On occasion there are injured patients that call for an ACLS trained medical staff and EMT, so they seek the help of air evacuation specialists. As they are not good to go by your usual normal air travel services ; due to the fact that these are individuals which have need of a flight doctor , or specialized surgery , jet ambulance establishments have to be coordinated with. The cases necessitate a complete respiratory kit and/or an advanced cardiac life support nurse — and these are the cases that do not have the ability to go on the everyday planes. Where elderly patients are in need of an emergency room setup, there almost always are fleets that do exist . Elderly patients often will try to find air ambulance miami florida when they are not helped by a trained special case manager.