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Riders on the Storm: Hurricane Preparations for Medical Air Ambulance Services

Following the recent storms that devastated parts of the United States and resulted in power losses, airport shutdowns and the need for cooperation of Air Medical and EMS services from many different states, a discussion of the preparations Air Medical Services can make in advance of an approaching storm seems as relevant as ever.

Air Medical Services located in the Caribbean or along the southeastern seaboard of the United States probably know exactly what to do to prepare for a hurricane, including operating procedures far beyond the scope of these suggestions.

However, air ambulances in areas that are not used to being hit by hurricanes may not know where to begin when a tropical storm or hurricane is approaching.

The first part of this blog will discuss basic hurricane preparations for EMS / air medical flight crew personnel. The second part will discuss preparations for the aircraft itself, and is more intended for air ambulance operators and administrators.

This article is not intended to replace established operating procedures or the advice of storm/aviation experts when it comes to actually enacting preparations for an approaching storm. It is intended to merely bring to mind a few basic preparations air medical services may want to start seriously thinking about if they are facing an unexpected storm.

We welcome and encourage air medical services to add to this article by leaving comments at the bottom of this page.

Most importantly, always follow the instructions of local authorities in the event of any disaster.


Hurricanes cause catastrophic damage to coastlines and several hundred miles inland. They can produce winds exceeding 155 miles per hour as well as give birth to smaller tornadoes that pose even further danger.

(Photo: A helicopter transports patients to other hospitals as Hurricane Lili approaches in October 2002)

These massive storm systems can cause surges along the coast and cause extensive damage from rainfall alone. Excessive rain can also result in landslides and flash flooding.

Flying debris, flooding, and powerful winds cause widespread injuries, deaths, and catastrophic destruction across wide areas.

atlantic storm tracking

As you can see by this image of Atlantic hurricane tracks from 1851-2005 (click to enlarge), hurricanes are not limited to the Eastern seaboard of the U.S.. Air Ambulance Services located in other areas may be caught off-guard by these intense storms and have only days to prepare.

There are many hurricane preparedness guides for non-EMS personnel. Here, we’ve begun a discussion of some preparations that air medical services and their crews can expect when a storm threatens their operating area.

Medical Flight Crew Preparations

Emergency Air Medical Services that will be operating after the storm passes need to prepare to respond to post-storm emergencies.

Depending on the severity of the storm and the amount/type of damage caused, pilots and medical personnel can expect a higher volume of transport calls. The aircraft, the crew, medications, and medical kits should also be prepped and ready to respond to those calls.

Charter Air Ambulances, Private Medical Jet services, and other for-hire/taxi air medical carriers may also find themselves handling an influx of calls after the storm passes. This may be particularly true if the storm affects hospitals and surgical centers in the area.

Medical flight crew members who stay within the storm zone may be able to provide emergency medical assistance at designated hospitals acting as shelters before and during the hurricane.

The procedures are different everywhere, so you will need to find out how you can help in your community. You should receive more information from your local authorities, hospital, or air medical service in advance of the storm.

If an Evacuation is Ordered

It goes without saying that the air ambulance will not be flying during the storm. Of course, if an evacuation is ordered in the area where your air ambulance is based, the crew members may or may not be able to stay in the area.

When the evacuation order is issued, you will receive further information from authorities on how you can assist. Hospitals in your area may assemble disaster response teams for responding to events during and immediately following the storm.

The most critical patients may also need to be evacuated to healthcare facilities outside of the storm’s zone.

As proven by the great work done by EMS crews who cross state lines to assist with hurricane response efforts, medical personnel on flight crews can still make a huge difference — saving lives even if they are located outside of the storm zone.

Keep Organized

Depending on the damage the storm brings with it, the situation in your air ambulance service’s operating zone may be chaotic. Electricity and communication lines may be down in the wake of a hurricane or other powerful storm.

Keeping clear and accurate communication is the first step in an air medical team’s ability to provide care for hurricane victims.

