Travis County, Texas air ambulance operator STAR Flight commenced AW169 EMS helicopter operations in the summer. Its three AW169s are the first in service in the US and support the company's 24/7 helicopter EMS provision in Texas, a role that includes highly specialised rescues such as emergency medical transport, still and swift water rescue, search and rescue, high angle rescue, fire suppression/aerial reconnaissance and law safety assistance. The company also transports neonatal, pediatric ICU and high risk obstetrics medical teams and patients. Its fleet of AW169s is equipped with a rescue hoist and 300-gallon Simplex belly tank for fire suppression.

Travis County presents many geographic challenges for rescue crew. Known as 'flash flood alley', it is the number one location in the US for flash flood rescues as its many lakes and rivers often make access to patients difficult and remote. The AW169 EMS helicopter provides more power and range than competing light-intermediate twin engine models and can transport up to two patients and five medical personnel plus critical care equipment. Flexible interior layouts provide 360 degree patient access and wide doors offer smooth and efficient patient loading, while a roomy baggage compartment stores extra equipment and stretchers. Large windows support emergency egress.