If you require air ambulance assistance or consultation, please contact us.

Complete Guide Air Ambulance Process for Patients & Families:

1) What an Air Ambulance Is—and When You Might Need One

An air ambulance is a medically equipped aircraft—usually a small jet or turboprop—that functions as a mobile intensive-care unit, staffed by a doctor and/or critical-care nurse/paramedic. It’s used to move patients between hospitals (bed-to-bed) when they’re too unwell to fly commercially or when time, distance, or border logistics make ground transport unsafe or unrealistic. Common reasons include severe injury overseas, heart attack or stroke away from home, complex postoperative complications, neonatal and pediatric emergencies, or a need for specialist care not available locally. Alternatives sometimes exist: a medical escort on a commercial airline, a commercial flight with a stretcher (on certain long-haul aircraft), or waiting to stabilize locally. A reputable provider will explain options honestly, including when a full air ambulance is not medically necessary.

2) Your First Steps in an Emergency

If you have travel or health insurance with assistance benefits, call the 24/7 assistance number on the policy card first. Give the claim number if you have one. If you don’t have insurance—or the insurer declines to help—you can contact an accredited air ambulance operator directly. In either case, be ready with the patient’s full name, date of birth, location, current hospital and treating doctor’s contact, diagnosis, major treatments given (e.g., surgery, ventilator, blood thinners), allergies, current medications, most recent vital signs, and passport details. Don’t worry if you don’t know it all; the provider will speak to the hospital doctor for clinical details. If language is a barrier, ask the provider to use an interpreter or to speak directly with the ward nurse or physician.

3) The Fit-to-Fly Medical Assessment

Before accepting a mission, the provider’s flight physician or senior flight nurse will review the medical facts to judge whether the patient can fly safely and what level of support is needed. Aviation places unique stresses on the body: lower cabin oxygen, vibration, noise, and sometimes turbulence. Certain conditions—untreated pneumothorax, uncontrolled bleeding, active labor, very high intracranial pressure—require stabilization first. The flight medical team will coordinate with the treating hospital to optimize the patient (e.g., chest drain insertion, blood pressure and oxygen targets, pain control, anticoagulation plans). This stage determines the aircraft type, the crew composition (adult, pediatric, neonatal, ECMO), oxygen and medication loads, and any special equipment (isolation pod, incubator, invasive monitoring). Families should expect direct, plain-language explanations of risks, benefits, and the plan to mitigate those risks.

4) Paying for the Flight: Insurance, Costs, and Authorizations

If insurance is involved, the assistance team will seek “medical necessity” approval and a guarantee of payment to the provider. They may also need your signed consent and copies of passports and the policy. Expect questions about pre-existing conditions and how the injury/illness occurred; be truthful and prompt to avoid delays. If you’re self-funding, request a written quotation that states what’s included: aircraft, medical crew, ground ambulances on both ends, airport/handling fees, overflight permissions, any planned fuel stops, family seating, luggage limits, and what could change the price (e.g., hospital delays, weather, re-routing). Deposits are common. Typical costs can range widely depending on distance and clinical complexity; transparent providers will explain the drivers of cost and offer options where appropriate.

5) Logistics You Won’t See—but Matter Hugely

Behind the scenes the operator plans the flight route, requests overflight and landing permits, books airport slots, coordinates customs/immigration, arranges ground ambulances, and secures acceptance from the receiving hospital and consultant. For international flights, they may also secure medical visas where necessary. Weather, air-traffic control, and permit offices can introduce real-world delays even when the patient is medically ready. Reputable teams keep you updated and build buffers where possible; they’ll also advise if a night curfew or airport closure requires schedule adjustments.

6) Preparing the Patient Clinically

The treating hospital and flight team work together to optimize the patient for flight. Typical steps include confirming airway security and oxygen needs, ensuring pain and nausea are controlled, securing lines, tubes, and drains, managing fluids and blood products, dressing wounds appropriately, placing a chest drain if needed, confirming blood sugar and temperature targets, and completing any stabilizing imaging or labs. The goal is to depart with the safest possible patient rather than the fastest departure at any cost. Families can help by ensuring consent forms are signed, the passport is available, personal belongings are collected, and the patient’s usual medications are identified (especially rare or expensive ones).

