CRM - why does it matter? Mario Pierobon looks at the roles that medical crewmembers play inside rotary and fixed-wing aircraft, and how operators strike a balance between flight safety and patient care The practice of crew resource management (CRM) training is now considered essential by those operating in the airborne special missions sector, whether it is for search and rescue or air ambulance operations. Whether medical personnel onboard rescue flights should be considered as part of the crew is not always immediately easy to determine from a regulatory point of view. Under European aviation safety regulations, for example, the role of medical personnel is not regulated as that of crew members, unlike the operators of hoist and night vision imaging systems, who are considered crew in all respects. Indeed, medical personnel are referred to as ‘medical passengers’ only. Yet their role often encompasses more than just looking after the health of the casualty or rescue and, because of this, they need to be integrated with the rest of the operating crew in accordance with CRM principles.