Emergency medical equipment installed on aircraft operated by European air medical operators are governed by the European Aviation Safety Agency (EASA) and must conform to certain regulations, including Part 21 (design) and CS-25/CS-23 (certifications specifications for aircraft).
The regulations ensure that certain standards are met in medically equipped aircraft.
Equipment needs to be secured to sustain inertia forces during aborted take-off and/or emergency landing. Stretchers and oxygen bottles installed on aircraft are subjected to certification specifications. And emergency medical equipment installation, which modifies the original design of an aircraft, must be performed by an approved Part 21-certified organization.
Once installed, there would be a type certificate approval delivered by EASA following a process including a compliance statement, drawings, safety analysis, ground test, flight tests and additional inspections. This usually takes about 10 months. Once fulfilled, the STC is then registered on the European-approved STC list, which allows it to be used over a variety of aircraft. Furthermore, the medical STC defines what ongoing maintenance and operational procedures of the medical equipment are required.
On EMS helicopters, there are variations to the requirements governed by size and space available. However, equipment guidelines require familiarity with the equipment, professional maintenance, daily and weekly checks and storage, and regular reporting about unnecessary equipment or adverse events. Equipment also must be ready for use at the end of each day. There are also standard procedures with regard to drugs carried.
Blood is currently not mandated on aircraft. But companies like Wiltshire Air Ambulance (WAA) in the U.K. have been carrying blood for the last year and have influenced patient recovery rates.