7) Documents and Personal Items to Prepare

Gather passports (patient and anyone accompanying), visas or residency cards, insurance certificate and claim details, next-of-kin details, advance directives or DNR forms if applicable, a recent medical summary (the hospital will provide), copies of key imaging or ensure digital transfer is arranged, a list of medications with doses, and allergy alerts. Pack lightly: most air ambulances have strict weight limits. Essentials include phone, charger, minimal comfortable clothing, glasses/hearing aids/dentures, and prescribed medicines in original packaging. Avoid bringing valuables, large suitcases, or items restricted by aviation rules (large oxygen cylinders, certain batteries, aerosols). Ask your provider for their specific baggage allowance and prohibited items list.

8) Who Can Travel With the Patient—and What It’s Like

Depending on aircraft type, one family member can usually accompany the patient, sometimes two, space permitting. On neonatal/pediatric flights, a parent is typically accommodated when safe. The medical team has final say based on clinical needs and weight/balance limits. Expect the cabin to be compact, with medical equipment occupying much of the space. It is noisier than a commercial jet; headsets or ear protection are provided. Seats are limited and upright for takeoff/landing. Eating and drinking are possible on many flights, but service is simple and focused on patient safety. Toilet facilities may be basic or, on small aircraft, unavailable; ground fuel stops are planned with this in mind.

9) The Day-Of Timeline (Typical Flow)

The medical team arrives at the sending hospital and introduces themselves, confirms identity, reviews consent, inspects equipment compatibility (IV lines, drains, catheters), and performs a head-to-toe assessment. They give medications for comfort (pain, anti-nausea, sedation if needed), set monitoring, secure the patient on a transfer stretcher, and start transport ventilators if appropriate. The team completes a structured handover with the ward/ICU staff and gathers records. A ground ambulance then moves the patient to the airport, often via a private terminal (FBO) to streamline customs/immigration. The aircraft is pre-cooled/heated; the crew loads the patient and secures monitors, oxygen, and power. After safety checks and a final briefing, the aircraft departs. Depending on distance, there may be fuel stops where the patient stays aboard while the aircraft is serviced. On arrival, customs and immigration are handled at the FBO, the receiving ambulance is waiting, and the medical crew escorts the patient directly to the receiving hospital bed for handover.

10) At the Sending Hospital: What You’ll See and Hear

Expect a structured “SBAR” handover (Situation, Background, Assessment, Recommendation). The flight team will ask the nurse/doctor about trends (vital signs, urine output, ventilator settings), last doses of medications, allergies, recent imaging/labs, and any lines/tubes. Families may be asked to step out briefly during patient packaging for safety and dignity, then invited back to say goodbye before departure. If you want photos or updates to share with family, ask the team what’s appropriate—they’ll prioritize the patient’s privacy and focus.

11) During the Flight: Monitoring, Comfort, and Communication

Continuous monitoring (heart rhythm, oxygen saturation, blood pressure, end-tidal CO₂ if ventilated) is standard. The team documents assessments at set intervals and treats issues immediately (oxygen titration, bronchodilators, pain relief, anti-emetics, antibiotics per plan). Ear pressure or sinus discomfort can occur; the crew has strategies for this. Turbulence may temporarily pause non-essential tasks; the patient’s safety remains paramount. If the patient is conscious, the crew will explain what’s happening in clear, calm language. If a family member is on board, they’ll get simple, regular updates—but during critical moments, please allow the crew to work without interruption.

12) Arrival and Handover at the Receiving Hospital

The air ambulance team accompanies the patient by ground ambulance to the hospital that has accepted the case. A formal bedside handover covers the pre-flight status, treatments given in transit, any complications, current lines and devices, drug timings, and the plan agreed with the accepting consultant. Paper and electronic records, imaging, and medication lists are transferred. The receiving team confirms acceptance of care; only then is the mission officially complete. Families are oriented to the ward/ICU routine and visiting rules. If you need accommodation or local transport, ask the provider or hospital social worker for vetted options.

