# How do medevac helicopters work? **URL:** \ **Category:** Factual Questions\ **Created:** [August 5, 2025, 4:30pm UTC](https://boards.straightdope.com/t/how-do-medevac-helicopters-work/1021728 "2025-08-05T16:30:49Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Zakalwe](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/zakalwe/32/270_2.png) [@Zakalwe](https://boards.straightdope.com/u/Zakalwe)\ **Post date:** [August 6, 2025, 11:22pm UTC](https://boards.straightdope.com/t/how-do-medevac-helicopters-work/1021728/21 "2025-08-06T23:22:42Z")
In other words, they’re paying insurance. ---
**Author:** ![Stranger\_On\_A\_Train](https://avatars.discourse-cdn.com/v4/letter/s/13edae/32.png) [@Stranger\_On\_A\_Train](https://boards.straightdope.com/u/Stranger_On_A_Train)\ **Post date:** [August 6, 2025, 11:53pm UTC](https://boards.straightdope.com/t/how-do-medevac-helicopters-work/1021728/22 "2025-08-06T23:53:29Z")
> [@Retzbu\_Tox](#): > > I don’t think anyone upthread mentioned yet that in at least some places, you can pay for something like a $99 yearly “membership” in a medevac service. I’m going to pay my fee and use the hell out of that any time there is traffic on the road. (Just kidding; I hate those Spinning Blades of Death machines with a passion, and would fly in one now only if the alternative was being consumed by lava or hunted by a bunch of dinosaurs some maniac bred from DNA fragments because he didn’t listen to my lecture about the lack of humility before nature and chaos theory.) Stranger ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [August 7, 2025, 12:08am UTC](https://boards.straightdope.com/t/how-do-medevac-helicopters-work/1021728/23 "2025-08-07T00:08:41Z")
> [@Timz](#): > > Firstly, the scene of the car crash. Who decides to call in a copter, instead of an ambulance? Well, a helicopter was recently called to a bad car crash in my town. I think the ambulance crew called for it. The first responders picked up the guy, and drove him to the nearest open space, a school athletic field, where they were meet by a medical helicopter, which took the guy to a nearby trauma center. He died anyway. It probably was expensive. I suppose the dead guy had insurance and an estate to bill. ---
**Author:** ![Retzbu\_Tox](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/retzbu_tox/32/11829_2.png) [@Retzbu\_Tox](https://boards.straightdope.com/u/Retzbu_Tox)\ **Post date:** [August 7, 2025, 12:21am UTC](https://boards.straightdope.com/t/how-do-medevac-helicopters-work/1021728/24 "2025-08-07T00:21:38Z")
> [@Stranger\_On\_A\_Train](#): > > Spinning Blades of Death The local Air Evac Lifeteam service lost a security officer at their landing pad in 2001. He accidentally walked into the tail rotor. ---
**Author:** ![Chronos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chronos/32/134_2.png) [@Chronos](https://boards.straightdope.com/u/Chronos)\ **Post date:** [August 7, 2025, 12:22am UTC](https://boards.straightdope.com/t/how-do-medevac-helicopters-work/1021728/25 "2025-08-07T00:22:56Z")
[Moderating] This is not the thread to debate the merits or lack thereof of the American health care system. There are plenty of threads about that in the political forums. Stick to the facts. ---
**Author:** ![Stranger\_On\_A\_Train](https://avatars.discourse-cdn.com/v4/letter/s/13edae/32.png) [@Stranger\_On\_A\_Train](https://boards.straightdope.com/u/Stranger_On_A_Train)\ **Post date:** [August 7, 2025, 12:44am UTC](https://boards.straightdope.com/t/how-do-medevac-helicopters-work/1021728/26 "2025-08-07T00:44:08Z")
> [@Retzbu\_Tox](#): > > He accidentally walked into the tail rotor. Most people would be shocked at how often this happens, or the tail rotor gets caught on an unseen line. I honestly don’t understand while helicopter manufacturers haven’t gone exclusively to shrouded rotors or directional thrust systems. Stranger ---
**Author:** ![Retzbu\_Tox](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/retzbu_tox/32/11829_2.png) [@Retzbu\_Tox](https://boards.straightdope.com/u/Retzbu_Tox)\ **Post date:** [August 7, 2025, 12:48am UTC](https://boards.straightdope.com/t/how-do-medevac-helicopters-work/1021728/27 "2025-08-07T00:48:04Z")
I should pay attention to their current helicopters to see if they still have the exposed tail rotors. My wife works for the hospital where it happened, so I go by the landing pad fairly often. ---
