Wings of life

In all other ways, each case is different and unpredictable. The blue-jumpsuit-clad crew — typically a pilot, and a specially trained critical-care transport nurse and paramedic — might ferry a badly burned child from rural New England to Boston in the morning, and pick up an adult cardiac patient attached to a ventilator in the afternoon.

Celebrating its 25th anniversary this year, Boston MedFlight, headquartered at Bedford’s Hanscom Air Force Base, is best known for swooping into an accident scene by helicopter — but it isn’t the dramatic entrance that matters most, said its medical director, Dr. Suzanne Wedel. The goal is to connect a critical-care medical team to the sickest patients — whether they are lying on a highway after a car accident, or in a bed at a community hospital — as quickly as possible to start advanced life-saving care.

Only 18 percent of the 2,941 patients her team transported last year were of the seen-on-the-evening-news variety, Wedel said.

The bulk of its calls don’t make headlines. Crews, using a helicopter or a ground ambulance, might transport premature or critically ill babies who need a specialist at Children’s Hospital Boston, or pregnant women en route to the intensive-care unit at Brigham & Women’s Hospital. Or they might staff a small jet to rush a patient from Martha’s Vineyard, Nantucket, or Bermuda to the emergency room at Beth Israel Deaconess Medical Center or Massachusetts General Hospital.

The common theme is desperate people in medical situations where minutes count, said Wedel. “We are meeting these people on what is probably the worst day of their lives. Nobody wakes up in the morning knowing that they are going to be one of our patients.’’

Boston MedFlight is a nonprofit cooperative venture created in 1985 by Boston’s six teaching hospitals. Since then, the service has transported 43,000 patients, with demand increasing by 1 to 2 percent annually, according to the company.

Although Boston has a fiercely competitive medical community, the consortium is proud of MedFlight — considered one of the best critical-care transport services in the country — and the cooperative nature of the program has helped keep rival hospitals on the same page, said Dr. Peter Burke, Boston Medical Center’s chief of trauma services.

“It’s a very valued program,’’ said Burke. “The key is the assessment they do at the scene. The earlier you can assess someone, the better they are going to do when they reach the facility that can help them.’’

The support has helped the program thrive in an era when financial pressures squeeze just about every aspect of health care. Insurance companies pay about 90 percent of Boston MedFlight’s $24 million annual budget. Transport costs vary widely, depending on vehicles used and distance traveled, but the average medical helicopter ride is about $10,000, Wedel said. The six hospitals, plus MedFlight’s fund-raising efforts, cover the roughly $3 million annual deficit for uninsured patients every year.

Also key to the success of Boston’s program is the judicious use of helicopter transport, Burke said. Unlike in some other parts of the country, where for-profit helicopter services are allowed to offer medical flights, MedFlight requests can be made only by first-responder police or fire officials, or a doctor. “There are services . . . that will use a helicopter for an ankle fracture. This not your normal helicopter transfer. This is for people who need Level 1 trauma center care immediately,’’ he said.

When a call comes into the dispatch center in Bedford, the initial decision is only whether a safe transport from Hanscom — or a smaller base in Plymouth — is possible.

If weather conditions indicate a safe flight can be attempted, the pilot accepts the call. The group is deliberately told nothing about the patient or injury until they are en route, a level of objectivity credited, in part, with a clean safety record for the past quarter-century. Its helicopters — including the program’s newest $11 million state-of-the art craft, which has specialized equipment for critically ill children and more room for family members or additional medical staff — have night-vision capability, allowing them to navigate in areas where high-power lines could be present.

A specific hospital is designated for almost all pediatric, cardiac, neurological, and obstetric patients by the doctor who requested the transport, while most trauma patients are assigned to one of the consortium’s six emergency rooms on a rotating basis by the dispatcher.

On a recent afternoon at MedFlight’s Hanscom headquarters — in an airplane hangar next to the military base — dispatcher Ken Panciocco tracked the flight patterns of its helicopters along with other activity aloft throughout New England.

A 10-year veteran of Boston MedFlight, Panciocco was on duty the night of Feb. 20, 2003, when flames ripped through the Station nightclub in West Warwick, R.I., killing 100 people and injuring more than 220.

Panciocco coordinated flights for several of the 13 victims needing emergency airlifts to Boston burn and trauma centers. Most shifts are not that harrowing, he said, but “you do go home at the end of the day feeling like you made a difference.’’

As the need grows, the types of patients have changed. New seatbelt laws have reduced the numbers of some types of highway traumas, for example, while improved life-saving technology has created a larger number of critically ill patients eligible for transport, Wedel said.

Staffers often get thank-you notes from patients, and MedFlight holds an annual reunion for pediatric patients eager to explore the helicopters they rode in. “It’s the parents that are most touched by it,’’ Wedel said. “Their kid doesn’t remember much, but for them it was the worst thing they ever went through.’’

Jennie Santiago of New London, Conn., credits Boston MedFlight with saving her husband’s life while he was recovering from a heart transplant.

Ricardo Santiago, 31, had returned home a month after the surgery when, on the morning of March 12, his breath grew shallow and he felt weak and lethargic. His alarmed wife measured his blood pressure, and found it registering as critically low.

An ambulance took Santiago to Lawrence & Memorial Hospital, a few blocks from their house, and doctors there agreed he needed to be seen immediately by his transplant specialists at Tufts Medical Center. Boston MedFlight arrived 40 minutes later to stabilize Ricardo and take him to Boston.

Meanwhile, Jennie Santiago ran home to pack a bag and make child-care arrangements for their 2-year-old son, Aries.

“I was so distraught. I had no idea whether I would see my husband again.’’ She saw the helicopter carrying her husband from an upstairs window in her home as it lifted off and headed to Boston. “I broke down crying and praying that everything would be OK,’’ she recalled.

She later learned that Ricardo had sepsis, a dangerous blood infection. Halfway through her 90-minute drive from New London to Boston, MedFlight staffers called to reassure her that Ricardo was at Tufts, alive and getting treatment.

Her husband spent nearly a month in the hospital recovering from the infection, and has been doing well for the past two months, said Santiago. “We owe a lot to them for getting him there when he needed to be there,’’ she said. “He was pretty much on the brink.’’

Erica Noonan can be reached at enoonan@globe.com.