On February 20, the FAA issued a far-reaching final rule that will require helicopter operators, including air ambulance services, to abide by stricter flight rules and procedures that better prepare both pilots and helicopters for safer operations. Within 60 days, all operators will be required to use enhanced procedures for flying in challenging weather, at night, and when landing in remote locations. Within three years, air ambulance helicopters must use the latest on-board technology and equipment to avoid terrain and obstacles, and within four years they must be equipped with flight-data monitoring systems. Part 135 helicopters will be expected to install radio altimeters and use higher weather minimums for alternate airports, and all occupants will be required to wear life preservers when beyond power-out gliding distance of shore. Pilots must also be trained to handle inadvertent encounters with instrument conditions, as well as both whiteout and brownout conditions. Pilots of air ambulance helicopters will also be required–under a variety of deadlines–to hold an instrument rating and operate only helicopters equipped with terrain avoidance and flight-data monitoring equipment. Eventually, all ambulance flights will need to fly using Part 135 limitations on weather and crew flight, duty and rest times.