What every HEMS pre-duty brief should cover

A practical, base-ready checklist for the start of every air medical shift: aircraft, weather, NOTAMs and TFRs, risk, crew and handoff.

BRIEFED · Updated October 2026

The first minutes of a shift set the tone for everything after it. When the tones drop, nobody has time to look up a TAF, chase down the last pilot's maintenance note or wonder whether a TFR popped up overnight. A good pre-duty brief answers those questions before they're asked, the same way at every base, every shift.

This checklist is a starting point for programs building or tightening their brief. Adapt it to your aircraft, your terrain and your operations manual.

1. The shift and the people

  • Date, shift and base. It sounds obvious, but a brief that isn't tied to a specific shift can't prove anything later.
  • Who is on. Pilot in command, flight nurse, paramedic and any rider or specialty team, named rather than assumed.
  • Fitness for duty. A quick personal check (for example, the I.M.S.A.F.E. model: illness, medication, stress, alcohol, fatigue, emotion) for everyone on the crew, not just the pilot.

2. The aircraft

  • Status and airworthiness. Any open write-ups, deferred items or MELs, and whether the aircraft is in service.
  • Times and fuel. Total time, fuel on board and anything the previous crew noted about burn or loading.
  • Maintenance due. Days and hours to the next inspection, so a launch never runs into a hard limit.
  • Medical equipment and oxygen. Oxygen quantity, equipment checks and anything restocked or missing.

3. Weather, from official sources

  • Current and forecast conditions at home base and the airports you're most likely to use: METARs and TAFs, with the flight category (VFR, MVFR, IFR, LIFR) for each.
  • Area hazards: AIRMETs, SIGMETs and Center Weather Advisories (CWAs) that touch your service area.
  • Freezing level, winds and visibility trends, especially for night and mountain operations.
  • Light conditions: sunrise, sunset and moon illumination for NVG operations.
  • An overall call. A clear GO, CAUTION or NO-GO that the whole crew hears, with the reason stated when it isn't GO.
Pull weather and NOTAMs from the source, such as the National Weather Service Aviation Weather Center and the FAA, rather than from screenshots or third-party summaries that may be out of date by the time you read them.

4. NOTAMs and TFRs

  • Airport and heliport NOTAMs for home base and likely destinations: closed runways or pads, lighting outages and obstacles.
  • Temporary flight restrictions in the service area: wildfires, VIP movement, events and stadiums.
  • Acknowledgment. Each hazard read and acknowledged, not just displayed.

5. Risk

For helicopter air ambulance operations, FAA rules (14 CFR Part 135, Subpart L) require a preflight risk analysis. Many programs carry the same idea into the start-of-shift brief: a risk score for the shift's conditions, with mitigations agreed before the first call rather than in the middle of it. Record the score and any mitigations with the brief.

6. The med crew brief

The med crew needs the same picture as the pilot. A shared checklist keeps it consistent: shift weather, aircraft items, oxygen, seat assignments, launch and loading duties, scene and landing zone duties, decision-making and CRM commitments, and a short safety topic. Have the med crew acknowledge it, ideally right on the device.

7. The handoff

Close the loop with the outgoing crew: what they changed, what they noticed and what's still open. If the aircraft's story doesn't carry over, the next crew has to rediscover it. See Closing the gap at shift change.

Make it the same everywhere

The value of a checklist comes from consistency: the same steps, in the same order, at every base. That's also what makes the record useful afterwards, whether for a safety review or an accreditation visit. Tools like BRIEFED turn this checklist into a guided five-step brief on any device and keep every brief on record.

See it with your bases

Book a 30-minute walkthrough with a live brief built for one of your bases.

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