Its always funny to see the paramedics transfer to a smaller aircraft. They have to reduce their carry on baggage, so to speak.
As Aesir said; "Even a small helicopter is better than NO helicopter".
There are too many variables; sitter vs stretcher, over land vs over water, sea level vs mountainous terrain etc etc.
At the end it will depend on what the Client is willing to pay for the service required.
In the perfect world the aircraft would do the following and the client would be happy to pay for it;
SPIFR capable within the area of operation
Carry max fuel with max payload (crew compliment etc) for all ops within the area of operation
Able to conduct a vertical departure from an off site landing at gross weight
a resonable TAS (not the old 100kts)
An aircraft that ergonomicaly fits the pilot and crew
Oh well, enough dreaming - back to reality