North Carolina has always been proud of being first in flight. More than 120 years after the Wright brothers took to the air at Kitty Hawk, a small rural EMS system in the eastern part of the state is once again asking what flight might mean for the future. In this episode of EMS One-Stop, Rob Lawrence heads to Hyde County, North Carolina, where EMS leaders have become the first in the nation to operationally deploy an electric vertical takeoff and landing — eVTOL — aircraft to get a paramedic rapidly to a 911 call.
Rob is joined by Hyde County EMS Chief Brooke Cox; Todd Baker, director of education and clinical services with Code Blue Resources and a captain with Hyde County EMS; and Carla Baker, owner of Code Blue Resources. They explain how a geographically challenging rural county moved from an ambitious idea to an operational proof of concept; working through state EMS regulation, the FAA, aviation safety, clinical requirements, pilot training and more than 1,000 training missions.
They also describe the moment a paramedic reached a remote patient about 20 minutes ahead of the responding ambulance, what the project has taught them, and why this is not about replacing ambulances or helicopters. It is about finding another tool to overcome the challenge of time and distance — and proving that even a small rural EMS system can do very big things.
| MORE: N.C. county EMS is first in nation to deploy eVTOL aircraft on 911 calls
Key quotes
- “We’re here for the patient. We’re here for the community. We’re here to make a difference nationally; not just in our little pond.” — Brooke Cox
- “Let’s look at what we can do to make it work and overcome challenges.” — Todd Baker
- “Why has somebody not done this before?” — Carla Baker
- “Come visit Hyde County. We are a small, small county, but we’re doing big things and we have a heart for community.” — Brooke Cox
- “Let’s utilize the technology, the innovation that’s out there and see if it works, and if it doesn’t, it doesn’t.” — Todd Baker
- “This was never meant to replace an ambulance. It’s not meant to replace a helicopter, a medical air helicopter.” — Carla Baker
- “It is to figure out if this particular asset will help you overcome obstacles in various response areas. And that’s what it’s about.” — Carla Baker
Additional resources
Episode timeline
- 00:36 – Rob introduces EMS One-Stop and the extraordinary concept of flying a paramedic to a 911 call aboard an eVTOL aircraft — meet the guests: Hyde County EMS Chief Brooke Cox, Captain Todd Baker and Carla Baker of Code Blue Resources
- 02:38 – Understanding Hyde County: rural geography, marshland, water, Ocracoke Island and the challenge of accessing timely EMS and air-medical resources
- 04:31 – Brooke describes moving from a resource-rich EMS environment to one where a critically ill patient could wait almost 3 hours for a helicopter
- 06:01 – The eVTOL concept: essentially a large electric vertical takeoff and landing aircraft capable of carrying a paramedic
- 07:14 – Carla explains Code Blue Resources and how conversations about bringing the technology into EMS began
- 09:34 – Todd traces the project back to December 2024 and the effort to turn the concept into an operational reality
- 09:59 – The first regulatory hurdle: determining how North Carolina’s Office of EMS would classify the aircraft and what equipment it would need to carry
- 11:22 – Brooke describes being a dreamer, becoming a trailblazer and the unforgettable moment the aircraft first launched
- 13:37 – Inside the aircraft: battery power, operational range, controls, safety systems and even an emergency parachute
- 16:29 – Working with the North Carolina Office of EMS and finding a regulatory pathway for something nobody had previously attempted
- 18:34 – Building the clinical package around providing what a paramedic might need during the first 15 minutes of an EMS call
- 20:26 – Taking the project to the FAA and learning how EMS and aviation had to develop a common language around risk and life safety
- 22:34 – Selecting the paramedics: why clinical judgment, aviation awareness and experience mattered more than simply putting out a job advertisement
- 23:43 – Meet Quinn Reese, the paramedic who flew the first operational mission
- 24:16 – Preparing clinicians for the aircraft and ensuring they were fully credentialed within Hyde County’s EMS system
- 26:33 – Brooke goes to California to train: VR simulation, repetitive skills development, fatigue management and progressing to proficiency
- 29:14 – Who actually flies it? Brooke explains the dual joystick controls and the authority of the paramedic operating the aircraft
- 30:03 – How Hyde County positioned the aircraft and used call location, range, weather and operational parameters to determine whether a mission was viable
- 31:51 – Todd tackles some of the misinformation surrounding the program and explains the multiple layers of operational and pilot decision-making
- 33:31 – More than 1,000 training missions during the proof-of-concept period
- 33:53 – The operational call that demonstrated the potential: a paramedic finds a remote patient and arrives approximately 20 minutes ahead of the ambulance
- 36:17 – The reaction after a successful mission and the satisfaction of seeing months of planning and training translate into patient care
- 37:33 – Lessons learned: leadership support, educating decision-makers, having a clear mission and understanding the strengths of the team
- 39:34 – Todd explains the culture of asking, “How can we make this happen?” rather than immediately looking for reasons why it cannot
- 41:51 – The wider Hyde County team: how law enforcement and EMS routinely work together in a resource-limited rural environment
- 43:16 – The proof of concept has ended — for now — as Hyde County looks toward the next generation of longer-range eVTOL technology
- 44:49 – “This is just the tip of the iceberg:” Brooke explains why Hyde County is not finished with the concept
- 45:21 – Carla discusses interest from other organizations and manufacturers and what has been learned about building a comprehensive eVTOL EMS program
- 47:09 – Brooke’s message from Hyde County: a small county doing big things and trying to put community back at the center of EMS innovation
- 47:36 – Todd on the need to think beyond the traditional model of simply placing two people in an ambulance and sending them toward every call
- 49:54 – Rob closes: North Carolina is first in flight once again — and the team in Hyde County has shown it has the right stuff
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