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The size of the airport is relative; what may seem big in one locale may not be so big compared to Cleveland Hopkins Airport or Boston's Logan Airport, which have fine emergency services available.
But with smaller airports, there may be nothing more than a fire extinguisher available. Even if the field is operating a Part 135-airplane charter, the airport still isn't required by the FAA to supply emergency equipment. There may even be a question of who has jurisdiction over the field as far as fire department support or ambulance services. Locally, there could be a lot of private ambulance companies competing. Fortunately, most accidents that happen are minor. For example, someone may forget to put their landing gear down or runs off the edge of a runway. But for serious accidents, there may not be any immediate help. Before traveling on an air charter, you have the right to ask these important questions for your safety and the safety of the flight.