Despite the availability of good medical care in most of the world, you might find yourself in places where access to proper health care is problematic — or, in the case of remote adventure trips, doesn't even exist. In such cases, a medical evacuation is the best option. Here are a few things to consider.
Local care and evacuation procedures
Before traveling to remote or underdeveloped destinations, research the health care system and evacuation procedures and capabilities. Basic care is generally available in the world's populated areas. In some countries with socialized-medicine programs, you can receive treatment for free or at little cost. In many less developed countries (e.g., India and Mexico), the quality of care is even comparable to that in the United States. In emergencies involving foreigners, authorities in underdeveloped countries generally suggest (and ambulances generally transport patients to) private, high-tech hospitals. Be sure that you will, indeed, receive care in such facilities, as opposed to those serving the masses.
When medical evacuations are necessary
You should be evacuated if: a facility can't deliver advanced care (i.e., that beyond emergency care), you don't feel comfortable with the care, you need long-term care or you suffer a debilitating condition in a remote wilderness area. Medical evacuations in the last instance are usually the purview of government agencies administering wilderness regions, at home or abroad.
What to expect during medical evacuations
During an actual evacuation, the patient is usually transported by air ambulance, which is basically a mobile ICU, with all the necessary equipment. Family members don't accompany the patient and must plan to meet up with him or her at home. With certain stable conditions that don't require advanced medical equipment, patients are transported via commercial carriers accompanied by a physician or a nurse and any travel companions.