 Most aircraft used as air ambulances, with the exception of charter aircraft and some military aircraft, are equipped for advanced life support and have interiors that reflect this.The challenges in most air ambulance operations, particularly those involving helicopters, are the high ambient noise levels and limited amounts of working space, both of which create significant issues for the provision of ongoing care.While equipment tends to be high-level and very conveniently grouped, it may not be possible to perform some assessment procedures, such as chest auscultation, while in flight.