The evolution of air ambulance through the decades

Since the 1960s, air ambulance medical services—have been saving lives. 1,494 seriously injured people were given their lives by London’s Air Ambulance in just 2020. Over 550,000 patients use air ambulance services annually in the United States.

Even though an air ambulance’s services are expensive (the usual cost in the US is between $36,000 and $40,000), they are essential.

But how did air ambulance services get their start, and how did they change through time?

Jules Verne

The Robur the Conqueror by Jules Verne, published in 1886, has the first documented description of an air ambulance in literature. Robur, the main character, set out to demonstrate that an object may fly even if it is heavier than air. Then, in order to support his theory, Robur uses his flying contraption to travel around the globe. In the course of the adventure, a party of sailors who have been shipwrecked are saved by the flying machine.

The siege of Paris

During the Siege of Paris, the first recorded usage of an air balloon as an air ambulance took place. Invading Prussians in 1870 starved Parisians into submission. As it was confined to the city, the government started sending people, mail, and news out to the outside world via manned balloons.

Later, when injured soldiers needed to be transported out of the city and to surrounding hospitals, the balloons carried more than just mail.

Aircraft from the 1900s were frequently utilized in World War One as weapons, as well as to transport men and weapons. Although there have been instances of injured troops being flown in the fuselage of military aircraft, there is no proof that a coordinated aeromedical transfer took place.

Zed expedition of 1920

Records suggest that the first aeromedical operation may have occurred in the early 1920s during a frontier conflict in Somalia, however, this is not officially acknowledged.

As Secretary of State for War at the time, Winston Churchill approved the creation of a unique Royal Air Force (RAF) force with the codename “Z” or the “Zed expedition” to conduct a final offensive against the Somali rebels.

To aid the Zed expedition, the RAF established a medical division. 12 DH-9 De Havilland biplanes were reportedly provided for the trip. It was suggested that one jet be converted into an air ambulance so that sick and injured people in far-off places might be transported.

In Australia, the Royal Australian Air Force (RAAF) established Medical Air Evacuation Transport Units and Air Ambulance Units (MAETU). In August 1941, the RAAF conducted its first medical evacuation flight. Records show that each flight carried the wounded with a male orderly.

15 nurses from the Royal Australian Air Force joined the conflict in 1944 as it grew more intense.
Recruitment and training for the Force Nursing Service (RAAFNS) included instruction in tropical hygiene, emergency survival techniques, and in-flight medicine and treatment.

A sister and a male orderly made up the in-flight teams, which would follow the injured on board.

1950s: Korean War

Early in the 1950s, US Forces began using helicopters specifically for medical evacuation. With a bubble-fronted Bell 47, the first rotor wing medical evacuation was carried out in 1950.

The longest-running medical comedy-drama sitcom, MAS*H, popularized the Bell 47. (which stands for Mobile Army Surgical Hospital). Three times as long as the Korean War, in which the sitcom was based, the show ran for 11 years.

Over 20,000 injured soldiers are thought to have been flown out of Korea by helicopter.


The US automobile industry was thriving in the 1960s. An average new car cost $2,752 in 1960. Never before has cars been so easily and affordably available.

As a result, there was a startling rise in automobile traffic accidents in the US. As a result, the US Congress passed the Medicare law, 911 was established for emergencies, and paramedic training programs were created.

American surgeon R Adams Cowley, who is regarded as a pioneer in emergency medicine, began developing his legacy—an organized approach to trauma care—in 1960. Cowley established guidelines for handling medical emergencies. One of them featured qualified paramedics both aboard the aircraft and at the accident scene. In Baltimore, Maryland, Cowley also built a Shock Trauma Center with a nearby area for helicopter landings.

Vietnam War / 1970s

At the Hospital of Harlaching in Munich, Germany, the first ever permanent civil air ambulance helicopter, Christoph 1, went into operation in 1970.

In the 1970s, civilian air ambulances increased in frequency. Paramedics started working for air ambulance services in the late 1970s. Aircraft pilots and air ambulances had not previously been required to provide medical care or treatment.

Medevac units had an enormous significance as the Vietnam War continued. Bell UH-1 helicopters were frequently utilized by med-evac teams.

The airplane, known as the “Huey,” was roomy enough to carry medical professionals, supplies, and injured people. The area allowed for the triage of injured patients to begin as soon as the aircraft took off. Over 900,000 wounded soldiers are thought to have been transported by helicopter ambulances during the Vietnam War.


Air ambulance businesses quickly grew in the 1980s in the United States, Canada, and Germany. Government studies that demonstrated the benefits of air ambulances as well as the development of increasingly dependable and secure aircraft that could carry more sophisticated medical equipment were two factors that contributed to the air ambulance’s growing “popularity.”

The value of air ambulance services had finally been realized by the late 1980s. When the Olympic Committee included the Shock Trauma Air Rescue Service Foundation (STARS) as part of the emergency preparedness for the Calgary Winter Olympics in 1988, the service officially acquired status as an essential service.

Mont Blanc started offering services for aerial work, firefighting, and medevac missions in France in the 1990s, which involved rescuing stranded or hurt skiers from far-flung mountainous places.
The French emergency medical services began establishing air ambulance services in the early 2000s. Mont Blanc also quickly rose to prominence as one of the nation’s earliest providers of HEMS (helicopter-based emergency medical services).


Helicopters still played a crucial part in military medical evacuation at this point. The US military employed the UH-60 Black Hawk a lot in Iraq and Afghanistan.

Trauma care can start as soon as the chopper takes to the air since Black Hawks can fit many medical professionals and cutting-edge field equipment.

According to a 2012 study by medical publication Hindawi, patients transported by helicopter had a higher probability of surviving, arrived at the hospital sooner, and received treatment more swiftly.
Present – the pandemic years

Today, medevac services are available in urban regions as well as distant areas, making air ambulance operations a necessary component of society.

In April 2022, the London Ambulance Service and the Metropolitan Police utilized an air ambulance to land in the centre of Trafalgar Square and rescue an 81-year-old man who had been struck by a car.
Medical repatriation changed as a result of the epidemic since commercial planes were cancelled. The financial and insurance firm Allianz claimed that their air ambulance transfers climbed by 25% from March to August 2020 in comparison to the same period in 2019.

Air ambulances had to use contemporary medical technologies during the pandemic in order to keep up with the Covid-19’s difficulties. Demand for on-board medical equipment, particularly quarantine equipment, increased during the pandemic years.

Sales of EpiGuard, a Norwegian manufacturer of medical equipment, increased by 2000% in 2020–2021 for its isolation pods used to transport Covid patients.

The EpiShuttle was created to carry patients who are very contagious. The pods have interchangeable operator ports, allowing for intubation and central venous line insertion as well as intensive care therapy for the infected patient.

Although technology and design have altered the appearance of air ambulances over time, the goal has remained the same: to save lives quickly.

Jules Verne would undoubtedly be proud that, nearly 140 years later, his vision of saving lives is a daily element of aviation even if his concept of a flying vehicle was considered to be a flight of imagination in 1886.

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