When responding to calls following a disaster, it is just as critical as ever for Air Medical Crews to stay organized and focused on providing expedient, safe transport and the highest quality care to patients.

Securing the Aircraft

The first option is to leave the aircraft in a hangar. Even for a Category 1 storm, tying down the aircraft will not be sufficient. Contact the airport administration for further advisement.

Many services that employ fixed-wing air ambulances will already have a hangar designated for their jet or turbo-prop plane. Other services and HEMS providers may need to find a temporary hangar to provide shelter for their aircraft.

Not all aircraft hangars are built equally; hangars may or may not be constructed to withstand hurricane-force winds.

Furthermore, hangars that are specifically rated to withstand hurricane force winds may not be able to stand up against higher category hurricanes.

Therefore, regardless of a hangar’s wind resistance rating, the second and best option (if possible) is to relocate the aircraft to an airport outside of the storm zone temporarily.

If an air ambulance will be relocated to another hangar/airport as part of a storm preparation plan, then the further in advance the aircraft can be arranged to be moved, the better. Available hangar space at nearby airports outside the danger zone may become limited very quickly as the storm approaches.

While it is more likely that a hangar built more recently will be better able to stand up to storm winds than an older hangar, this factor alone should not be depended upon.

Air Medical Services planning to leave their ambulance inside a hurricane-resistant hangar that will fall within the path of the storm should learn exactly what storm category the hangar is rated to hold up against.

Above, you can see evidence of the damage a storm can wreak on a hangar, exposing the aircraft inside to strong winds, flying projectiles, and other storm hazards. Air Ambulance services should keep in mind that a hangar may not provide adequate shelter for their aircraft if the airport is located in the storm’s path. This photo shows nearly-destroyed Hangar 17 at Lakefront Airport in New Orleans following Hurricane Katrina (Category 5) in 2005.

Ultimately it is aviation/airport authorities, air ambulance administrators, and the storm itself that will shape the most viable plan for protecting an expensive aircraft from the wrath of Mother Nature.

Transporting the Air Ambulance (and the Pilot)

Another point for Air Medical Services to consider is whether to have the air ambulance moved by the air ambulance pilot or by an outside pilot.

Depending on circumstances, there may be certified flight instructors or other qualified pilots willing to move the aircraft either for financial compensation or simply for the flight time.

In either of these scenarios, arranging one-way return transportation/accommodation for the pilot must be factored in by the air ambulance service as well.

Relocation Reimbursement

Some aircraft insurance policies may already include reimbursement for hurricane relocation cost incurrence. Most level-headed aircraft insurers would naturally rather pay for the cost of relocating an air ambulance than compensate for higher repair costs if the aircraft incurs storm damage in its present hazardous location.

Other Considerations

Another reason not to leave the air ambulance in a hangar at an airport that may be hit by an extremely powerful hurricane is the chance that an aircraft — even an undamaged one — may become “stranded.”

Like any other natural disaster, hurricanes may wreak havoc on control towers, secondary buildings, runways, and other airport infrastructure in addition to potentially damaging buildings that house aircraft.

Thus, there is the potential that damage to the airport could prevent or interfere with moving the air ambulance from its hangar location for a period of time even if the aircraft itself survives the entire storm without a scratch.

Along with the air ambulance itself, you will want to consider temporarily relocating vulnerable medical equipment, kits, and medications so they will not be destroyed by projectiles, falling debris, or excessive rainfall during the storm. Post-storm theft and looting is another concern if the integrity of the hangar structure is affected.


By combining the tips suggested in this article with the advisement of your local authorities, your air ambulance and flight crew can weather the storm and be able to continue doing what you do best — providing the best possible care to the patients most in need.

Tell Us

How does your Air Ambulance service prepare for a hurricane or other large storm? What other specific preparations did we not mention here? Contact us, or leave a comment below, and let us know.


Your thoughts are welcome.

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