Expense is also a huge factor - each airlift costs approx $30K. If it is a tossup between 2 hospitals - the closest would be the first choice (IMO). Not sure that either a Trauma 1 or a Trauma 3 would matter in the cases of the 2 girls who have died. Honestly, a .40 caliber @ close range to the head is not going to be a good outcome. Nate got very lucky as he was shot in the jaw. I think his brain was spared from the trauma that the others endured. Brain trauma is a very tricky thing. I once knew someone who hung themselves and had brain swelling - he lived through the ordeal after hospitalization, ICU, and near death. He lost his times tables initially and gained a tremendous amount of rage and a further criminal history in the longterm outcome. Many family members were so excited that he came out of the coma and brain trauma, but they didn't like the person he became over the years due to the brain damage suffered.