There are cases who are not able to go by everyday airline service . That is frequently because these are men or women that need a flight paramedic, so they are flown by air evac specialists. There generally are men or women who require a respiratory therapist – and as a result these are the cases who cannot be transported by your usual normal air travel charters. As they are dependent on a flight staff , medflight fleets must be contracted. Nearly all air ambulances are commercial enterprises that are privately – held. Accredited medical air evacuation services generally are looked up by customers when they are not assisted by a special case manager. It is really astounding that there can be a situation with patients that are not able to go by the usual airline outfits ; due to the fact that these cases call for special treatment and a flight staff.