Programs that offer the services of trained medical personnel (generally licensed nurses, paramedics or EMTs) who provide in-flight patient care for severely ill or injured individuals who are traveling domestically or internationally using the commercial airline system. Services may include screening for travel fitness; travel planning and ticketing for all traveling parties; ground transportation; priority check-in; in-flight medical care including oxygen, sedation and pain management; arrangements for required medical equipment; international stretcher service; and medical reporting to the receiving facility. Some programs can also assist individuals who are traveling by rail.