Hyde County Emergency Medical Services, Code Blue Resources, and Pivotal have achieved a national milestone by completing the first live emergency medical deployments of an electric vertical takeoff and landing aircraft in the United States.
During two live 911 calls, a flight-trained paramedic piloted the Pivotal eVTOL aircraft directly to emergency scenes using GPS coordinates. On one call, the aircraft arrived approximately 20 minutes before traditional ground ambulances, allowing Advanced Life Support (ALS) treatment to begin while ground crews were still en route. Spanning nearly 1,500 square miles of land and water, Hyde County represents one of North Carolina’s most geographically challenging response areas. By bypassing rivers, farmland, and other terrain barriers, the initiative drastically reduces the “First-to-Patient” interval, the critical window between dispatch and the arrival of advanced care.
Hyde County EMS Chief, Brook Cox, said, “Every decision we make is about getting advanced care to our citizens faster. These missions proved that we can overcome distance, reach patients sooner, and redefine emergency response in rural communities.”
Carla Baker, President of Code Blue Resources, said, “From the beginning, our goal wasn’t simply to prove an eVTOL could respond to a 911 call—it was to prove that Advanced Life Support could reach patients sooner. This project demonstrated far more than the successful integration of aviation into EMS. It validated a new model for emergency response—one where experienced paramedics can be safely trained to fly, respond, and begin advanced patient care sooner in communities where time and geography have always been barriers. We believe the framework developed through this partnership provides a practical foundation for other communities exploring Advanced Air Mobility and the future of emergency medical response.”
The operational milestone was preceded by months of planning and operational preparation. Hyde County EMS, Code Blue Resources, and Pivotal developed the nation’s first concept of operations (CONOPS) for integrating eVTOL aircraft into emergency medical response, completing over 300 training sorties under Public Aircraft Operations. Akute Networks served as Aviation Program Manager, establishing the operational framework, protocols, and flight procedures for the missions.
Paramedic Quinn Reece piloted the aircraft on both live operations, functioning as both pilot and the sole ALS provider. Carrying essential medical equipment—including a cardiac monitor, airway supplies, and a primary response bag—Reece was able to initiate immediate patient assessment and care upon landing.
Unlike conventional medical helicopters designed for patient transport that require large landing zones, ultralight electric VTOL aircraft can land in tight clearings, grass, and pavement close to the patient. The electric aircraft also features a low acoustic signature and lacks the heavy rotor wash of traditional helicopters, allowing safer operation in environments where conventional helicopters may be impractical.
Ken Karklin, CEO of Pivotal, added, “Emergency medicine has measured response in miles driven for decades. The Hyde County program demonstrated that it can instead be measured in minutes saved. When a flight-trained paramedic can fly directly to a patient rather than drive around rivers, farmland and other geographic barriers, advanced medical care begins sooner. This is an entirely new approach to first response.”
While traditional air ambulances remain essential for patient transport, this program introduces a distinct category of first response: rapidly deploying single paramedics directly to the point of need. The framework developed through this partnership offers a practical blueprint for emergency medical agencies nationwide looking to leverage Advanced Air Mobility to improve response times in underserved rural regions.
