When an indigent patient needs a helicopter: a case report and an accepted institutional policy

Emergency aeromedical systems have become an integral part of the practice of critical care medicine. These systems provide specialized care to the severely injured, including transport to the nearest trauma center with the highest level. Aeromedical physicians and nurses called to care for injured indigent patients, however, may be placed at odds with the financial interests of their institution. "Patient dumping" in aeromedicine may lead to ethical, legal, professional, and regulatory dilemmas for emergency professionals and health care institutions. Institutional policy for aeromedical transport of severely injured patients must be instituted, regardless of their ability to pay.