RALEIGH, N.C. — What do Durham, Orange, and Pitt counties have that Wake County does not -- air ambulances. Wake County has no air emergency service. WakeMed wants to add a helicopter to its ambulance fleet, but on Tuesday, the state denied its request.

Holly Springs Mayor Dick Sears led an effort by the Wake County Mayor's Association to get an air ambulance and lost.

"If you have, God forbid, a heart attack in Wendell, two, three, four or five minutes could be a matter of life or death," Sears said.

WakeMed has the helipad and wants the chopper to go with it, but the state, citing a law which prohibits two air ambulance services within 60 miles of each other, denied the request.

"Times have changed. The laws that we're dealing with are 25 years old and have not been modified in that time," said Dr. Bill Atkinson, chief executive officer of WakeMed.

The law does not apply to Duke and UNC's Carolina Air Care helicopters because they were grandfathered in when the law was adopted. Atkinson said WakeMed's Trauma and Heart Centers are among the biggest in the state, so the need is there.

"It's long overdue -- this type of service in Raleigh," Atkinson said.

Duke Hospitals disagrees and sent a letter to the state last November arguing that another helicopter program simply is not needed.

"It doesn't make any sense to me. I think there are some politics involved here," Sears said. "I think there are a few other issues, but we're going to get through all that."

The law-of-need only applies to trauma centers, not to heart centers. Atkinson said WakeMed will ask lawmakers for assistance with getting a helicopter.