The role of the life-flight pilot is to transport patients and, occasionally, organs. In both cases, medical personnel accompany the flight.
Because of the time-critical nature of life flights, small jet aircraft are often used. Slower piston or turboprop planes are used when time is not a factor. Life-flight planes are often configured to accommodate medical equipment and patients on stretchers.
Both fixed-wing and rotor-wing pilots spend much of their nonflying time on call. Pilots are expected to be airborne within an hour or less on time-critical flights. A heart destined for a heart transplant must be transplanted within four hours of removal. Other organs have similar time constraints. The organs are normally transported in simple Styrofoam containers filled with dry ice.
A pilot operating a life flight that is time critical will receive priority clearance from departure to arrival. A notation of "life-flight" or "life-guard" on the flight plan is usually all that is needed.
Most air ambulance companies operate under Part 135 of the federal aviation regulations. The minimum flight time requirement for a pilot acting as pilot in command is 1200 hours; the minimum is 1500 hours and an Airline Transport Pilot (ATP) certificate for an aircraft requiring two pilots.