“Anyone who tells you these things are big and luxurious is just fibbing,” cracks Annie Riggs-Bacon as she inventories emergency medical supplies just prior to departing on an 18-minute flight to Wenatchee in a Learjet 35A just barely big enough to accommodate five people — one of whom will be strapped down to a gurney.

“It doesn’t even have a bathroom,” she said. “How’s that for flying first class?”

Luxury, of course, isn’t the point.

“We’ve got pretty much everything aboard that any intensive care unit would have,” said Shirley Stearns, like Riggs-Bacon a registered nurse (RN) with Airlift Northwest, “because that’s actually what we are — a flying ICU.”

Headquartered at Boeing Field in Seattle, Airlift Northwest provides advanced life support and transport services on approximately 4,000 flights per year in Washington and Alaska.

And Kitsap County is one of the company’s best customers, accounting for about 16 percent of Airlift Northwest’s annual trips.

“We’re over in Kitsap literally every day,” Riggs-Bacon said. “One day about a month ago, I made four trips to Kitsap during one 24-hour shift. People who live over there don’t always realize just how isolated they actually are until they need help.”

Surrounded on three sides by water, residents of the Kitsap Peninsula are largely served by Harrison Medical Center in Bremerton and its satellite campuses throughout the county for routine medical treatment.

But when the needs are more pressing, the quickest way to reach the only Level 1 trauma center in Washington state, Harborview Medical Center in Seattle, is by air.

“From the moment we’re contacted, our goal is to be flying within 10 minutes,” said Airlift Northwest Regional Manager Julie Hoffman. “The pilots and nursing crews are ready 24 hours a day, seven days a week.”

Once airborne, it takes just six to 10 minutes for one of Airlift Northwest’s Agusta Powers or Mark III helicopters to reach one of the four designated landing sites in Kitsap County — South Kitsap High School in Port Orchard, Harrison Medical Center in Bremerton, Harrison’s Silverdale clinic and Bainbridge Island Fire Department’s Station 21.

Which isn’t to say those are the only sites the choppers can set down.

“We can land on any space 100 feet-by-100 feet,” Hoffman said. “If we need to pick the patient up right at the accident scene, we do.”

The procedure, she said, is dictated by the fire chief at the rescue scene.

“We do landing zone training with all the fire districts,” Hoffman said. “If they want to transport the victim to a designated landing zone by ambulance, we’ll meet them there. But if that would take too long or the victim is too badly hurt, we can drop down pretty much wherever they may be.”

About 40 percent of the calls Airlift Northwest responds to are trauma. But the rest can be just about anything.

“People think you’ll only be airlifted if you’re seriously injured in a car crash or something like that,” Hoffman said, “but a large number of the cases we respond to are cardiac patients.”

And an increasing number of those patients are being airlifted to Kitsap County rather than from it.

“Since Harrison (Medical Center) opened its cardiac-catheterization unit, we’re transporting a lot of people from places like Port Angeles to Bremerton,” Hoffman said. “It’s not like every call we go out on has to wind up at Harborview.”

Airlift Northwest operates a total of five bases located strategically throughout Washington. With helicopters based in Bellingham, Arlington, Seattle and Olympia, Airlift Northwest teams are positioned to arrive within minutes to sites throughout Western Washington.

Fixed-wing aircraft based in Juneau, Alaska, and Seattle allow Airlift Northwest to provide timely air medical services throughout a much broader region, including any location in the continental United States and Canada.

The aircraft are leased to Airlift Northwest by Air Methods Corporation and Executive Flight provides the aviation services, pilots and mechanics.

Altogether, the company employs about 80 flight nurses — all of them RNs.

“That’s pretty unusual for an airlift service,” said Tia Barrett, who has been a flight nurse for Airlift Northwest since 1987. “Most of them use standard EMTs (Emergency Medical Technicians) rather than nurses, who are much better trained.”

In addition, Barrett said each two-nurse rotary aircraft team includes one specially trained to handle adults cases and one for pediatrics.

“You never know what you’re going to encounter, and there’s a difference between adults and children,” she said. “We have to be prepared to handle anything.”

According to the company’s Web site, Airlift Northwest began when a house fire in Sitka, Alaska, killed three children before they could be safely transported by air to a regional burn center for care.

Dr. Michael Copass, Airlift Northwest president and medical director, was teaching in the Sitka hospital that day and was called into the local emergency room to help care for the children.

“I came away from it saying that was the last time any doctor would have to get on the phone and beg someone to come and pick up a child,” he said.

He returned to Seattle, determined to find a way to provide air medical transport for residents in Alaska and the Pacific Northwest.

In 1982, Airlift Northwest was born.

Since then, the service has transported more than 55,000 patients — including more than 250,000 takeoffs and landings.

Twice in the company’s history, its helicopters have crashed — once in 1995 and again in 2005. In both cases, the pilot and two flight nurses were killed.

“You don’t think about the risks,” Barrett said. “The air is just the place we work. It’s our office.”

But it’s an office that frequently exposes her and the other crew members to horrific experiences.

“That’s part of the job, too,” she said. “When you’re a caregiver, you can’t let yourself be affected by it or you can’t function. It’s hard to do sometimes, but you just have to distance yourself and just concentrate on doing your job.”