What is a "rual" area? And when you say "real area" what kind of real area are you talking about?
I work part time at a service that is 90 miles to hospital with no air support and only 1 ambulance. We have some patients that it takes about 2 hours response time, then it takes well over 3 hours transport time to the hospital. Most response times are closer to 20 minutes. Nearest mutual aid is an hour away. We are primary for over 2000 square miles, and mutual aid for another 4000+ square miles.