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SPA.HEMS.110 Equipment requirements for HEMS operations

ANNEX V (Part-SPA) · Regulation (EU) No 965/2012 · EAR revision 27 Mar 2026

IRImplementing rule

SPA.HEMS.110Equipment requirements for HEMS operations

(a)The installation on a helicopter of all dedicated medical equipment and any subsequent modifications to that equipment and, where appropriate, its operation, shall be approved in accordance with Regulation (EU) No 748/2012.

(b)For VFR flights over routes navigated by reference to visual landmarks, the helicopter shall be equipped with a device that provides a moving map display with own-ship position and obstacles. The map and obstacle database(s) shall be kept up to date.

(c)By way of derogation from point CAT.IDE.H.240 of Annex IV, complex, non-pressurised helicopters operated in HEMS with a MOPSC of nine or less shall comply with the oxygen requirements applicable to other than complex, non-pressurised helicopters.

(d)By way of derogation from points CAT.OP.MPA.285 and CAT.IDE.H.240 of Annex IV, short excursions above 13 000 ft without using supplemental oxygen may be undertaken by day, subject to prior approval by the competent authority, provided that all the following conditions are met:

(1)the excursion above 13 000 ft is necessary for the embarkation/disembarkation of persons or for HEMS HEC operations;

(2)the flight is not conducted above 16 000 ft;

(3)the duration of the excursion above 10 000 ft without oxygen is limited to 30 minutes within a HEMS mission;

(4)the safety briefing in accordance with point CAT.OP.MPA.170 of Annex IV includes adequate information to crew members and passengers on the effects of hypoxia;

(5)SOPs are included in the operations manual covering points (1) to (4);

(6)the operator’s experience of conducting operations at high altitudes without using supplemental oxygen is adequate for the operations to be performed;

(7)the experience of the individual crew members and their physiological adaptation to high altitudes are adequate for the operations to be performed;

(8)all crew members involved in the operations have received initial and recurrent training in hypoxia;

(9)none of the crew members involved in the operations have been diagnosed with a medical condition that could lead to hypoxia.

(e)For single-pilot operations at night, the helicopter shall be equipped as follows:

(1)for a helicopter first issued with an individual CofA before 25 May 2024 or earlier, with a suitable stability augmentation system or autopilot;

(2)for a helicopter first issued with an initial CofA on or after 25 May 2024, with an autopilot. [applicable from 25 May 2028 — Implementing Regulation (EU) 2023/1020]

(f)For HEMS operations by day, the helicopter shall be equipped with the flight instruments required under points (a)(6) and (a)(7) of point CAT.IDE.H.130 of Annex IV.

(g)The helicopter shall be equipped with a radio altimeter capable of emitting an audio warning below a pre-set height and a visual warning at a height selectable by the pilot.

(h)Instruments and equipment required in points (e) and (g) shall be approved in accordance with the applicable airworthiness requirements.

(i)The operator shall ensure that all relevant information is documented in the minimum equipment list.

IR · SPA.HEMS.110 — Regulation (EU) No 965/2012 · Regulation (EU) 2023/1020 · Air OPS Easy Access Rules · EAR revision 27 Mar 2026

AMCAcceptable means of compliance

AMC1 SPA.HEMS.110(b)Equipment requirements for HEMS operations

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MOVING MAP DISPLAYS The moving map display should show the relative altitude of the surrounding terrain and obstacles to that of the helicopter, and may be any of the following:

(a)an HTAWS that is airworthiness approved;

(b)a display that is integrated in the cockpit environment and is airworthiness approved;

(c)a type B EFB software application. The database should cover the area where the helicopter usually performs HEMS operations.

