The executive in charge of Airlift Northwest said she was puzzled when first responders at the scene opted to transport patients by ambulance instead of helicopters that were hovering nearby.

And the head of trauma at Harborview Medical Center in Seattle said she wonders why patients weren’t sent immediately to her hospital.

All four wounded victims were taken by ambulance to Providence Regional Medical Center Everett, which is about 8 miles from the high school. It is a Level II trauma center. Two later were transferred to Harborview, which is 38 miles away by highway and 10 to 20 minutes by air. It is the region’s sole Level 1 trauma center.

Their concerns were first reported by The Seattle Times on Tuesday.

Greg Corn, chief of the Marysville Fire District, said that while helicopters were available, “Patients were already loaded in medic units for transport.”

“Even if the helicopters were hovering at the high school, it would have taken at least ten to fifteen minutes to set up a landing zone and transfer the patient to the helicopter,” he said in a statement Tuesday.

Timelines provided by fire officials and Airlift Northwest support Corn’s analysis. Ambulances  began departing the high school about the time two helicopters arrived overhead. The ambulances arrived at Providence within 10 to 12 minutes.

Still, Chris Martin, executive director of Airlift Northwest, said the helicopters might have saved time, even for the trip to Providence.

“It just seems like to all of us, a school shooting with multiple victims, it was just odd that both helicopters were turned away” without even landing, she said.

Meanwhile, Dr. Eileen Bulger, the chief of trauma at Harborview, wondered why it wasn’t involved in early treatment.

Harborview, she said, was ready with a team that included a pediatric trauma team and other pediatric specialists. All four patients were teenagers.

While she has questions, Bulger said she didn’t have enough information to know if Harborview specialists could have made a difference in the outcome for the patients.

“We’ll have a meeting with everyone involved, the emergency medical services, the airlift team and the hospitals to debrief the incident,” Bulger said. “That will allow us to have a better sense of what factors” went into the decisions.

At about 10:39 a.m. Friday, Jaylen R. Fryberg, 15, shot his five friends in the M-P cafeteria with a handgun. One friend died at the scene. Then Fryberg shot himself fatally in the head. That left four wounded in need of urgent medical care.

Medics were on the scene at 10:49 a.m. after police determined it was safe. By 11:25, all four patients had arrived at Providence — the first at 11:10.

Corn said the decision to transport those patients by ambulance was made by the incident commander, a fire department battalion chief, based on direction from Providence. “That comes out of Providence’s emergency room,” he said.

Dr. Eric Cooper, the medical program director for Snohomish County emergency medical services, said that given the number of patients and their injuries, Providence “thought this would be the quickest way to move unstable patients to the hospital.” Cooper works as an emergency-medicine specialist at Providence.

“They were able to start moving the patients from the scene to the hospital pretty quickly,” Cooper said.

Corn said he was “a little surprised” that Providence said they could take all the patients. “That being said, we’d heard they had two neurosurgeons at the hospital at the time and a third one readily available. I think … the hospital thought they could take care of them.”

Asked if it would have been better to transport the patients by helicopter to Providence, Corn said, “not necessarily.”

Corn said he thinks an examination of the response is appropriate. “Anything we can do to better treat our citizens and patients, we want to learn from,” he said.

Providence declined requests for interviews on Tuesday but issued a statement from Dr. Joanne Roberts, the hospital’s chief medical officer. It said in part:

“Our EMS colleagues are experts in assessing the frontline situation in a mass-casualty and taking appropriate action. As with every mass-casualty, we will participate in the standard debriefing process at the appropriate time.”

Three of Jaylen Fryberg’s five victims are still hospitalized. Zoe R. Galasso, 14, was shot in the head and died at the high school. Gia Soriano, 14, died Sunday night at Providence. Shaylee Chuckulnaskit, 14, is in critical condition at Providence. Andrew Fryberg, 15, is in critical condition at Harborview. Nate Hatch, 14, is in satisfactory condition at Harborview. Andrew Fryberg underwent surgery at Providence, then was transferred by helicopter to Harborview. Hatch’s ambulance was sent to Harborview three minutes after it arrived at Providence. His wounds were less severe.

Last weekend, after Gia Soriano, died at Providence after organ donation, her family was unequivocal about their opinion of the care she received there.

“Thank you to Providence for their excellent care — bar none — from beginning to end,” the Sorianos said in a written statement. “Thank you to our friends and family who have supported us. Thank you to Drs. Bill Finley, Sanford Wright and Anita Tsen for their tremendous support and compassion.”

Here is a timeline of activity of Marysville Fire Department medics and Airlift Northwest helicopters on Friday after the shootings at Marysville Pilchuck High School. This account combines timelines provided by SNOPAC, the emergency dispatch center for much of Snohomish County, and Seattle-based Airlift Northwest. Where there are discrepancies, two times are cited.  Patient names are included based on earlier Herald reporting about their treatment at Providence Regional Medical Center Everett.

10:39 a.m.: Marysville firefighters are dispatched to a general fire alarm at Marysville Pilchuck High School.

10:42: Dispatchers add a request for a medic unit upon word that it is a shooting at the school.

10:44 or 10:45: SNOPAC alerts Airlift Northwest to be ready to respond to a school shooting with multiple victims, including gunshot wounds to the head.

10:45: The Airlift 2 helicopter is dispatched from Boeing Field in Seattle and told to fly toward Arlington Municipal Airport, a few miles north of the high school, where another chopper is stationed. That aircraft, Airlift 6, is away on another emergency call.

10:47: Airlift 5, based in Bellingham, is directed to fly south to Arlington.

10:49: Emergency medical crews are cleared by police to enter the high school’s cafeteria where the shooting occurred.

10:49: Medic unit 63 is on the scene.

10:50: Medic units 1 and 61 are on the scene.

10:54: SNOPAC asks that Airlift 2 “fly to the ballfields of the Marysville Pilchuck High School.”

10:55: SNOPAC requests that Airlift 5 also head to the ballfields.

10:57: Marysville medics are advised that there are now three helicopters in the Arlington area. (By Airlift’s accounting, there are only two in the vicinity.)

10:58: Medic 61 departs the high school with the first patient and arrives at Providence Regional Medical Center Everett at 11:10 — a 12-minute drive.

11:05 or 11:06: SNOPAC tells Airlift Northwest to cancel Airlift 5.

11:07: Medic 63 departs the scene with a second patient, arriving at Providence at 11:19 — a 12-minute trip.

11:07: While hovering above the high school, Airlift 2 is canceled. Both aircraft head back to their bases.

11:10: Medic 1 departs the high school with a third patient, arriving at Providence at 11:20 — a 10-minute trip. Three minutes later, that unit departs Providence for Harborview Medical Center in Seattle, arriving there at 12:01 — a 38-minute drive. This patient is Nate Hatch, 14, whose jaw wound is less severe than the others’ head wounds.

11:14: Aid 61, a medic unit, departs with a fourth patient, arriving at Providence at 11:25 — an 11-minute trip.

11:23: Providence requests that a helicopter be on standby on its helipad.

11:43: Airlift 6, back in service, arrives at Providence from the Arlington airport.

12:17 p.m.: Airlift 6 reports that it has been released from the hospital and is returning to base in Arlington.

1:35: Airlift 6 is asked to return to Providence to transport someone to Harborview Medical Center in Seattle. This patient is Andrew Fryberg, 15, who has undergone surgery for a gunshot wound to the head.

1:52: Airlift 6 flies back to Providence.

2:35: Airlift 6 leaves for Harborview, arriving at 2:45 — a 10-minute trip.