ABSTRACT
I. INTRODUCTION It has been over 50 years since the first rotor-wing rescue of a patient occurred in Burma during the waning stages of World War II. That event set the stage for the further use of helicopters in Korea and the subsequent extensive use of helicopter rescue in Vietnam. This military experience led to the development of civilian helicopter systems around the world. Helicopters have rescued millions of people since 1945, yet they still remain controversial, especially in this era of health care budget cuts. Are helicopters useful and cost-effective or are they expensive flying billboards? Do they save lives or are ground ambulances just as efficacious at transporting the sick and injured? Is it more complex than that (i.e., is one is more useful at one time than another)? Just as with any other modality of treatment or transport in out-of-hospital medicine, the helicopter or ground vehicle each has its own utility and crew capabilities, depending on the circumstances of the event. The proper usage of any out-of-hospital treatment requires active physician oversight with continuous quality management and utilization review to continuously attempt to make the system better. An emergency medical services system, including ground, helicopter, and fixed-wing, is a continuously evolving system and not a static entity.
