First air evacuation was done in 1870 33 yrs. before the historic Kitty Hawk flight when 160 wounded casualties were evacuated by air balloons during Prussian siege of Paris by French Physiologist and Father of Aero medicine Paul Bert. In 1909 Capt George Gosman thought of using fixed-wing aircraft as air ambulance. In 1917 French aircraft Dorand AR II was used as the first such air ambulance. During World War II nearly 1 million causalities were evacuated by air with a death rate of 4/100000.

It was not until 1933 that the first British Civilian Air Ambulance Service was started serving the Scottish Isles; the descendants of this service still operate today carrying the sick and the invalids from the remote islands of Scotland to the Midland.

Long distance high altitude aero medical evacuation was however pioneered by the Luftwaffe during the Spanish Civil war and the Second World War. In the later years of the war more than 90% of allied causalities were evacuated by air from all the sectors.

One month after the start of the Korean conflict the first medical evacuation was made on August 4 1950. The helicopter a Bell 47 with externally mounted litters was flown by Marine Corps pilots of VMO-6 squadron to the hospital ships Repose and Consolation as they were equipped with a special helicopter landing pad.

The Military Assistance to Safety and Traffic (MAST) system began opertions in 1969 at Fort Sam Houston in San Antonio Texas. MAST was started as an experiment by the Department of Transportation to study the feasibility of military helicopters augmenting existing emergency medical services. In the first ten years of operation MAST expanded nationally and transported more than 16000 patient’s casualties.

The US Army MAST program probably provided the first stimulus for health care facilities to transport patients by helicopters. Later during the Vietnam and Gulf conflicts helicopter air ambulances proved their worth in evacuating a large number of casualties.