As the costs of medical air transportation are likely to increase in the future, the form of transportation and planning should be optimized by further epidemiological assessment in larger studies. By comparing the costs per flight time (min) and per distance (km), we showed that a stretcher in

a scheduled aircraft is significantly cheaper than an air ambulance Alectinib in vitro (p < 0.0001). Although there is no doubt that proper medical response should be the main goal while choosing the appropriate form of air transportation, awareness of the different costs, and logistical characteristics of different forms of AE should be considered. Furthermore, we believe that besides an emergency physician who accompanies and monitors the patient, auxiliary personnel, such as an intensive care nurse or paramedic, are essential for providing adequate care. We have observed that medical assistance enables the physician to concentrate exclusively on the medical care of the patient and this should be considered in the planning of AE cases. Planning of AE cases often represents a logistical challenge. Difficulties involving gathering adequate patient medical information, decisions on transport, route planning, different time zones, languages, and the variety of different health organizations in the country of transport origin should

not be underestimated. Defining the factors for evaluating the necessity of immediate AE has been the subject of recent research. Duchateau and colleagues U0126 chemical structure identified patient age <15 years, lack of a high standard of structure in the country and location in sub-Saharan Africa as independent factors indicating the need for AE.5 They also reported on the Marco Polo evaluation program, which evaluates 1,143 hospitals in 120 countries worldwide. Each year it rates medical

facilities on a five-point scale and thereby assists decision making for immediate AE. Despite all of the identified assisting factors, it is the role of the physician who is in charge of transport planning to communicate with the patient, with the physician on-site, and with the patients’ relatives to determine and evaluate the need for AE. Limitations of the present study are the small Dapagliflozin study size, the fact that patients were all transported by the same organization, and that they resided in a single European country. As the demand for AE is likely to increase in the future, the cost-effectiveness and selection of the appropriate form of air transportation, while assuring the right medical response, will be of increasing importance. M. S., M. B., D. S., H. L., C. T., C. C., P. A., and F. G. B. critically revised the manuscript for intellectual content. All authors read and approved the final manuscript and had full access to the study data. The authors M. S., D. S., C. T., P. A., and F. G. B. declare that they have no competing interests. The authors M. B., C. C., and H. L. work for the Workers’ Samaritan Federation Germany.