**Author:** ![Nyvaak](https://avatars.discourse-cdn.com/v4/letter/n/5f8ce5/32.png) [@Nyvaak](https://boards.straightdope.com/u/Nyvaak)\ **Post date:** [August 7, 2025, 1:07am UTC](https://boards.straightdope.com/t/how-do-medevac-helicopters-work/1021728/28 "2025-08-07T01:07:48Z")
> [@Broomstick](#): > > How exactly these operations are run varies considerably from one place to another, and one nation to another. This. All sorts of possibilities exist, and if you can imagine a way for it to be run, there’s probably an agency somewhere doing it. > [@Timz](#): > > Who decides to call in a copter, instead of an ambulance The person calling for med-evac from a pre-hospital emergency scene might be a lone first responder who drove to the scene, first-aid kit in hand. Much (MUCH) more often it’s the on-scene incident commander, with input from the senior medic present. Or it’s an E.R. physician in a small hospital faced with a patient too critical for the limited resources she or he has at hand. Emergency services will probably have guidelines and protocols guiding such decisions, at the state or county level, or even at the level of the individual service. When I was doing med-evac in Virginia, it was often at the level of a given hospital’s catchment area. That is, on-scene personnel had to request permission from their area’s hospital before calling for med-evac. (Lots of other ways it happened. It could be large industrial facilities, remote farms, you name it.) > [@Timz](#): > > It all sounds expensive. What does pay for it? Usually the patient’s insurance. We were adamant that those who called us should consider the patient’s welfare first and not worry about the bill. It meant we operated at a loss. But ours was a hospital based helicopter, as were many at that time. (I have no idea if this has changed much.) Those patients came to our O.R. or various ICUs and paid hospital bills for a long time We were also a (very expensive) flying billboard for the hospital. > [@Timz](#): > > He’s supposed to be able to decide where/whether the copter can land near the crash scene LZ training may have evolved since then, but in my med-evac days we traveled around the state, doing landing zone training, teaching EMS services or hospital staff how to set up a landing zone, what frequencies to use to talk to the pilot or the crew, what information we needed, when it’s safe to approach the aircraft, what criteria to use when considering med-evac, etc. > [@Timz](#): > > How much territory is one helicopter supposed to guard? It’s fuelled and ready, 24 hours? It’s fueled and ready 24-hours a day. It might go out of service briefly for inspections or mechanical issues, but if these are expected to last too long a reserve craft is put in service. Or not. Different agencies have different resources. The territory is going to vary extremely widely depending on population density, how many hospitals are in the area, etc. Also, I’m sure, by what sort of agency is operating it (hospital based, private company, county government, etc.) > [@Timz](#): > > The crew is on duty, hanging around playing cards waiting for a call? Yes, in reality this could and did take place, although I don’t ever remember it being cards. Much more likely it was a movie, or in my case, a nose in a book. More often, though, we were kept busy with patient follow-up, liaison with referring agencies, etc. Also - every day - inventories of every piece of equipment or vial of medication in the aircraft. And training. Training on a vast number of possible emergencies, as well as the use of our specific equipment and meds. And at times we worked in the Emergency Room, praying that we wouldn’t get called out while we were in the midst of something critical with a patient there. ---
**Author:** ![wolfpup](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wolfpup/32/10618_2.png) [@wolfpup](https://boards.straightdope.com/u/wolfpup)\ **Post date:** [August 7, 2025, 1:24am UTC](https://boards.straightdope.com/t/how-do-medevac-helicopters-work/1021728/29 "2025-08-07T01:24:25Z")
> [@FinsToTheLeft](#): > > > [@Timz](#): > > > > When he calls, he must have some idea who/what is going to pay? > > This is the most American of views. Here in Ontario, medical emergency transport is handled by Ornge (yes, it’s really spelled like that!). It’s a non-profit largely funded by the province and operates fixed wing and rotary aircraft. Indeed. You can get more information about their operations **[from their own website](https://www.ornge.ca/home)**. There is basically no cost for air ambulance services for Ontario residents covered by the OHIP insurance program. The Ornge website has a section discussing invoicing, but that’s only for non-residents. As to how much they’re utilized, I have no idea, but I appear to be under a flight path for medevac helicopters from northern Ontario to major Toronto hospitals. I know this because I occasionally hear the deep “thrum” of a big helicopter heading south, and if I’m outside can see its distinctive orange colour. But it’s very rare – maybe once every couple of months. ---
