How Safe is your Medical Transportation in the Event of an Emergency?

As we move into December and into the thick of the holiday season, we also enter a danger zone for accidents. AAA estimates that during this Christmas and New Year’s season, nearly 95 million Americans will hit the road, traveling long distances to visit friends and family. Unfortunately, during the end-of-year holiday travel period, nearly 27,900 Americans will be seriously injured in auto accidents, and more than 250 will die.  

Most people don’t give the topic of emergency responder transportation much thought, they just expect that when an emergency happens, the best help available will arrive and act. But how do you know you are getting the most qualified and safest transport available? Many of the best services demonstrate their quality by following the rigorous Accreditation Standards and achieve accreditation through an organization called the Commission on Accreditation of Medical Transport Systems or CAMTS. CAMTS provides such accreditation for air and ground emergency medical transport systems.

“CAMTS is a peer review organization dedicated to improving patient care and transport safety by providing a dynamic accreditation process through the development of standards, education, and services that support our vision,” said Associate Executive Director Dudley Smith.

Emergency medical services that respond directly to the scene will transport patients to the nearest appropriate hospital or call in an area medical helicopter to do so, because of its increased speed and/or medical expertise. Patients taken to the nearest hospital may also need a higher level of care, resulting in a transport to a second hospital. CAMTS provides accreditation, for those services that meet its standards, for helicopters and ambulances that respond to scenes and for airplanes that support longer travel  and provide care between medical facilities. Part of those standards measure appropriate care, transport mode and receiving facility such as a Level I or II Trauma Center, stroke patients to a hospital with specialized stroke care, acute myocardial infarction patients to a hospital with a staffed cardiac catheterization lab, major burns to a Level I or II burn center and high-risk OB patients to a hospital with OB services and a Level II or III NICU, etc.

Given the critical nature of emergency transportation, all CAMTS accredited programs are overseen by a medical director(s). This person is a physician who is responsible and accountable for supervising and evaluating the quality of medical care provided by the medical personnel. The medical director ensures competency and currency of all medical personnel working with the service. The medical director must also have experience in both air and ground emergency medicine.

“When you call for emergency response, knowing those answering the call are CAMTS- certified offers a level of assurance that the patient is in the absolute best hands,” adds Smith. 

One of the goals of CAMTS is to assure that the medical care needs of the patient are met by the skills and expertise of the transport team. Critically ill or injured patients may require the skills of a critical care or emergency medicine nurse or physician, while stable patients may be best serviced using a paramedic and Emergency Medical Technician (EMT).

It’s also important to note, all persons who drive a ground ambulance must be, at a minimum, certified as an EMT or have equivalent training.  Additionally, drivers are required to complete a defensive driving training program that is developed by the provider or outside agency. The training must include an Emergency Vehicle Operations Course (EVOC) or equivalent course, which consists of at least four hours of reviewed ambulance driving under emergency conditions. The training program must be repeated for each driver at least every four years.

CAMTS Standards also specify the duties of the ambulance co-pilot, who supports the driver in navigation — setting/verifying GPS input, lights and sirens response, as well as monitoring driver fatigue/impairment — the ambulance co-pilot is expected to stay alert on all legs of the transport. Standards also include the importance of securing the patient, the crew and medical equipment and supplies, which can become missiles should the ambulance crash;  providing required supplies and inspected medical equipment; doing daily inspections on the vehicle; maintaining temperature control in the patient compartment and assuring there is appropriate communication with the program dispatch center and medical control.

Since aircraft, often helicopters, respond to the most serious medical scenes, this mode of transport must too adhere to strict screening. 

Standards address not only pilot and maintenance qualifications and training that exceed FAA regulations, but also, medical configurations and operational policies and practices as well.

“We want it to be clear that a CAMTS certification means that the particular transportation provider has met the most rigorous criteria with the ultimate goal being patient safety and a positive outcome,” said Smith.

CAMTS is an association of twenty-one non-profit organizations dedicated to improving the quality and safety of air medical or ground transport services.  The Commission offers a program of voluntary evaluation of compliance with accreditation standards, which demonstrate the ability to deliver a measurable, quality level of service.

Originally developed in 1991, the Accreditation Standards address issues of patient care and safety in fixed and rotary wing services, as well as ground inter-facility services providing critical care transports. Accreditation Standards are revised every 2-3 years to reflect the dynamic, changing environment of medical transport with considerable input from all disciplines of the medical profession. They serve as a marker of excellence for federal, state, and local governmental agencies, as well as private agencies and to the general public.

In order to obtain accreditation, a medical transport service must be in substantial compliance with the Accreditation Standards and pass a detailed site visit done by specially trained and experienced site surveyors. Learn more by visiting

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