The recent biopolitical history of air ambulance development and the need for regulations is reviewed. There has been significant interaction between Aerospace Medical Association committees, the Federal Aviation Administration, and the Civil Aeronautics Board. The Federal Aviation Administration's Advanced Notice and Withdrawal of Proposed Rulemaking, the latter based on the FAA supposition that the "majority" of states had enacted regulations and guidelines, is compared to actual data that only seven states have regulations and two have guidelines. The precedence for FAA to act on regulations is established. The Aerospace Medical Association and the National Highway Traffic Safety Administration - not the FAA - have established and documented excellent guidelines. The FAA is providing a valuable service to aviation in general and air ambulance operations specifically through physiological training at military facilities which can provide information to promote patient protection in air ambulance operations.