A nationwide first that has the potential to transform emergency medical response in rural America was unveiled by Hyde County Emergency Medical Services, Code Blue Resources and Pivotal. A paramedic with flight training flew an electric vertical takeoff and landing (eVTOL) aircraft directly to patients during two live 9-1-1 emergency calls. One call arrived around 20 minutes before the ambulance was grounded and Advanced Life Support (ALS) was started while workers were still en route.

The operational missions are the first time an eVTOL aircraft has been used in a regular emergency medical response in the United States. The program offers a novel approach to provide life-saving care in geographically difficult locations where every minute can affect patient outcomes by significantly lowering the "First-to-Patient" interval, which is the crucial period between dispatch and the delivery of advanced medical care.

The milestones were preceded by months of planning, extensive flight training, and operational readiness. Before beginning live missions under Public Aircraft Operations, Hyde County EMS, Code Blue Resources, and Pivotal completed more than 300 training sorties to create the first concept of operations (CONOPS) in the United States for integrating eVTOL aircraft into emergency medical response. As the Aviation Program Manager, Akute Networks collaborated with the partners to create the flying procedures, protocols and operational architecture that enabled the historic missions.

“Every decision we make is about getting advanced care to our citizens faster,” said Hyde County EMS Chief Brook Cox. “These missions proved that we can overcome distance, reach patients sooner, and redefine emergency response in rural communities.

Hyde County is one of the biggest and most geographically difficult EMS response locations in North Carolina, including an area of almost 1,500 square miles of land and ocean.

"From the beginning, our goal wasn't simply to prove an eVTOL could respond to a 9-1-1 call—it was to prove that Advanced Life Support could reach patients sooner," said Carla Baker, president of Code Blue Resources. "This project demonstrated far more than the successful integration of aviation into EMS. It validated a new model for emergency response—one where experienced paramedics can be safely trained to fly, respond, and begin advanced patient care sooner in communities where time and geography have always been barriers. We believe the framework developed through this partnership provides a practical foundation for other communities exploring Advanced Air Mobility and the future of emergency medical response."

Paramedic Quinn Reece flew the Pivotal eVTOL aircraft to GPS locations close to each emergency incident during both operations. Reece packed vital medical equipment, such as a heart monitor, airway supplies and a main response bag, so that patient assessment and treatment could start as soon as the plane landed. Reece was both the pilot and the only ALS professional on board.

Pivotal's electric VTOL aircraft can land in tiny clearings close to a patient's location, such as grass, pavement or other suitable surfaces, in contrast to standard medical helicopters, which are typically sent for patient transport and require huge landing zones. Responders can operate safely in situations where traditional helicopters might not be feasible due to its low sound signature and lack of the strong air blast produced by helicopter rotors.

"Emergency medicine has measured response in miles driven for decades," said Ken Karklin, CEO of Pivotal. "The Hyde County program demonstrated that it can instead be measured in minutes saved. When a flight-trained paramedic can fly directly to a patient rather than drive around rivers, farmland and other geographic barriers, advanced medical care begins sooner. This is an entirely new approach to first response.

The program's accomplishment is significant for improved air mobility and emergency medicine. The Hyde County model, which uses ultralight electric vertical take-off and landing aircraft to quickly deliver trained medical professionals directly, expands emergency reach while decreasing response times. Helicopters are still essential for transporting sick and injured patients.

The Hyde County framework will act as a model for emergency medical services around the country looking for quicker, more effective ways to provide patients with Advanced Life Support.