Unfortunately, the reality is often quite different. This starts already by choosing your place of residence. Generally, (big) city dwellers get help much faster than people that live in smaller villages. This makes sense, since the route with an ambulance to a patient living in the country is simply much farther. This is why there is a search for alternative emergency routes, for instance via air to help heart attack patients where every minute counts. So far, in severe cases a rescue helicopter was used in addition to the land-based rescue service. Only a few countries, like the Australian outback for instance, are an exception to this two-tier rescue model.
The reason for this is that after the initial emergency care, vehicle transportation might be preferable to a helicopter transport, if the patient could be stabilized for instance. Even so, there are deliberations to allow exclusive air rescue services in the near future, if there are compelling models for this. This is the starting point of the PrimAir Project, which is sponsored by the German Federal Ministry for Education and Research (German: Bundesministerium für Bildung und Forschung, BMBF), and whose objective is "the development and description of a model for the innovative design of emergency medical services in large-scale, sparsely populated and structurally weak areas". The air –based preclinical rescue service forms “the basis of this model". Nevertheless, the project, which is scheduled for three years and is still running for another 1.5 years, needs to still solve different problems. There are some questions to be asked. Which already established rescue services should be given up for instance? Are there enough stations in Germany that are available for 24-hour air rescue services (the German Air Rescue currently has eight stations; ADAC Air Rescue has three)? After all, night flights currently come with special strings attached (e.g., the helicopter build, night vision goggles, airfield lighting). It might perhaps still take a while until we are used to looking towards the sky instead of listening for the ambulance siren.