**Author:** ![FinsToTheLeft](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/finstotheleft/32/2930_2.png) [@FinsToTheLeft](https://boards.straightdope.com/u/FinsToTheLeft)\ **Post date:** [August 7, 2025, 1:36am UTC](https://boards.straightdope.com/t/how-do-medevac-helicopters-work/1021728/30 "2025-08-07T01:36:23Z")
> [@wolfpup](#): > > As to how much they’re utilized, I have no idea, but I appear to be under a flight path for medevac helicopters from northern Ontario to major Toronto hospitals About 20,000 transports a year. Their latest data is available up to Monday, where they transported 72 patients. > **[Ornge - Stats Centre](https://www.ornge.ca/stats-centre)** ---
**Author:** ![Snipe70e](https://avatars.discourse-cdn.com/v4/letter/s/51bf81/32.png) [@Snipe70e](https://boards.straightdope.com/u/Snipe70e)\ **Post date:** [August 7, 2025, 1:55am UTC](https://boards.straightdope.com/t/how-do-medevac-helicopters-work/1021728/31 "2025-08-07T01:55:54Z")
My Brother needed a Medevac once. The local Helicopter was already transporting someone else. But luck was with him. The Army was doing exercises and had a military medevac helicopter open. They put my brother in an ambulance and drove about 2 miles to a parking lot. The ambulance and helicopter both reached the parking lot at the same time. ---
**Author:** ![Spiderman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/spiderman/32/230_2.png) [@Spiderman](https://boards.straightdope.com/u/Spiderman)\ **Post date:** [August 7, 2025, 2:12am UTC](https://boards.straightdope.com/t/how-do-medevac-helicopters-work/1021728/32 "2025-08-07T02:12:12Z")
@Broomstick gave some really good answers, let me add my 2¢ in as well. First, just like there isn’t _one_ color for fire trucks or _one_ style of the “POLICE” decal (font, size, color) on the side of cop cars, answers may vary by company, town, county, or state; especially when it comes to protocols. I’ve called for a helo before, I’ve physically put patients into a helo & I’ve done stand-bys for a helo landing, all multiple times. The specifics that I know may or may not be identical to what happens where you live. Typically a crew of three, pilot, flight nurse, & flight medic. There may be multiple companies involved in the operation of a helo/fleet; they may or may not be separate-but-related companies: - Company that owns the asset / helo - Company that maintains it - Company that staffs the pilots - Company (or hospital) that staffs the medical personal aboard It is not uncommon for there to be one company that has a fleet of helos & multiple contracts so when you’re local hospital’s helo goes in for maintenance they provide a different one, it might not be painted with the name of your local hospital but everything else on the inside is the same, > [@Broomstick](#): > > > [@Timz](#): > > > > Firstly, the scene of the car crash. Who decides to call in a copter, instead of an ambulance? > > First responders to the scene would make that decision. Yup. Factors going in to calling for it include time of day (I can drive to a trauma center faster at 2am than in the heart of rush hour). distance/time to trauma center, damage/intrusion to the vehicle &/or other deaths in same vehicle, weather, & even patient cooperativeness (they can make you go ‘bye-bye-sleepytime’ where we don’t have those meds aboard the ambulance.) I’ve heard of patients who were flown, by protocol, being released from the hospital before our shift ended. > [@Broomstick](#): > > > [@Timz](#): > > > > When he calls, he must have some idea who/what is going to pay? > > Not at all - priority for the people on scene is rendering aid and saving lives. In the US the air ambulance company will probably bill insurance to start and that sort of thing will be sorted out later. That’s probably true of some other places, which is why travel insurance is sometimes recommended - even if the place you’re vacationing has UHC for its own citizens tourists may not be covered. There is an awareness that this type of transport is expensive and should not be used lightly but where it’s needed at the time it’s used no one is thinking about payment. Even with _just_ an ambulance call, no one is taking the time at the side of the road to figure out if you have insurance (I don’t carry my wallet when I run or bike, nor would a minor necessarily know any info about their parent’s insurance), if this ambulance is in/out