Since then the charity, which relies entirely on donations, has completed more than 22,000 missions, making a difference to thousands of lives across the region.
These pictures are just a snapshot of some of the highlights during the past 21 years.
9.
Estate Agents hand over a cheque for 500 to the Air Ambulance crew
10.
North West Air Ambulance in action
11.
Doreen Rigby and daughter Viv Greenwood managed to have a photo taken when the Air Ambulance landed in Bamber Bridge. Doreen had asked for donations to the Air Ambulance for her 80th birthday, raising 760
12.
Colin Sigsworth, Andrew Stevens, Steve Campbell, Alan Rimmer, Phil Owen and Simon Thomas from Huntapac in Tarleton before the three peaks challenge to raise money for North West Air Ambulance