I bring you a weekly bite-sized chunk of the science behind helicopter human factors and CRM in practice, simplifying the complex and distilling a helicopter related study into a summary of less than 500 words.
TITLE:
Helicopter rescue at very high altitude: Recommendations of the International Commission for Mountain Emergency Medicine (ICAR MedCom) 2025.
WHAT?
This paper presents the first internationally endorsed recommendations for helicopter rescue operations above 3,500 m. It identifies 19 operational considerations aimed at improving safety and effectiveness during very high altitude (VHA) missions.
WHERE?
Developed through collaboration between the International Commission for Mountain Emergency Medicine (ICAR MedCom) and the ICAR Air Rescue Commission, drawing on experience from Europe, North America and the Himalayas.
WHEN?
Published in High Altitude Medicine & Biology in 2026.
WHY?
Combined a narrative review of the scientific literature with expert opinion from experienced rescue pilots, physicians and mountain rescuers. Recommendations were developed by consensus and organised into pre-mission, mission and post-mission phases.
HOW?
Rescues above 3,500 m involve unique challenges including hypoxia, degraded aircraft performance, difficult terrain and rapidly changing weather. Despite increasing numbers of VHA operations, no internationally accepted guidance previously existed.
FINDINGS:
The paper identifies team dynamics as the most important factor in successful VHA rescue. Strong Crew Resource Management (CRM), shared situational awareness and effective communication are considered essential because many accidents stem from human factors rather than technical failures.
Frequent training in high-altitude procedures, proximity flying and human external cargo techniques is recommended. Acclimatisation should be optimised whenever possible, and crews should recognise the effects of hypoxia on physical and cognitive performance. Supplemental oxygen is recommended for prolonged exposure above 3,500 m and mandatory above 4,000 m in the absence of local regulations.
The authors also emphasise structured risk assessment, contingency planning, minimising exposure time at altitude, and conducting post-mission debriefs. Awareness and management of psychological stress should form part of operational training.
SO WHAT?
This paper is significant because it establishes the first international framework for helicopter rescue at very high altitude. From a human factors perspective, its most important message is that success in helicopter rescue depends less on technical flying skill and more on CRM, teamwork and physiological preparedness.
The recommendations align closely with resilience engineering and modern CRM principles. Shared mental models, psychological safety, communication and after-action reviews are repeatedly emphasised as critical defences against error.
The paper also highlights the impact of hypoxia on cognition, reinforcing the importance of managing human performance as carefully as aircraft performance.
For HEMS and SAR operators, the study provides a practical foundation for training, risk management and SOP development in extreme environments.
REFERENCE:
McLaughlin, K., Shimanski, C., Zafren, K., Jackson, I., Biner, G., Folini, M., Hermansky, A., Ridington, E., Hicks, P., Strapazzon, G., Falla, M., Hopper, A., Weber, D., Jackson, R., & Brugger, H. (2026). Helicopter rescue at very high altitude: Recommendations of the International Commission for Mountain Emergency Medicine (ICAR MedCom) 2025. High Altitude Medicine & Biology, 27(2), 107–116.
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