of network, what the limits on your policy are, etc. > [@Broomstick](#): > > > [@Timz](#): > > > > He’s supposed to be able to decide where/whether the copter can land near the crash scene – near enough that someone (an ambulance crew, already there?) can carry the victim on a stretcher to the copter? > > The final authority as to whether or not a spot is safe to land is the helicopter pilot. If it’s possible to scout out a location ahead of the chopper arrival that will be done, if there are people available. Air ambulances do come with a crew with medical training and could carry a patient from accident scene to helicopter on a stretcher but EMT’s/paramedics/whatever on site might and can help out with that. Sometimes there’s a bunch of logistics involved in getting the patient to the helicopter. In some cases one of the air ambulance crew might lowered on a rope and have to get the patient into a stretcher/carrier to either get them in the helicopter or get them to a location where the helicopter can land and then load them more securely for further transportation. However, not all crews and the necessary training or equipment to do that sort of rescue. Basically, first responders, including medevac crews, will try to make things work out with whatever scenario they are facing. The helo companies around here to outreach/training with the local fire depts, teaching what their minimums are & how to give them an advanced report of what they’re coming into (field size & layout - surrounding trees, wires, towers, buildings, etc) If it’s really sketchy, they may ask us for a different site before they ever lay eyes on it. There is a nearby business with a helipad; to get approval to put it in, the town made them make it available to medical flights; since they don’t leave their helo there, only dropoff/pick up execs it literally doesn’t cost them anything. The medical helo pilots like that location in that it is a ‘regular’ LZ with published entry & egress paths & they _know_ they don’t have to deal with issues like wires or trees > [@Broomstick](#): > > > [@Timz](#): > > > > Secondly, the helicopter company. How much territory is one helicopter supposed to guard? > > I don’t know how that sort of “territory” decision is made. Those are management decisions based upon population & terrain; there probably more territory covered in rural Montana than central NJ, just on the basis of assuming one flight per day for every x thousand population. > [@Broomstick](#): > > > [@Timz](#): > > > > It’s fuelled and ready, 24 hours? The crew is on duty, hanging around playing cards waiting for a call? > > Is it different than having road ambulance fueled and ready, 24 hours? We pay fire crews to “hang around” until they get a call, how is this different? Most first responders (are required to) do a rig check when they start their shift, whether PD, FD, or EMS. For them - is it fueled, are there any maintenance issues, weather checks, any NOTAMs to be aware of, do they have all of their required meds, is the O2 bottle at least ½ full, etc. > [@Broomstick](#): > > > [@Timz](#): > > > > When a call comes, how soon can they get airborne? Probably have to check the weather, maybe check the copter? > > Depends on the set up, whether or not fueling or resupply of the ambulance part of the aircraft is required. If everything is ready to go and the chopper is warmed up (maybe from a prior run) 1-2 minutes. If starting cold maybe 5-10 minutes after engine start for more complex aircraft. > > > [@Timz](#): > > > > Probably have to check the weather, maybe check the copter? Or are other guys hanging around to do that? > > The company or head pilot is probably going to be checking the weather throughout the day since they’re on call. When called the final weather check probably won’t take more than minute or two, plus the pilot will have to plan their flight to get there and back, talk to ATC, etc. Medevac gets priority over pretty much anything else so they don’t get the wait times commercial passenger craft do, and they don’t normally fly where passenger/cargo jets do so that simplifies the planning in some ways. Having to deal with ground obstacles when flying low can complicate things. However, everyone involved are trained professionals so this is not a big deal. I remember one _bad_ car accident; we could have loaded the patient into the ambulance for a couple of hundred yard drive to the nearest open field or about 1½ miles the other way to the airport where they were launching from. By the time they finished their preflight, we were putting the patient in the back for them to fly off to the hospital