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In our survey of the 81 EMS incidents reported to the ASRS, it became evident
that “Lifeguard” and “Priority Handling” are phrases in need of clarification.
Some EMS pilots seem unclear about the degree of preferential treatment provided
by the “Lifeguard” call sign and how this situation compares to “Priority Handling.”
Similarly, some controllers seem unaware of pilots’ operational expectations when
“Lifeguard” is used. An ASRS report illustrates the expectation by a pilot that
“Lifeguard” call sign will provide immediate priority, and also suggests that the
controller had difficulty prioritizing this “Lifeguard” flight:
✍ “When requesting departure clearance and using ‘Lifeguard’ call sign, the
controller ignored my transmissions for nearly 4 minutes. I could have departed
safely and expeditiously in several directions completely away from the flow of
fixed wing traffic.” (ACN 159931)
Lifeguard
&
PriorityHandling
FAA Air Traffic Control Handbook
The FAA Air Traffic Control handbook, Order 7110.65J,
provides for “operational priority” for civilian air ambulance
flights. It states in paragraph 2-4, Operational
Priority:
“Provide air traffic control service to aircraft on a
‘first come, first served’ basis as circumstance permit,
except the following…
a.) Provide priority to civilian air ambulance flight
(LIFEGUARD). When verbally requested, provide
priority to military air evacuation flight (AIR EVAC,
MED EVAC) and scheduled air carrier/air taxi flight.
Assist the pilot of air ambulance/evacuation aircraft
to avoid areas of significant weather and turbulence
conditions. When requested by a pilot, provide notifications
to expedite ground handling or patients,
vital organs, or urgently needed medical materials.
2-4a) Note—Air carrier/taxi usage of “LIFEGUARD” call
sign, indicates that operational priority is requested.”
Airman’s Information Manual
In contrast, the Airman’s Information Manual offers no
guidance as to the nature or degree of “priority” afforded
the “Lifeguard” flight. This lack of information, and the
possibility of variable controller interpretations of FAA
Order 7110.65J when faced with different situations,
may create unrealistic expectations for both pilots and
controllers.
FAA Air Traffic Procedures Division
In a response to an inquiry from ASRS, the FAA Air
Traffic Procedures Division offered the following expanded
interpretation of “Lifeguard” and “Priority Handling”
terminology.
“The use of the term ‘Lifeguard’…provide[s]
priority…Even the expeditious movement of Presidential
aircraft or other special air operations are
listed behind air ambulance priority in Order
7110.65…
18 Issue Number 6
Lifeguard
 Is indicated by including the term “Lifeguard” in
the aircraft call sign (e.g., “Lifeguard Medic Flight
246”).*
 Indicates that human life is endangered to some
degree, regardless of other wording in the aircraft
call sign.
 Air ambulance aircraft will receive very high
priority when they are identified in the air traffic
system.
Priority Handling
 Is a request, usually following the aircraft call sign
(e.g., “Medic Flight 246, requesting priority handling”).
 Is treated like any other request until the pilot
states the reason for the priority, at which time the
controller can provide appropriate assistance.
 Is not, in itself, justification for an aircraft to receive
special handling from the air traffic system.
*As noted by the FAA Procedures Division, “In many locations the actual call sign of air ambulance aircraft can vary widely.
Examples are ‘DUSTOFF,’ ‘LIFE FLIGHT,’ or ‘MEDIC’ and often with an associated number such as ‘Dustoff one.’ These kinds of
call signs and air ambulance operations are normally accompanied by excellent communication between the operators and air
traffic control, both in the form of recurrent visits/briefings, and Letters of Agreement.”
Lifeguard
&
Priority Handling
“It is a fine line between normal operations and
emergency operations, both for the medical personnel
as well as for the controllers. While an
emergency in the air traffic control world generally
means that an aircraft (and therefore its
occupants) are endangered, this distinction blurs
　
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