Fixed wing medical air evacuation specialists are contacted by the patients sons or daughters without the help of a special case manager. What is more , fixed wing air ambulance outfits are required usually considering the issue that these patients are not able to be on public air travel services : because of the fact that these men or women necessitate a medical technician and an ACLS trained flight doctor and/or an IV monitor and care for narcotics. The cases are dependent on respiratory support when these individuals travel. Individuals that hire private air ambulance specialists do not want to be transferred on public charter airplanes . This is when these individuals are designated as being not in non life and death circumstance. There occasionally are medical air evacuation businesses who help patients in whatever country they may be in.