Ground Versus Air: Which Mode of Emergency Medical Service Transportation Is More Likely to Crash?

Published:November 15, 2022DOI:



      We analyzed helicopter emergency medical services (HEMS) and ground emergency medical services (GEMS) crash data in the United States during 1983 to 2020 to compare incidences of total, fatal, and injury crashes.


      HEMS and GEMS total, fatal, and injury crashes during 1983 to 2020 and 1988 to 2020, respectively, were analyzed in this retrospective study. Data were obtained from the National Transportation Safety Board and the National Highway Traffic Safety Administration. Additional data from the Federal Aviation Administration, the National Emergency Medical Services Information System, and prior literature were used for rate calculations. A Poisson regression model was used to determine rate ratios with 95% confidence intervals comparing total, fatal, and injury crash rates from 2016 to 2020.


      HEMS crash rates decreased since 1983. Total GEMS crashes have increased since 1988. Of the total crashes, 33% (HEMS) and 1% (GEMS) were fatal, and 20% (HEMS) and 31% (GEMS) resulted in injury. During 2016 to 2020, GEMS crash rates were 11.0 times higher than HEMS crash rates (95% confidence interval, 5.2-23.3; P < .0001).


      HEMS has a lower crash probability than GEMS. The availability of data is a limitation of this study. National GEMS transportation data could be useful in studying this topic further.
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