Your contribution is basically sound and accurate but for those faced with delivering an EMS service you have to do what you can with what you have got and what you can afford.
When we started the UKs first air ambulance nearly 20 years ago we were presented with a thousand reasons why it wouldn't work with a simple unstretched Bolkow 105 DB. The detractors came in every form but when it came to the crunch we managed extremely well. The DBS upgrade was obviously a step up and the 135 a step more. Training, practice, organisation and good reliable equipment all played their part. We generally did not have to fly more than 20 minutes, 30 at the most if you had a headwind. This gave us some confidence that if the patient was stabilised and prepared before leaving the ground with all necessary equipment to hand then the rucksacks could be left in the back. You worked on the basis that as a VFR service, day only, then if anything dramatic happened then you put down, shut down and sorted it on terra firma. It never happened to me but I can't speak for others.
Role changes for the 105 can be pretty instant if you rely 100% on portable equipment and pre-installed stretcher rails. The lack of on board O2 is a handicap but not a show-stopper.
G
