I've recently been watching an interesting documentary on helicopter paramedic teams. As you all probably know, their job consists of a lot of sitting around doing nothing before a scramble and then a short (or not-so-short) flight out to the middle of nowhere and back again. On the (UK) documentaries I've seen, the aircraft are usually based at reasonably large commercial airports, physically located close to the fixed-wing runways.
In order to find the guy lying injured in the field and help him out of asystole, they have to rapidly launch from a presumably busy airspace, and get there ten minutes ago. Do airports have procedures that allow them to always assume an "exit route" is always okay, under some ceiling? Do they have to get take off clearance as other private aircraft would? I understand that they get given priority ATC clearance when in controlled airspace, but quite often their target call-to-takeoff times are less than two minutes, and it seems unlikely that the nearby 777 on FA would be done that quickly.
What happens if it's not possible to be VFR entirely on route? I have seen cases reported where difficulties are encountered due to fading light halfway through treating a patient -- meaning that the pilot is worried he can't take off again. It seems rather odd that, if a pilot was able to land in a field comfortably with good visibility, he can't ask for a route to be cleared, file a flight plan, and go to hospital IFR.
For that matter, how do police helicopters chase the bad guys at night in zero visibility?
Disclaimer: I've never set foot in a helicopter in my life, but have a single-digit number of hours in light aircraft -- sick people are more my forte.