AMC · AMC1 SPA.HEMS.110(b) — Regulation (EU) No 965/2012 · ED Decision 2023/007/R · Air OPS Easy Access Rules · EAR revision 27 Mar 2026

GMGuidance material

GM1 SPA.HEMS.110(b)Equipment requirements for HEMS operations

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MOVING MAPS — TRAINING ORO.FC.125 requires differences training or familiarisation when introducing new equipment and procedures. For EFB applications, AMC4 SPA.EFB.100(b)(3) defines the related training. In either case, the training focuses not only on the usage of the equipment or EFB application, but also on its limitations, including the following limitations of moving maps:

(a)Not all terrain and obstacles will be included in the database.

(b)In VFR, the proper selection of altitude and efficient visual scanning of the environment remain the primary means of obstacle and terrain avoidance.

(c)A type B EFB software application can only be used for increased situational awareness.

GM · GM1 SPA.HEMS.110(b) — Regulation (EU) No 965/2012 · ED Decision 2023/007/R · Air OPS Easy Access Rules · EAR revision 27 Mar 2026

AMCAcceptable means of compliance

AMC1 SPA.HEMS.110(d)(3)Equipment requirements for HEMS operations

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SHORT EXCURSIONS ABOVE 13 000 ft WITHOUT OXYGEN

(a)SPA.HEMS.110(d)(3) limits the duration of excursions above 10 000 ft without oxygen to 30 minutes within a HEMS mission, this being the maximum limit. However, the operator should consider further limiting the duration of the excursion depending on the concrete maximum flight altitude. For that purpose, the operator should meet either of the following:

(1)The operator should comply with the maximum flight altitude and the maximum duration of the excursion above 10 000 ft without oxygen as defined in Table 1; or

(2)If the operator expects flight durations above 10 000 ft greater than 15 minutes but no greater than 30 minutes, combined with a maximum altitude between 14 000 and 16 000 ft, the operator should define its own limitations within these boundaries based on scientific evidence of no risk of hypoxia. Table 1 — Maximum duration of the excursion above 10 000 ft, based on the maximum altitude reached

Maximum altitudeMaximum duration of the excursion above 10 000 ft
14 000 ft30 minutes
16 000 ft15 minutes

AMC · AMC1 SPA.HEMS.110(d)(3) — Regulation (EU) No 965/2012 · ED Decision 2023/007/R · Air OPS Easy Access Rules · EAR revision 27 Mar 2026

GMGuidance material

GM1 SPA.HEMS.110(d)(3)Equipment requirements for HEMS operations

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SHORT EXCURSIONS ABOVE 13 000 ft WITHOUT OXYGEN

(a)The duration of the excursion includes all time spent above 10 000 ft during the HEMS mission. This includes:

(1)all time spent on ground above 10 000 ft;

(2)all time spent in flight above 10 000 ft within a single HEMS mission.

(b)The HEMS mission ends on return to base. Temporarily flying below 10 000 ft without returning to base does not reset the duration of the excursion.

GM · GM1 SPA.HEMS.110(d)(3) — Regulation (EU) No 965/2012 · ED Decision 2023/007/R · Air OPS Easy Access Rules · EAR revision 27 Mar 2026

AMCAcceptable means of compliance

AMC1 SPA.HEMS.110(d)(6)&(d)(7) Equipment requirements for HEMS operations

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AMC1 SPA.HEMS.110(d)(6)&(d)(7) Equipment requirements for HEMS operations SHORT EXCURSIONS ABOVE 13 000 FT WITHOUT OXYGEN If the operator or an individual crew member has no experience in flying without oxygen above 13 000 ft, then the operator should set operating conditions or individual limitations for crew members to progressively gain experience and adapt to altitude, based on a risk assessment. The limitations may restrict the maximum duration spent above 10 000 ft, or the maximum altitude, and should be removed when no longer relevant. The altitude of the HEMS operating base should be taken into account to assess the physiological adaptation of the crew member to high altitudes.

