Medical Evacuation Configuration

1. This proposed Special Condition was first consulted in August 2011 for Medical Evacuation configuration only. The update and publication at Issue 5 removed guidance for Ambulance Conversions and temporary Stretcher installations being outside the scope of Medical Evacuation. Instead, EASA issued Certification Memorandum CM-CS-012 containing this related guidance. The essence of the Special Condition for Medical Evacuation Configurations remained as published at Issue 4, except editorial updates were implemented.

2. The Special Condition D-XX on “Medical evacuation configuration” at the latest Issue 5 was released by EASA on 30 March 2020 and can be found under the following link:

3. https://www.easa.europa.eu/document-library/product-certification-consultations/special-condition-medical-evacuation

The associated Certification Memorandum CM-CS-012 was released by EASA for public consultation from 30 March to 20 April 2020 and can be found under the following link:

https://www.easa.europa.eu/document-library/product-certification-consultations/certification-memorandum-air-medical-services

With this update of the Special Condition on “Medical evacuation configuration” under the new reference SC-D25.803-01, more guidance and precision are added to address questions arising during past certification projects.

1. The conversion of the cabin of a large aeroplane from a passenger transport layout into a configuration to be used in case of Medical Evacuation (Medevac) foresees the installation of certain number of stretchers to carry patients that could be incapacitated and/or non-ambulant. In some cases, a significant number of incapacitated patients could be carried on board.

2. The stretchers may directly be attached to the aeroplane seat tracks or be restrained to a support unit that is attached to the aeroplane structure. The stretchers and their support units are compliant with §25.561 but do not comply with §25.562.

3. A rapid occupant evacuation required by §25.803, does not address evacuation of incapacitated patients transported on a stretcher. Compliance with §25.803 is demonstrated by an evacuation demonstration or by analysis, based on evacuation demonstrations (as applicable), in which stretcher installations have not been assessed. Therefore, EASA expects the applicant to provide a concept of evacuation. This concept should include the number of able-bodied persons involved in the evacuation and the associated procedures. Effectiveness of those procedures may need to be demonstrated. As there are multiple evacuation scenarios that cannot be reasonably foreseen, authorization for transporting occupants in addition to those identified in the approved procedures for Medical Evacuation must be obtained by the NAA that is in charge to authorize the operation of the aircraft.

4. Based on past experience with the installations of medical evacuation configurations, EASA has identified the following areas that may not be in full compliance:

• §25.785(j), i.e. do not provide to occupants/crew members a means to steady themselves in case of turbulence (firm handhold),

• §25.785(h)(2), i.e. the existing cabin crew seats (if installed) in the changed environment may be installed so that cabin crew may have no direct view of all cabin areas during TT&L.

• §25.1447(c)(1) e.g. if stretchers are installed on top of another. In case of cabin decompression, oxygen masks may not be automatically presented to the patients on the stretchers and life preservers might not be within easy reach of stretcher occupants.

1. Applicants are generally encouraged to clearly segregate between installation provisions and parts of the approved configuration. More guidance regarding this aspect is provided in EASA CM-CS-012 on “Air Medical Services with large aeroplanes”.

2. Stretchers sometimes incorporate mattresses, which may not be compliant with the overall §25.853 flammability requirement upgrade introduced by the cushion flammability test (oil burner) per CS 25 Appendix F Part II-

3. As CS 25 does not contain requirements that specifically address medical evacuation configurations, Special Conditions are needed to establish a level of safety compatible with that intended by the applicable airworthiness code.