Performing an emergency medical procedure on the ground is one thing, but it’s a whole new challenge 31,000 feet in the air.An air ambulance medical team yesterday offered a tour of an aircraft that has saved the lives of many Bermuda residents. Dozens of people depend on the service each year to help them reach quality medical care facilities overseas.Victims of major traffic accidents, premature babies and high-risk pregnancies have all been passengers. The medical team has been known to fly to Bermuda up to four times a week during busy periods, medical team director Mike Vallee said.Their journey is part of a three-company effort: Colonial Insurance provides medical insurance; Med-Valu facilitates the patients transfer and Med Escort provides the actual plane.Med Escort president Craig Poliner said in some cases they have transported two babies from the Island on the same day. At other times, weeks could go by without need for an emergency evacuation. Local employers who provide staff insurance cover through Colonial were invited to tour the plane yesterday morning. A second tour was to be held last night for 24 medical care providers.The small craft can accommodate three medical staff, two pilots and, in some cases, a family member. A fully-equipped Intensive Care Unit, it includes ventilators and monitors. Immigration issues that may arise such as an out-of-date passport are dealt with by Colonial’s senior clinical administrator Catherine Kempe.The company’s COO Naz Farrow yesterday said it was important for people to have medical insurance that covered such overseas transfers.Without insurance, patients will be asked to pay out of pocket. Costs range anywhere between $10,000 and $30,000, depending on the amount of staff and case complexity. She said in these tough economic times many people were choosing to downgrade their level of insurance coverage and putting themselves at risk.Such persons would not have coverage in the event they had to be air-lifted off the Island, she said. “We think it’s really important for the general community and the general public to understand how emergency services are handled especially in light of the fact Bermuda is a small island, some 700 miles from the East Coast of the United States.“Due to the recession we are in tight economic times. [Some] people are saying they can’t afford their insurance premiums and downgrade the level of cover that doesn’t include emergency care, and it can put their own lives at risk.”She said even though we had a good level of medical care on Island, the more complex cases could not always be handled locally. Heather Petrie, who serves as the flight’s chief nurse, said serving a critically-ill person on a plane has its own challenges. “It’s definitely not the same as looking after a patient on the ground.”She said in the air, problems could be caused by altitude, noise, vibrations and temperatures, all of which could affect small babies. There was also a risk of getting air trapped in organs like the brain, she said.Medical staff, however, must have at least five years of ICU training and have extensive knowledge in working with aircraft equipment and safety.She said they are also responsible for the patient from “bed to bed” from King Edward VII Memorial Hospital until landing at the receiving medical site.