Nov 20 2009, between 1300 and 1430 PST near Susanville CA, Chief Pilot, Chief Flight Paramedic and RN, FAR 91 with CFP in right seat. 70 knot sustained winds reported in area (?) unknown gusts in the mountains where incident occurred. Unknown what altitude.

Aircraft flew into severe turbulence, PIC and CFM both reported losing their headsets during the violent turbulence and the RN struck head on ceiling hard enough to bend the aluminum former and cause unconsciousness soon followed by projectile vomiting. An emergency was
declared, the aircraft returned to land and was met by Fire and EMS, RN transported in full spinal precautions to ER for assessment and CT scan for a possible closed head injury / probable concussion.

Same PIC/CFM/aircraft/different RN took another flight later the same day in the same general area and encountered sustained turbulence of almost the same intensity that prevented active patient care, tossed flight manuals and equipment around, and levitated crew and patient from seats/stretcher against seat belts repeatedly.

At this time it is unknown if reported to the FAA - required for damage to aircraft and injury causing hospital admission. Suspicion is that it will not be unless forced by FSDO 'visit'