The medical provider on scene (EMT, Paramedic, etc.) makes that determination based on their best judgment, considering the urgency of your particular ailment and the transportation resources available. If it’s life threatening, we want to get you to a hospital as quickly as possible. So if you have something very time-sensitive, such as a stroke or a heart attack, we’ll try to transport you in a helicopter. If you’re stable, and in our judgment you can go by ground, then you’d go by ambulance. In an ambulance it’s going to take roughly two hours to get from the center of our district to a hospital. On average, the same trip will take 20 minutes by helicopter.