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Critical Care Transport Team

Life Flight’s scope of practice is very simple: we will transport any critically ill patient, regardless of age. To meet this challenge, our critical care transport nurses, paramedics, and respiratory therapists are highly experienced in critical care and undergo an intense, thorough, competency-based orientation that is specific for the transport arena. Specific requirements include BCLS, ACLS, PALS, NRP, PHTLS, TNCC and EMT certifications.

Many staff members hold certifications in Emergency Nursing (CEN), Critical Care Nursing (CCRN), Flight Nursing (CFRN), Certified Flight Paramedic (FP-C) or Neonatal/Pediatric Specialty Credential (NPS). The teams' clinical practice is expanded to include advanced invasive surgical skills. This allows staff to perform intubations, cook catheter placements, femoral line placements and a variety of other procedures.

All transport providers are trained to care for patients ages 31 days to adult. Patients under 31 days old as well as pediatric patients are cared for by the specialty neonatal/pediatric team. The neonatal specialist providers perform skills during transport including umbilical arterial catheterization, venous catheterization, and intubations.


Life Flight's ground operations are supported by advanced life support paramedics.  While their scope of practice does not include critical care, these team members undergo the same rigorous orientation and training as the critical care team members.  Our paramedic providers support transports between hospital facilities as well as responsing to emergent needs in the health system's outpatient clinics.  All paramedics have BCLS, ACLS and PALS certifications.

Emergency Medical Technicians (EMTs)

EMTs are the crucial backbone of our ground fleet. They provide the safe transport of our ground patients to and from their destinations. Most have a background in either Fire or EMS and bring that valuable experience with them to Life Flight. Many are paramedic-level EMTs with some belonging to the National Registry of EMTs.

EMTs are responsible for performing daily safety checks of our ground ambulances to ensure their safe operation. In addition to driving, they also perform a valuable role in assisting the nurses with the packaging, loading, and unloading of our patients.

In cases of inclement weather, our EMTs perform the valuable task of providing safe and timely transport of our more critically ill patient population, including ground transport of critical neonates and cardiac patients requiring additional specialized equipment and personnel that the aircraft is unable to transport.  

Respiratory Therapists

Life Flight Registered Respiratory Therapists (RRT’s) are highly experienced in the critical care environment. All respiratory therapists are dedicated to the neonatal/pediatric transport team at this time. Life Flight respiratory therapists transport critically ill patients via ground ambulance, rotor wing, and fixed-wing aircraft.

Life Flight respiratory therapists have intense emergency airway training and are able to provide multiple modes of enhanced ventilation strategies.  In addition, RRTs at Life Flight are trained in many advanced invasive skills such as arterial line placement and umbilical line placement. The respiratory therapists encounter a thorough, competency-based orientation which is specific to the transport arena. Specific requirements include BCLS, ACLS, PALS, NRP, PHTLS and TPATC. Many Life Flight therapists possess the Neonatal-Pediatric Specialists (NPS) and/or Acute Critical Care Specialist (ACCS) certifications


Aviation expertise is contracted to Life Flight through Metro Aviation. The Metro Aviation team consists of eight pilots and six mechanics. Duke requires Life Flight pilots to have a minimum of 2000 hours of flight experience, instrument flight rating, and qualified training to operate all aircraft.

All pilots have previous military experience, with an average of more than 6000 flight hours. Initial aircraft training for the Life Flight program is received through a FAA certified company school at Air Methods Corporation.

Each pilot receives bi-monthly instrument flight training and quarterly inadvertent instrument meteorological conditions flight training. Each pilot is flight checked semiannually for instrument capability and annually in each aircraft for aircraft systems, company policy, and Federal Aviation rules knowledge. The pilots must also complete quarterly 25 hours of Computer Training Institutes Aviation Syllabus which focuses on all aspects of the aviation profession.


The Metro Aviation maintenance team at Duke Life Flight is comprised of a Lead Mechanic and 5 Line Mechanics. All of the mechanics are licensed and certified by the FAA, with over 80 years of combined experience with helicopters. Maintenance personnel has been factory trained by American Eurocopter specifically for the EC-145. They return periodically for training and updates on the various aircraft components.

The mechanics inspect each helicopter daily and service the aircraft as required before the aircraft is released for use by Duke Life Flight. Periodic maintenance and inspections are completed at our satellite base hangar at JNX airport in Smithfield, NC.

Communications Specialists

Our communications specialists are the nerve of our transport program. The communications center is staffed 24 hours a day by eleven, highly trained, air medical communication specialists, who are responsible for processing all transport requests for Duke University health System.

The communications center processes nearly 12,000 calls per year from hospitals with Duke University health System, EMS agencies across North Carolina, South Carolina, Virginia, and Tennessee and hospitals all over the world.

This team monitors both air and ground vehicles using satellite positioning through a sophisticated tracking program. At any given time, the communications center staff have the capability of tracking two Life Flight aircrafts, four ground units, and up to five mutual aide aircrafts. The team also monitors constantly monitors local and regional weather conditions to assure they are appropriate for air transports.