Air medical transport is performed using rotary wing aircraft (ie, helicopter) or fixed-wing aircraft (eg, engine propeller or jet air ambulance, or medical escort on a commercial airline). Rotary-wing aircraft are used for emergency transport over short distances, whereas fixed-wing aircraft are used for transport over longer distances (eg, > 150 miles).2
For long-distance transport that is elective (ie, for economic and/or social reasons), patients in relatively stable condition may be medically escorted aboard a commercial aircraft. Elective long-distance transport of patients in less stable condition (eg, early post-myocardial infarction [MI], receiving mechanical ventilation, or receiving IV vasopressors or antiarrhythmic agents) and emergency long-distance transport is performed using fixed-wing air ambulances. The type of fixed-wing aircraft used for air ambulance transport generally depends on the distance to be traveled, with single- or twin-engine propeller aircraft reserved for shorter flights, whereas jets may even be used to transport across continents. The quality of air ambulance services may vary across companies. Generally, air ambulances should be configured to function as flying ICUs with a full range of pharmaceuticals, and compact portable medical equipment including IV pumps, cardiac and hemodynamic monitor, defibrillator, ventilator, pulse oximetry, and blood gas analyzer. The medical crew should include an intensive care trained physician, nurse, and/or medic.