which was ultimately quicker to get the patient into the trauma bay & OR that they needed. > [@Broomstick](#): > > > [@Velocity](#): > > > > Not quite directly answering the OP’s question, but from some police videos I’ve seen, the medevacing isn’t necessarily done by a helicopter or pilot who specializes in that. One video showed a Texas cop being shot and bleeding severely and the footage was being captured by a police helicopter who had been doing the overhead pursuit-follow of the suspect car for a long time as it was fleeing the cops. The helicopter then itself landed right away, picked up the wounded trooper, then flew him to a hospital at once > > That can happen, but that’s not the usual medevac situation. It’s like when the Las Vegas country music concert was shot up and people were being transported to the hospital in the back of pick-up trucks rather than actual ambulance. Sure, it can be done but it’s not the preferred method. > > How exactly these operations are run varies considerably from one place to another, and one nation to another. Helos are typically setup for medical _or_ rescue (external winch to pull someone up from a gorge/crevasse but not both. However, in an “Oh, shit!” situation you make due with what you have. MD & NJ (if I remember correctly) are handled by State Police helos that _are_ setup for both. ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [August 7, 2025, 3:08am UTC](https://boards.straightdope.com/t/how-do-medevac-helicopters-work/1021728/33 "2025-08-07T03:08:48Z")
That was a free benefit at the hospital where I worked in Illinois. However, you had to use that company’s services to be covered. ---
**Author:** ![China\_Guy](https://avatars.discourse-cdn.com/v4/letter/c/779978/32.png) [@China\_Guy](https://boards.straightdope.com/u/China_Guy)\ **Post date:** [August 7, 2025, 3:52am UTC](https://boards.straightdope.com/t/how-do-medevac-helicopters-work/1021728/34 "2025-08-07T03:52:39Z")
A related tangent. Trying to find a news article from years ago. Author was a doctor that was invited to a wedding of a girl he had treated. She had been in an accident, air evac on military chinook helicopter to the hospital the doctor was at. Sounded like a T Rex as it approached. AI couldn’t find it, but Dopers prolly can. 😉 ---
**Author:** ![PatrickLondon](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/patricklondon/32/4422_2.png) [@PatrickLondon](https://boards.straightdope.com/u/PatrickLondon)\ **Post date:** [August 7, 2025, 8:26am UTC](https://boards.straightdope.com/t/how-do-medevac-helicopters-work/1021728/35 "2025-08-07T08:26:23Z")
Just been checking some of the UK’s services. Scotland - geographically biggest and some wildest terrain - had just short of 1000 callouts last year. London [treated over 2000 patients,](https://www.londonsairambulance.org.uk/our-impact/mission-map) Yorkshire just over 1000, East Anglia (the service Prince William was a pilot in) about 2500. All depend on charitable fundraising (lotteries, events, merchandise as well as the usual legacies and donations). They’re operationally integrated with NHS ambulance services, but apparently not funded by them (at least as regards the machines: I don’t know if the clinical staff are seconded from the base hospital - I see one of their websites says their job is to take the hospital to the patient, as much as the other way around). There are private commercial services advertised, but I guess that’s not for immediate response emergency services ---
**Author:** ![hogarth](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hogarth/32/1773_2.png) [@hogarth](https://boards.straightdope.com/u/hogarth)\ **Post date:** [August 7, 2025, 11:04am UTC](https://boards.straightdope.com/t/how-do-medevac-helicopters-work/1021728/36 "2025-08-07T11:04:45Z")
> [@FinsToTheLeft](#): > > Here in Ontario, medical emergency transport is handled by Ornge (yes, it’s really spelled like that!). It’s a non-profit largely funded by the province and operates fixed wing and rotary aircraft. Of course Ontario residents will remember that Ornge was mired in controversy due to a CEO who treated it as his own personal piggy bank (kickbacks, giving his girlfriend a cushy job, subcontracting to companies that he controlled, etc.). ---
**Author:** ![wolfpup](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wolfpup/32/10618_2.png) [@wolfpup](https://boards.straightdope.com/u/wolfpup)\ **Post date:** [August 7, 2025, 11:09am UTC](https://boards.straightdope.com/t/how-do-medevac-helicopters-work/1021728/37 "2025-08-07T11:09:53Z")
Wut’s that you say? Society is not perfect? Ontario is not Utopia? Quick, take me to my fainting couch! ---
