It is a well-know fact that all patients must be secured on the helicopter litter for transport. Does anyone out there, however, routinely secure with straps, the helicopter litter to the hospital gurney when going from helipad to hospital and vice-versa? Is it sufficient to just have the guard rails of the gurney raised on both sides of the cart? IS there a standard of care for rotor-wing transport regarding this issue. Please advise . Thanks! Looking forward to your replies.