The patients that seek the help of air evac fleets have a medical necessity to be transferred and/or are visiting away from their own country. Actually , medevac fleets occasionally are mandatory since they are in need of a catheter and other equipment. There are case patients who require an ACLS trained emergency medical technician and flight paramedic , and the highest trained professionals possible while they fly. In the case where immobilized patients are non US citizens or have a medical necessity of being transferred to a specialized facility, there are specialists that exist for the predicament of any patient. Specialized medevac crews are discovered by the family of the patient when they do not have the assistance of a licensed social work specialist.