We have a 30-40 min transport time to the nearest hospital .They will stabilize and send them on a helo. When we have some bad cases we just helo out from scene. We only staff 2 ambulances. We have 4. But if both are out of county at the same time (which happens often) it is up to anyone who lives in the area and works for the service to grab a truck and go. This can get hairy for us. But our volunteer depts. are great a responding and have driven us in to the hospital many times. It works out for the most part because most of our staff lives in county, but if we hired more outside of county we would be in alot of trouble.