The report was not intended to burden operators with undue requirements or to handicap this vital function in any way; rather the purpose of the report was to identify and recommend operational strategies and technologies that will help ensure that these vital EMS flights arrive safely and continue to provide a valuable service to the public.
Most of the recommendations to the FAA were closed as a result of the June 20, 1991, issuance of Advisory Circular (AC) 135-14A, "Emergency Medical Services/Helicopter (EMS/H)," which addressed equipment, training, crew resource management (CRM), decision-making, flight-following procedures, weather minimums, and the development of safety programs for EMS helicopter flights operating under 14 Code of Federal Regulations (CFR) Part 135.
The report also cited controlled flight into terrain (CFIT), in particular during the takeoff or landing sequence, as a common problem, as well as collision with objects (wires were the most common obstacles for EMS helicopters); inaccurate weather forecasts (about 26 percent of helicopter EMS accidents were weather-related, with most occurring because of reduced visibility and IMC while the helicopter was en route); and communications problems with air traffic control (ATC) or a lack of communications due to remote locations and high terrain.
On October 7, 2010, the FAA proposed new warning systems and increased training for emergency medical flights to deal with the spate of recent crashes.
[1] This article incorporates public domain material from NTSB/SIR-06/01: Special Investigation Report on Emergency Medical Services Operations (PDF).