Air ambulance services are a vital part of any regional emergency medical service system. The air transport system provides the critical link between local health care facilities and regional referral centers. Because of the speed of both fixed- and rotary-wing aircraft, the special equipment on board the aircraft and the special skills of the medical crew, air ambulance transports typically involve the most critically ill or injured patients within the health care system. As with any component of the emergency medical service system, each air ambulance service must have a single party or body that is responsible for the oversight of all aspects of medical care provided by the service. This is the responsibility of the medical director of each air medical service.