Serious, potentially life-threatening injury mandates expeditious emergency medical services (EMS) transportation to the hospital for urgent evaluation and stabilization. Transporting patients via helicopter EMS (HEMS) offers several obvious advantages vs ground transportation with regard to speed and access; however, these advantages are associated with significant cost.1 In this context, proper identification of prehospital patients who would benefit most from helicopter transport is both clinically and fiscally significant. Unfortunately, evidence suggests that first responders are often inaccurate in this determination.2 Thus, the mortality benefit and cost-effectiveness for HEMS remains controversial among trauma clinicians.3