If you're in a serious wreck, you may not have a choice in how you get to the hospital.
You could wind up being taken by helicopter.
But a NewsChannel 5 investigation has uncovered serious questions about one air ambulance service that flies hundreds of Middle Tennesseans every year.
Consumer investigator Jennifer Kraus discovered what the company isn't doing to keep you safe.
In an emergency, every second counts.
And, if you're critically injured or very sick, a Missouri-based company known as Air Evac Lifeteam says its goal is to save your life by getting you to the hospital quickly.
The air ambulance service has more than a dozen helicopters that fly in Middle Tennessee.
But critics question Air Evac's commitment to safety.
"The company is irresponsible," says Jim Hall, the former chair of the National Transportation Safety Board. The NTSB investigates aviation accidents and recommends safety reforms.
Deanna Moore was an Air Evac paramedic on a flight that crashed into power lines at an accident scene in Wilson County four years ago.
Moore now looks back at what happened and says, "We could have died."
She says it's a miracle no one was killed.
Looking at video of her helicopter as it was falling into the wires, Moore says, "It makes you realize just how fortunate we were."
But other Air Evac flights haven't been so lucky.
The company's choppers have been in at least 10 crashes around the country in the past five years -- accidents that have killed two patients and seriously injured crew members.
Hall, the former head of the NTSB, says, "It's a real tragedy."
He says he can't understand why Air Evac refuses to install basic safety equipment that the state has been pushing for years -- equipment that can help pilots land safely when severe or stormy weather suddenly moves in.
And pilots with other air ambulance services, like Mike Taylor with Vanderbilt's Lifeflight program, says this equipment is crucial, especially here in Middle Tennessee.
"The weather can change on you in a heartbeat. We feel it's important for our safe operation," Taylor says.
And when we asked pilot Robert Carter with the Hospital Wing Program of Memphis, "Would you fly without it?" Carter's reply, "This day and time, no. All of our aircraft are equipped."
In fact, every air ambulance service in Tennessee other than Air Evac has used this equipment for years.
But Air Evac went so far as to sue the state of Tennessee to keep from having to install it on their helicopters.
Bill West is Air Evac's attorney. Kraus asked West, "What's wrong with putting this safety equipment on?"
West answered, "It's an additional roughly $50,000 per aircraft."
Dr. Bryan Bledsoe says explanations like that "send the message that their (Air Evac's) primary orientation is the dollar."
Bledsoe was a flight paramedic in Dallas. He has spent years studying air ambulance companies around the country and is a noted industry expert.
He says it's crazy for Air Evac to refuse to add the equipment.
"It's just what's best for the patient," Bledsoe says.
But Air Evac's attorney Bill West argues, "Our equipment is superior."
West says they're not installing the safety equipment because the Federal Aviation Administration doesn't require it.
West says, "The FAA says we're safe. The FAA has certified us and the FAA says we meet all the requirements to be flying."
But Hall says, "The FAA sets minimum standards." And Hall says why only meet minimum standards when you're dealing with people's lives?
"I don't think it's in the interest of the public good that we would have operations in this state that don't attain to maintain the highest safety standards," the former NTSB chairman adds.
Deanna Moore, the former Air Evac paramedic, calls the equipment "valuable."
Moore says, while Air Evac is supposed to be saving patients' lives, she fears the company may be risking lives.
"If there's a piece of equipment that will make an aircraft more safe, I think that anybody would put that equipment on the aircraft."
Air Evac says none of its recent accidents have been caused by the weather.
In fact, most were blamed on pilot error.
But critics say that's all the more reason to make sure that pilots have all the equipment they need.
A judge recently sided with Air Evac in its lawsuit against the state over the safety equipment.
The judge ruled that the Federal Aviation Administration is the only entity that can police requirements for aircraft -- even if the state doesn't think those rules go far enough.