AMC · AMC1 SPA.HEMS.110(d)(6) — Regulation (EU) No 965/2012 · ED Decision 2023/007/R · Air OPS Easy Access Rules · EAR revision 27 Mar 2026

AMCAcceptable means of compliance

AMC1 SPA.HEMS.110(d)(8)Equipment requirements for HEMS operations

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HYPOXIA TRAINING

(a)Required crew members planning to fly above 13 000 ft without oxygen should have training aimed at the following:

(1)knowing themselves and identifying early signs of hypoxia; and

(2)recognising early signs of hypoxia in other crew members.

(b)The crews should undergo both theoretical and practical training.

(c)The theoretical training should take place every 3 years and should include the learning objectives of module 050 of the CPL/ATPL theoretical knowledge that are relevant to hypoxia, as defined in Annex I (Part-FCL) to Regulation (EU) No 1178/2011.

(d)The initial and recurrent practical training of (a)(1) should take place every 6 years and should take place in one of the following:

(1)a hypobaric chamber that simulates an altitude for a sufficient duration for hypoxia to occur in an oxygen-deprivation scenario that is representative of a helicopter mission;

(2)a device that ensures that the gas the trainee breathes has the same partial pressure of oxygen as at the desired altitude, for a sufficient duration for hypoxia to occur in an oxygen-deprivation scenario that is representative of a helicopter mission. (e.g. reduced oxygen breathing device);

(3)a helicopter at the altitude required for the individual trainee to experience hypoxia, for the recurrent training only, provided that the trainee is in the cabin with medical assistance and an instructor using oxygen is able to ensure the safety of the training.

(e)The initial and recurrent practical training of (a)(2) should take place every 6 years and should comply with one of the following:

(1)The trainee should not be deprived of oxygen and should observe another crew member that undergoes the training described in (d) and that becomes hypoxic;

(2)The training takes place in a helicopter / FSTD where the instructor plays the role of a hypoxic crew member. The instructor should have attended at least 6 training sessions described under (d) as an observer or instructor or active crew member. In this case, neither the trainee nor the instructor need to be deprived of oxygen.

(f)In the context of hypoxia training, the validity period of flight and technical crew recurrent training should be as specified in AMC1 ORO.FC.145(g).

AMC · AMC1 SPA.HEMS.110(d)(8) — Regulation (EU) No 965/2012 · ED Decision 2023/007/R · Air OPS Easy Access Rules · EAR revision 27 Mar 2026

AMCAcceptable means of compliance

AMC1 SPA.HEMS.110(e)(1)Equipment requirements for HEMS operations

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SUITABLE STABILITY AUGMENTATION SYSTEM (SAS) OR AUTOPILOT The SAS or autopilot should have at least the following functions:

(a)Pitch rate damping and attitude / attitude rate stabilisation;

(b)Roll rate damping and attitude / attitude rate stabilisation; and

(c)Yaw damping. [applicable from 25 May 2028 — ED Decision 2023/007/R]

AMC · AMC1 SPA.HEMS.110(e)(1) — Regulation (EU) No 965/2012 · ED Decision 2023/007/R · Air OPS Easy Access Rules · EAR revision 27 Mar 2026

AMCAcceptable means of compliance

AMC1 SPA.HEMS.110(e)(2)Equipment requirements for HEMS operations

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AUTOPILOT The autopilot should have at least the following functions:

(a)Attitude hold;

(b)Altitude hold mode; and

(c)Heading hold mode. [applicable from 25 May 2028 — ED Decision 2023/007/R]

AMC · AMC1 SPA.HEMS.110(e)(2) — Regulation (EU) No 965/2012 · ED Decision 2023/007/R · Air OPS Easy Access Rules · EAR revision 27 Mar 2026

All rules in SUBPART J: HELICOPTER EMERGENCY MEDICAL SERVICE OPERATIONS

Consolidated from the EASA Easy Access Rules (revision 27 Mar 2026, extracted 17 Aug 2026) for convenience. Not the official publication — verify against the Official Journal of the European Union and the EASA publications before operational use.

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