The success of the helicopter EMS model in the U.S. is prompting its emulation worldwide. While many nations have had this service for years, only now are they making a serious effort to develop it on a meaningful scale.

One prime growth market: Russia. Anyone who has watched a YouTube video of Russian drivers can see how the need for helicopter EMS in the country would be acute.

But there is another, even more obvious reason: Russia has the largest land mass of any country on Earth — 6.6 million square miles, stretching 5,592 miles east to west across two continents and 11 time zones. Perhaps no country could reap more benefits from helicopter EMS.

Of course, the Russians have been at it for years, but with a fleet that is less than one-tenth the size of that flying in the U.S. in a country known for its harsh climate and lack of rural infrastructure.

However, with Russia's domestic helicopter industry focused on producing large/medium helicopters — most of which are destined for the military and export markets — Russian EMS providers are often being forced to turn to Western OEMs to form partnerships to provide equipment and further develop the nation's helicopter EMS capacity.

Airbus Helicopters has been selling into the Russian market since 1995 and has operated a wholly owned subsidiary there — Airbus Helicopters Vostok — since 2005. Earlier this year it signed a deal to license production of as many as 160 H135 light twins there over the next 10 years, mainly to serve the emerging in-country HEMS market.

Airbus said it was ready to share its HEMS "experience and technological know-how with our Russian colleagues and partners." Under the agreement, the helicopters will be assembled at the Ural Works of Civil Aviation (UWCA) in Yekaterinburg.

In a similar vein, Bell Helicopter has had success with introducing its model 429 light twin into the Russian EMS market beginning in 2014 with Heli-Drive in St. Petersburg. Throughout the St. Petersburg region, the Ministry of Healthcare of the Russian Federation and the local Department of Healthcare has begun an aggressive drive to expand the number of helipads at regional hospitals.

Despite its long history, Russian HEMS is still in its nascent stage, but major growth could be just around the corner.

According to EMERCOM, the Ministry of the Russian Federation for Civil Defense, Emergencies and Elimination of Consequences of Natural Disasters, the Russian HEMS market may need as many as 350 helicopters in the coming years. That would make the Russian fleet still less than half the size of that of the U.S., but nevertheless one of the world's largest.