13) After the Flight: Paperwork, Bills, and Follow-Up

If insured, the provider usually invoices the insurer directly. If self-funding, expect a final invoice itemizing aircraft time, medical crew, ground ambulances, airport and handling fees, and any extraordinary costs (e.g., unexpected night operations or diversions). Keep all receipts related to the event. Ask for a copy of the flight medical record for your files. If you have concerns or compliments, reputable operators have a formal feedback process and clinical governance review. For ongoing medical care, ensure the receiving hospital updates the family physician and provides a clear discharge plan when the time comes.

Special Scenarios You Should Know About

Neonatal and pediatric transfers. Specialized teams use transport incubators, pediatric ventilators, and dosing protocols. Parents may accompany when safe; space is tighter and weight limits stricter.
Pregnancy. Transfers are case-by-case. Active labor or high-risk complications may require tocolysis, continuous fetal monitoring, and an obstetric team; sometimes flying must wait until safer.
Critical care and ECMO. Certain centers provide in-flight ECMO or advanced ventilation. These missions involve larger teams and more equipment; timelines are longer and aircraft choice narrower.
Psychiatric or cognitive impairment. Safety plans may include sedation strategies and secure, dignified restraint policies. Informed consent and legal frameworks must be respected.
Infectious disease. Isolation pods and enhanced PPE may be used. Expect additional permits, routing constraints, and careful receiving-hospital selection.
Remote or austere locations. Reaching the patient might require helicopter shuttles to a runway or coordination with local authorities. Weather and daylight can dictate windows of opportunity.
Bariatric patients. Weight and dimension limits affect aircraft choice and loading equipment; disclose accurate weight for safety and comfort.

Common Questions

Can I choose the receiving hospital? Usually yes, if a bed and the right specialty are available and the insurer agrees. In emergencies, the nearest appropriate facility takes priority.
How many family members can fly? Often one; occasionally two if clinically safe and within weight/balance limits. The medical team has final authority.
How much luggage can we bring? Minimal—often one small soft bag per person. Medical equipment takes priority.
Will there be toilets on board? Sometimes; many small jets have limited or no lavatory. Crews plan fuel stops to manage this.
What happens if the weather is bad? Safety first. Flights may be delayed or re-routed. Your coordinator will update you and the hospitals.
What if the patient gets worse en route? The team treats immediately and can divert to the nearest appropriate hospital if needed.
Can we bring a pet? Rarely and only on non-medical legs; medical safety and customs rules make this impractical for patient flights.
Is it pressurized like an airliner? Yes, but cabin altitude varies by aircraft and plan. The crew sets targets appropriate for the patient’s condition.
What if our visas are not in order? The provider helps with immigration coordination, but you must supply accurate documents; entry is always at border officials’ discretion.
Can we cancel? Yes, but fees may apply for permits, ambulances, and aircraft/crew already dispatched. Ask about the cancellation policy before you commit.

Quick Checklists You Can Use

Before You Call

• Insurance policy number, assistance phone, claim (if any)

• Patient ID: full name, DOB, passport details

• Current hospital name, ward, treating doctor contact

• Diagnosis and key treatments so far; allergies; medication list

• Next-of-kin contact and your preferred language

During Planning

• Written quote or insurer authorization, with inclusions/exclusions

• Confirmation of bed-to-bed service and receiving hospital acceptance

• Who can accompany, baggage allowance, and any costs for family

• Expected timeline (including possible delays) and cancellation policy

• Point-of-contact phone/email available 24/7

Day of Transfer

• Passports/visas and consent forms ready

• Personal essentials packed; valuables secured

• Copies of medical records or confirmation of digital transfer

• Charge phones; share coordinator number with family

• Clear understanding of when/where you’ll reunite after handover

After Arrival

• Request copies of the flight medical report and invoices

• Confirm who pays whom (insurer vs you) and keep receipts

• Ask for the receiving team’s plan and expected next milestones

• Share updates with family via a single designated spokesperson

Medical evacuations are emotionally draining. Decide who in the family will be the primary contact to reduce confusion. Keep a shared note with key numbers, timelines, and questions. Sleep and eat when you can; accept practical help from friends (lodging, meals, airport rides). Ask for chaplaincy or spiritual support if it helps you. Remember: asking questions is not a nuisance—it’s part of keeping your loved one safe.