Medevc services would have extremely limited use in NYC. Their main purpose is for rural areas where the time to the closest hospital is quite long war for transportation between major facilities. There are very few locations in NYC where helicopters could land safely close enough to an incident to make them useful!
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I'll give a good example. I work fire/ems in eastern Kentucky, so our closest trauma centers are either in Lexington, KY, Huntington, WV or Kingsport, TN. Just four days ago, my paramedic and I had a helicopter land in a small clearing for an ATV accident where the operator flipped it off a ridge line, which required us to ride off-road to as well to get to our patient. Us being the closest unit were one county over, so imagine the time distance it takes to get from Tottenville to anywhere during traffic and you have a general idea. The clearing was so small, the pilot was only able to gradually descend so far, before taking the helicopter straight down above us. The remoteness was so that the patient was already lying in 100+ heat and humidity for over an hour before we arrived and was finally flown out close to three hours after the initial incident.
I can't imagine too many places to land a helicopter in NYC, other than many of the parks, even having grown up in Staten Island. Many direct scene flights in my part of Kentucky frequently happen directly on main roads. We'll shut them down completely, have whatever local FD set up the LZ and land the helicopter in the middle of the road. For others where that option isn't safe, there are pre-determined LZ's that we transport to and meet the helicopter. If a helipad or local airport exists, that's always an option as well.
I've had incidents where I've had multiple helicopters circling overhead for MCI's, landing and transferring patients to each bird one by one and I've even had an LZ where two helicopters landed almost simultaneously for two separate incidents, one for my patient that flipped a lawn mower off a rock wall and another for the ALS crew and their MVC.
To get a helicopter here, the magical time usually seems to be around fifteen minutes from the request, to them flying in, then another twenty minutes or so from the time of loading at the scene and landing at the hospital. It's a good question that was posed, but you can be sitting in any ER by then.
