after successful completion of the initial pilot training program.

Base Housing - All Air Evac bases have company-provided quarters (no cost to you) during a 7-day hitch, both on and off your 12-hour shift.

Career Advancement at Air Evac Lifeteam

Base Pilot Supervisor - $5,000 stipend in addition to current base salary and if applicable, includes the geographic modifier.
Area Pilot - $12,000 stipend in addition to current base salary.
Strike Team Pilot - $22,750 stipend in addition to current base salary. The schedule for Strike Team pilots is a 14/14 rotation. (Hired internally only.)
Flight Training Department - $3,000 stipend for Flight Instructors and $5,000 stipend for Check Airman, in addition to current base salary.

FAA Regulations and Training Programs

FAA Regulations for Helicopter Air Ambulance Operations

Docket FAA-2010-0982, 79 FR 9975, Feb. outlines specific regulations for helicopter air ambulance operations. Key aspects include:

Applicability: These regulations apply to any flight, or sequence of flights, with a patient or medical personnel on board, for the purpose of medical transportation, by a part 135 certificate holder authorized by the Administrator to conduct helicopter air ambulance operations.
Definitions: Helicopter air ambulance operation means a flight, or sequence of flights, with a patient or medical personnel on board, for the purpose of medical transportation, by a part 135 certificate holder authorized by the Administrator to conduct helicopter air ambulance operations.
Equipment Requirements: After April 23, 2018, no person may operate a helicopter in air ambulance operations unless it is equipped with an approved flight data monitoring system capable of recording flight performance data.
Weather Requirements: The certificate holder must obtain a weather report from a weather reporting facility operated by the NWS, a source approved by the NWS, or a source approved by the FAA, that is located within 15 nautical miles of the airport.
Operational Procedures: This includes procedures for approaches, departures, pre-flight checks, enroute operations, and rerouting the planned flight path.
Preflight Risk Analysis: Prior to the first leg of each helicopter air ambulance operation, the pilot in command must conduct a preflight risk analysis and complete the preflight risk analysis worksheet in accordance with the certificate holder's FAA-approved procedures.
Operations Control Center: After April 22, 2016, certificate holders authorized to conduct helicopter air ambulance operations, with 10 or more helicopter air ambulances assigned to the certificate holder's operations specifications, must have an operations control center. This center must have appropriate staffing, documented duties and responsibilities, and training programs.
Operations Control Specialist Training Requirements: Before performing the duties of an operations control specialist, each person must satisfactorily complete the certificate holder's FAA-approved operations control specialist initial training program and pass an FAA-approved knowledge and practical test given by the certificate holder. Initial training must include a minimum of 80 hours of training. Recurrent training is also required. The certificate holder must maintain a training record for each operations control specialist employed by the certificate holder.
Duty Time Limitations: Each certificate holder must establish the daily duty period for an operations control specialist so that it begins at a time that allows that person to become thoroughly familiar with operational considerations, including existing and anticipated weather conditions in the area of operations, helicopter operations in progress, and helicopter maintenance status, before performing duties associated with any helicopter air ambulance operation.
Drug and Alcohol Testing: Drug and alcohol testing is mandatory.
Medical Personnel Briefing: The briefing required in paragraphs (a)(2) through (9) of this section may be omitted if all medical personnel on board have satisfactorily completed the certificate holder's FAA-approved medical personnel training program within the preceding 24 calendar months.

Air Force En Route Care Training

The Air Force School of Aerospace Medicine (USAFSAM) provides initial, advanced and continuing en route care and currency education and training for Total Force nurses, physicians, medical technicians and respiratory therapists, as well as Department of Defense and international military medical personnel involved in delivering capabilities for the aeromedical evacuation system to ensure safe and optimal outcomes during patient movement.

The department employs various high-tech, high-fidelity patient manikin simulators and maintains a KC-135, C-17, four C-130’s, a partial 767 aircraft fuselage, and a UH-60 Black Hawk trainers to provide enhanced multi-modal learning in more realistic care delivery environments. Plans are underway to add a 767-2C to the trainer fleet.

The Academic Operations (ETA) Division provides academic assistance to the entire En Route Care Training Department, including all divisions described below. ETA is also the point of contact with USAFSAM’s Office of the Dean.

The Initial Inflight Care (ETI) Division provides foundational aeromedical evacuation ground training to nurses and technicians. Courses include the Flight Nurse (FN), Aeromedical Evacuation Technician (AET), Critical Care Air Transport (CCAT)-Initial, Ground Surgical Team (GST) Austere Training, and the Enlisted Critical Care (ECC). The FN and AET course content includes altitude physiology, stresses of flight, in-flight nursing care considerations, patient safety, medical equipment, aircraft configurations, mission requirements and crew resource management. The FN course is an AFSC awarding course (46F) and provides 80 hours of continuing education units. The AET course provides six Community College of the Air Force credit hours.

The CCAT-Initial course (ETII) educates and trains critical care experienced physicians, nurses and respiratory therapists assigned to CCAT team Unit Type Codes (UTCs) in the fundamentals of CCAT. Course content includes altitude physiology, crew resource management, patient movement items, UTC equipment and supply allowance standards, the Joint Trauma Training System and Clinical Practice Guidelines. Utilizing high-fidelity patient simulators, each 3-member multi-disciplinary team is stepped through and later evaluated on their performance during realistic AE mission profiles with critical care patients aboard three different fixed-wing aircraft fuselage trainers.

The GST Austere Training course provides Unit Type Code training for Air Force physicians, nurses, administrators and surgical technicians to function as a small surgery team located in austere environments.

C-STARS Training Sites

C-STARS Baltimore is located at the University of Maryland Medical Center in the R Adams Cowley Shock Trauma Center in Baltimore, Maryland.

C-STARS Cincinnati is located at the University of Cincinnati Medical Center in Cincinnati, Ohio. This site is the platform for the CCAT-Advanced training. Instruction for critical care physicians, critical care nurses and respiratory therapists includes airworthy medical equipment, table of allowances/supplies, implementation of the JTTS, CPGs during trauma and critical care high-fidelity simulation training.

C-STARS St Louis is located at Saint Louis University Hospital and Washington University in Saint Louis, Missouri.

C-STARS Omaha is located at the University of Nebraska Medical Center in Omaha, Nebraska. This infectious disease cadre provides AFSC specific infectious disease and biocontainment skills. The training focuses on hands-on, high acuity in-patient care.

C-STARS Las Vegas is located at the University Medical Center in Las Vegas, Nevada.

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