Like all distress calls, those handled by Hanne Rasmussen and Jonathan Taylor in their Sheung Wan office are unpredictable and urgent - a patient with a leaking major artery carrying blood from the heart, a car crash, a heart attack. All require immediate medical attention, and like all professional doctors and nurses, they give each patient the best possible treatment available. But how the two medics go about their business is enough to make The Flying Doctors, ER, and Casualty look insipid. For their patients, most in a critical condition, are not usually to be found in Hong Kong, but in the remotest parts of northern Asia. 'The rescue I did last month was up in Tibet where a Japanese lady suffered altitude sickness while climbing,' said Mr Taylor, the operations director of Swiss-based rescue company International SOS Assistance (HK) 'Her tour originated in Japan so the emergency call went to our Tokyo alarm centre. Tokyo then informed Beijing. The request was to get the patient down the mountain where she could stabilise.' After discussions with the treating doctor in Shiquan, in the northwest corner of Tibet (also part of the Himalayas), the diagnosis was altitude sickness complicated by dehydration. She was to be taken to Urumqi immediately. For Mr Taylor and his team, the rescue meant flying to Beijing from Hong Kong and then to Urumqi where they would get a helicopter to fly to Shiquan. 'Obviously, sourcing a helicopter took a day or so. During that time, SOS doctors and nurses were constantly in consultation with doctors up in Tibet to give appropriate medical advice and monitoring [via the phone],' he said. Mr Taylor, a registered nurse, and colleague Dr Rasmussen, are medics whose job is to give medical support to, and rescue, the growing number of expatriates who fall sick or are injured while travelling or working in the region. Both medics prefer this job to working in a hospital because it is more challenging. 'You never know who you are going to help next and because you are working without the support you get in the hospital, the constant change of environment is a challenge,' said Mr Taylor, who has previously worked in an intensive care unit. 'This job is also very rewarding.' Sometimes medical teams need to carry out operations, but mostly they give advice and assistance to doctors at the scene. They also usually fly the patient back to their home countries. International SOS Assistance is one of three major international rescue companies in Asia which offer to fly clients out of a country during a crisis, such as serious illness, an accident or political instability. It set up its offices in Beijing and Hong Kong seven years ago. Other rescue companies include AEA (Asia Emergency Assist) and SSA Assistance. Two years ago, International SOS Assistance had to airlift Dr Winston Chang Hsiao-tzu , the grandson of former Taiwanese president Chiang Kai-shek from Beijing to Taipei after he suffered a cerebral haemorrhage. According to Dr Rasmussen, a 36-year-old anaesthetist and the company's general manager, her office carries out one evacuation every three days on average. Some of these rescues have taken her team of medics to the remotest parts of the world. Last December they flew to Ulan Bator to save a 43-year-old woman suffering from an eating disorder. Since there were only two chartered flights to Ulan Bator a week, they hired a jet from Singapore because the patient's condition was deteriorating. The medical team arrived late the following afternoon. 'When we left Hong Kong it was 25 degrees and sunny. When we arrived at Ulan Bator it was around minus 10. But that was not the worst. When we left the next morning, it was minus 35,' Dr Rasmussen said. 'We flew to where the patient was. We knew she was in her 40s. But if you have an eating disorder like hers you look much older. When we first saw her, we thought there was a mistake because she looked 70. 'The patient had suddenly stopped eating and that had a major impact on her heart and kidneys. According to her blood test, she should have been dead. The hospital had done very well in keeping her alive and stabilising her. They had nothing up there.' When the medics arrived with their equipment, Mr Taylor said, Mongolian staff were amazed by the technology. 'The nurses and doctors were picking up the pieces of equipment, holding them up and looking at them and asked: 'How do you use them? Can we get something like this and can you leave us some?' They were friendly people,' the 28-year-old said. Apart from the logistical problems they encounter in China (getting a helicopter, landing permits and official approval can cause delays), a lack of information about a patient's condition can also hamper their work. 'Getting a complete picture of a patient, especially out of China, can be difficult,' Mr Taylor said. 'Treating doctors are reluctant to paint the full picture because it is very threatening to have some outsiders go in and say, 'we'll take over now and we will take your patient away'. 'We don't want treating doctors, who have tried their best, to lose face. But quite often they are very [selective] in the information they want to give because they don't want to expose themselves to further questions which they may not be able to answer.' Not knowing what to expect can make the flying medics nervous. 'Sometimes we have butterflies in our stomach when we go into the middle of nowhere in China to pick up a patient because we know the medical information given by a mainland hospital is not always reliable,' Ms Rasmussen said. 'Maybe the patient is in a much worse condition than we expected. It is not a glamorous job bringing patients out of China.' Another difficulty the flying doctors face during a rescue operation is when a patient insists on leaving a country - even though they are not fit enough to do so. 'We had this gentleman who had had multiple operations in the past and had a leaking aorta [major artery], an extremely rare medical condition and complication. It was like a time bomb as it could rupture without any warning,' Mr Taylor said. His family said the only place he could have the operation was in Houston, Texas, so the company had to fly him to Los Angeles in a commercial carrier and then transfer him to a private jet. 'Within 24 hours he was on the surgeon's table in Houston but we flew a time bomb from Hong Kong,' Mr Taylor said. Dr Rasmussen remembers how the family looked when she told them if the patient started bleeding, he would bleed to death and there was nothing she could do for him. 'They were shocked. But you have to be honest and up-front with people,' she said. Mr Taylor added: 'We are a profit-making organisation, but from an ethical point of view, we have to live with ourselves from a professional stance at the end of the day. 'Neither of us are willing to do something that will compromise the patient's life.'