Trauma Star Air Ambulance

Trauma Star LR W


Monroe County owns and operates an emergency air-ambulance helicopter service called Trauma Star. The service is a joint effort of Monroe County Fire Rescue and the Monroe County Sheriff’s Department.

Trauma Star is the only air ambulance service in Monroe County. Since the program began in 2001, Trauma Star has transported more than 5,000 patients to critical care not available in the Keys. 

For an island chain that is isolated from the mainland by distance and a busy single highway – Trauma Star saves critical minutes for patients to receive life-saving interventions. These precious minutes saved decrease the loss of heart and brain tissue, which reduces or eliminates permanent disabilities.

The Trauma Star program has two twin-engine Sikorsky helicopters, with a third backup helicopter scheduled to begin operations at the end of 2018, early 2019. The helicopters are staffed by highly-trained critical-care nurses, firefighters/paramedics and pilots. Each helicopter can transport up to two critically injured or ill patients at a time.

Trauma Star's Cost for Transport

There is a base rate of $12,000 for a Trauma Star transport, with an additional $100 per mile calculated from origin to destination. The average billed amount is about $20,000 to $23,000 per trip -- which is less than half of the amount usually charged by the previous private air transport company that operated in the Keys.

No Out-of-Pocket Costs for County Residents

There are no out-of-pocket costs for County residents who use the life-saving service. In the past, private air ambulances in the Keys have charged County residents tens of thousands of dollars in out-of-pocket costs for transport to mainland hospitals.

Photo of Trauma Star landing at Channel 2 Bridge during following a major accident on 10-5-18-3

FY 2018:  Record Number of Transports

Fiscal Year 2018, which ended Sept. 30, was another record year for Trauma Star. The air ambulance program flew 987 patients to mainland hospitals to receive life-saving care not available on the island chain. This is a significant increase from the 814 patients who were transported during the 2017 Fiscal Year.

In FY2018, Trauma Star flew 227 patients for trauma, 33 for stroke, 27 for heart attacks and 3 first response flights to the Dry Tortugas. The remaining 700 transports were hospital-to-hospital transfers of critically ill patients that required specialty care not available at Keys hospitals.

During FY2018, Trauma Star flew 551 patients from the Key West base and 436 from the Marathon base. Others were flown from the field, including bridges.

The breakdown by area: 135 patients from the Upper Keys, 172 from the Middle Keys, 677 from the Lower Keys and 3 from the Dry Tortugas.

In FY2018, Trauma Star flew 716 County residents and 271 non-County residents. (For FY2017, Trauma Star flew 634 County residents and 180 non-County residents.

Trauma Star Operating in the Black

Trauma Star is operating in the black despite no out-of-pocket costs for County Residents. The program’s operational cost was $6.6 million for Fiscal Year 2018. With an aggressive in-house collection program, Trauma Star has collected $7.9 million. In FY 2017, Trauma Star also operated in the black with $5.6 million in revenues and $4.7 million in operation costs.

Specialized Medical Abilities

Trauma Star has been in the forefront of new standards of quality care, with a direct affiliation with the University of Miami Miller School of Medicine and the Army Trauma Training Department (ATTD), located at the Ryder Trauma Center.

Trauma Star was the first air ambulance service to provide immediate access to the highest level of care to patients experiencing a myocardial infarction (heart attack) and has since flown more than 125 heart attack patients directly from the field.

Trauma Star was the first air ambulance service in the United States to transport patients exhibiting signs of a Neurological deficit (stroke) to a comprehensive stroke center for immediate interventions and has since flown more than 180 stroke patients directly from the field.

Trauma Star was the first air ambulance service in the United States to combine the use of Telemedicine in the field to perform neurological examinations by stroke physicians. It now is in the final stages of implementing new ultrasound transmission capabilities for trauma patients via Telemedicine to surgeons at Ryder Trauma Center.

The Fleet

In 2017, Trauma Star became the only air ambulance service in Monroe County – with a second Trauma Star base opening in Key West at the Lower Keys Medical Center. The Trauma Star’s main headquarters is in Marathon. It is a joint effort of Monroe County Fire Rescue and the Monroe County Sheriff’s Office.

In January 2017, the BOCC approved the purchase of a second Sikorsky S76C+ helicopter. In June 2017, a second Trauma Star base was opened in Key West at the Lower Keys Medical Center.

In 2018, Monroe County purchased a third helicopter from Switzerland. It will be used as a backup when the other helicopters are undergoing routine maintenance. The helicopter cost $1.2 million plus additional legal and transport fees. Insurance proceeds from another Trauma Star helicopter providing $925,000 toward the purchase. The third helicopter is scheduled to go into service in the next few months.


Trauma Star has bases in Marathon and Key West, both staffed around the clock to be ready for launch at a moment’s notice. Trauma Star’s primary mission is to provide emergency helicopter transportation for individuals who are critically injured either by natural causes such as heart attacks or stroke, or by other causes such as a vehicle crash or criminal action.


Trauma Star’s response is initiated through the emergency 911 system, and the helicopter often times will land at the accident scene to provide the quickest response to qualified medical facilities in south Florida.

Monroe County Residents

There are no out-of-pocket costs for Monroe County residents

View the application form for the resident fee waiver (PDF). If you qualify for the resident fee waiver, Monroe County will continue to seek reimbursement from any private insurance companies, but any remaining unpaid fees would be waived.

Types of Transports

If you have a severe auto accident or suffer any severe trauma, Trauma Star will fly you from your location directly to a Level One Trauma Center in approximately 45 minutes from anywhere in the Keys, including the Dry Tortugas. If you are having a heart attack or brain attack (stroke) and call 911, Trauma Star will fly you from your location directly to a fully staffed cardiac or stroke treatment center on the mainland. There are no trauma, therapeutic cardiac, or neurosurgical service centers within the Florida Keys.

In addition to the primary mission of providing critical trauma-related transports, Trauma Star also assists local hospitals by providing hospital-to-hospital transfers. If you are at an area hospital and require a critical care interfacility hospital transport, you or your representative can request the services of Trauma Star through the hospital staff (provided you meet the State of Florida interfacility transfer guidelines).

Transportation Services

Monroe County Trauma Star is committed to providing the highest quality air ambulance transport care. Trauma Star is staffed with highly-trained flight nurses, flight Firefighter/Paramedics, and helicopter pilots. Hiring requirements exceed industry standards and Trauma Star’s safety record is exemplary.

The twin engine Sikorskys cruise at 150 knots, making them the fastest rotor craft in the Florida Keys. The Trauma Star helicopter is fully configured to carry two critical patients, and the Trauma Star program has been recognized by the State of Florida and the FAA as professional and fully compliant with all regulatory standards.

Additional Information

For more information about Trauma Star or the Resident Fee Waiver Program, contact Monroe County Fire Rescue at 305-289-6010.

Trauma Star Statistics