**Author:** ![Cartooniverse](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/cartooniverse/32/3084_2.png) [@Cartooniverse](https://boards.straightdope.com/u/Cartooniverse)\ **Post date:** [August 12, 2025, 2:31am UTC](https://boards.straightdope.com/t/how-do-medevac-helicopters-work/1021728/38 "2025-08-12T02:31:41Z")
Retired New York State E.M.T. chiming in. Similar to other states. There’s some warmup time involved in putting the bird in the air. So, depending on the severity of the call going IN to the 911 call center, a so-called STATFlight might be put on standby to fly. That gets the crew to the bird and they start their warmup and check procedures. They don’t fly until told to. When I was working, early 2000s, it was $ 10,000 to do a helicopter transport. I was in Orange County, NY and that meant that the first choice was Westchester County Medical Center, the closest Level 1 Trauma Center. If the 911 call center doesn’t make the call, assessment is made pretty quickly when the Paramedics show up. EMTs are Basic Life Support. If we took a call and advanced Paramedic-type life support was required, we’d call them in. Frequently to save time and lives ( of course), they’d be simultaneously dispatched and we would work out who did what on site. The truth is that you know within 90 seconds of facing a patient if they need to fly or not. In an extreme case, an EMT might want to call for a flight. The crew might be sent to warm up the bird but a Paramedic would be on site before that 15-minute warmup time was close to expiring to make the call. A lot of the time, we’d transport to the closest hospital to stabilize AND a helicopter would be sent there to transport to WCMC. It’s not the movies. Even a seasoned Flight Nurse is no replacement for a fully staffed Operating Room that’s close by. It’s interesting the calls that do NOT result in a STATFlight event…some of the more gruesome and seemingly dire moments were best handled with a 9-minute drive at high speed and right into the OR instead of waiting for the bird and then the…20 minutes to WCMC? Maybe a bit more, all depending on where in the county you were landing. Doing lifesaving work in the back of an ambulance that’s rocking and rolling at 85 mph is hard. Doing next-level lifesaving work in a helicopter? Much respect. ETA: The non-fiction book [Shock-Trauma by Jon Franklin](https://www.amazon.com/Shock-Trauma-Jon-Franklin/dp/0312717415) is an incredible read if this kind of thing interests you. I read it quite a few times when I was in the EMT business. Passed it on to a nephew who was interested in the business. ---
**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\ **Post date:** [August 13, 2025, 7:03pm UTC](https://boards.straightdope.com/t/how-do-medevac-helicopters-work/1021728/39 "2025-08-13T19:03:50Z")
> [@Dewey\_Finn](#): > > And note that these helicopters aren’t only used for transport from accident sites to hospitals. Sometimes, they are used to move patients from one hospital to another, often rural hospitals to larger academic ones that have special skills. Emphasizing that this is the case for most helicopter patient transports. The patient is likely seen and initially stabilized at a local hospital and then transported to a specialty or Level I trauma facility like Children’s Hospital of Oakland - by ambulance, helicopter or fixed-wing aircraft. Hard to imagine there are that many cases where there’s a major traffic accident or other trauma leading first responders to conclude that ambulance transport to local hospitals is undesirable, and then having enough landing space at the site to accommodate a helicopter, especially in urban areas. ---
**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\ **Post date:** [August 13, 2025, 11:17pm UTC](https://boards.straightdope.com/t/how-do-medevac-helicopters-work/1021728/40 "2025-08-13T23:17:44Z")
> [@Jackmannii](#): > > Hard to imagine there are that many cases where there’s a major traffic accident or other trauma leading first responders to conclude that ambulance transport to local hospitals is undesirable, and then having enough landing space at the site to accommodate a helicopter, especially in urban areas. This is a big part of medevac in Saskatchewan. Low population density, so the hospital may be an hour or more away by road. And flat country for the helicopter to land and take off? Yeah, we got that covered. [Previous page](https://boards.straightdope.com/t/how-do-medevac-helicopters-work/1021728.md?page=1) [Next page](https://boards.straightdope.com/t/how-do-medevac-helicopters-work/1021728.md?page=3)