Evening,
There was some talk a few years ago about fixed line's which scared everyone to death!
Not so scary at all. This technique is used quite succesfully on the continent (Europe) on EC135's. Especially in the mountains, operators cannot afford the weight and space penalty of a winch operator. If necessary the Paramedic and Emergency Physician are flown in as "underslung Load". They stabilize the patient and put him into the stretcher. Helicopter picks them up and lands at a suitable location nearby where the patient is treated further and transferred into the inside.
This is even done with variable lenght line where the paramedic can abseil down from a 10m fixed line at his "leisure" for another 80m without having to move the helicopter (used for ravines or very steep slopes).
Takes a bit of extra time to rig up the line and to transfer the patient inside but certainly not a bad solution.
Regards,
Woolf