Saving lives is a growth business for REACH Air Medical Service, which uses helicopters and airplanes to transport critically injured patients.
The Santa Rosa company's revenue grew to $40 million last year, up 33 percent from 2006.
It has expanded rapidly in the past three years, adding air bases in Oregon, Illinois and remote areas of California.
Demand for air ambulances is strong in Sonoma County and other locales where hospitals with trauma units can be more than an hour's drive away for some residents.
REACH's appeal is easy to understand: In the remote coastal enclave of The Sea Ranch last week, a 79-year-old resident collapsed of an apparent heart attack. His heart was barely beating, about 10 beats per minute. At that point, without treatment, his remaining life could be measured in minutes.
A REACH medical helicopter touched down in The Sea Ranch 15 minutes after his collapse.
Todd Peltier, a registered nurse with REACH, jumped out of the helicopter and rushed to his side.
Peltier and a REACH paramedic loaded the patient into the helicopter and got to work, inserting a breathing tube and applying an external pacemaker, which brought his heart rate back to 70 beats per minute.
The REACH team had the patient at Sutter Hospital within 30 minutes of the heart attack -- a trip that would have taken more than an hour by ambulance.
On Thursday, the man was moved out of the intensive care unit -- a new pacemaker in his chest -- and was expected to make a full recovery.
Lots of people contributed to saving his life: his wife who called 911 and administered CPR; the paramedics who arrived first in an ambulance; and the doctors and nurses at Sutter. But REACH fills a life-saving niche that wasn't around 22 years ago.
"Every day, I know we make a difference. It's great," said Jim Adams, chief executive officer at REACH and a former flight nurse.
Without access to trauma care, people with critical injuries are up to twice as likely to die because of missed diagnoses or treatment delays, according to the Centers for Disease Control and Prevention.
"They are a godsend when it comes to getting patients from point A to point B quickly," said Jan Gritsch, trauma program manager at Memorial Hospital. "The whole premise of the 'golden hour' is that if you can get a patient to a trauma center within an hour, their mortality rate will drop."
REACH, which stands for Redwood Empire Air Care Helicopter, employs 260 people who help manage a fleet of 16 medical helicopters and four planes. It expanded to western Oregon in 2006, and to the Chicago area this year.
The idea of air ambulances came out of the Vietnam War, and then blossomed alongside the growth of hospital trauma units in the 1980s, Adams said.
Sonoma County is primarily served by four emergency helicopter services -- REACH, Sacramento-based CALSTAR, the Sonoma County Sheriff's Department and the California Highway Patrol. Only REACH and CALSTAR are staffed with registered nurses.
"You can consider us a flying intensive care unit," said Darin Huard, a flight nurse for REACH.
Dr. John McDonald started REACH in 1987 while working in Memorial Hospital's emergency room, which he also co-founded in 1971.