Pre-Hospital Guidelines - A non-profit helicopter emergency medical service for south Texas.

Most people who need emergency medical care can be appropriately transported by ground ambulance. However, some patients need the critical care and speed that HALO-Flight provides. Below are some HALO-Flight critical care usage guidelines.

This list is not all inclusive and should not replace your decision to transport based on medical judgment.


  • Mutual aid for BLS and ALS units requiring a Critical Care RN / Paramedic MICU team
  • A decreased transport time is necessary to optimize patient outcome
  • The patient’s condition requires critical care life support (monitoring, personnel, medications or specific equipment) not otherwise available
  • Patient requires rapid access to a definitive care facility not available within the local area
  • The potential for delays in transport may be associated with worsened patient outcome
  • The use of your local ambulance would leave the local area without adequate EMS coverage for an extended period of time
  • The local resources are overwhelmed with the number of patients (MCI)


  • Multiple system injury
  • Spinal cord injury
  • Paralysis
  • Chest wall injury with known or possible development of respiratory/cardiac issues
  • Patients requiring advanced airway treatment
  • Unstable pelvis or long bone fractures
  • Fractures/dislocations/injuries to extremities with the loss of distal pulses
  • Death of occupant in same car
  • Prolonged extrication with known or unknown injuries
  • Altered mental status secondary to trauma related incident
  • Falls > 20 feet or with significant injury
  • Near-drownings
  • Shootings/Stabbings to the head, neck, chest, thorax or pelvis


  • Respiratory distress
  • Altered Mental status
  • Mechanical ventilation required
  • Suspected Sepsis
  • Cardiogenic shock
  • Cardiac arrhythmias
  • Stroke
  • Overdose with an altered level of consciousness
  • Uncontrolled seizure activity
  • Suspected DKA or other diabetic emergencies
  • Anaphylaxis
  • Environmental emergencies (hypothermia, hyperthermia)

Inter-Facility Guidelines

Bypass Protocols

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