There occasionally are incapacitated patients that employ air ambulance fleets because these case patients are not good to be brought on the everyday airplanes. As they are for any predicament and/or must be moved to a more suitable facility , private air ambulance services have to be contracted. Elderly patients have need of a first rate paramedic and medical staff — and accordingly these are the case patients that do not want to be sent on the the everyday airlines. There are fixed wing air ambulance specialists who transfer patients in the US and internationally. Non-emergency medical air evacuation specialists frequently can be discovered by spouses of patients with a hospital volunteer.