MEDEVAC ACFT USES WRONG ALTIMETER SETTING. ALTDEV.

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MEDICAL EVAC FLT (MEDEVAC). BET-MRI. 2 PLT CREW. DURING THE FLT; THE MEDICAL CREW WAS VERY WORRIED ABOUT THE PATIENT'S CONDITION. THE FLC HAD TO INITIATE RADIO CALLS AND RELAY MESSAGES BTWN THE HOSPITAL AND THE MED CREW. AS THE FLT PROGRESSED THE MEDICAL CREW BECAME INCREASINGLY DISTRESSED. THERE WAS A LOT OF NOISE AS THE BLOOD COVERED DOCTOR YELLED INSTRUCTIONS TO THE NURSES. THIS WAS DISTRACTING TO THE FLC. APPROX 20 MIN PRIOR TO LNDG OUR DEST ARPT WENT BELOW LNDG MINS (SPECIAL VFR). THE FO WAS TAKING CARE OF ALL ATC COM AND I WAS TALKING TO COMPANY AND THE HOSPITAL ON THE OTHER RADIO. THE FO TOLD ME THAT WE WERE CLRED FROM FL210 TO 14000. WE BEGAN DSCNT AND ACCOMPLISHED THE IN RANGE CHKLIST. PASSING FL180 WE SET ALTIMETERS TO 29.89. THE RADIO TFC BECAME VERY BUSY NOW AS WE TRIED TO COORDINATE OUR PLANS WITH THE HOSPITAL. A NURSE CAME FORWARD TO THE COCKPIT TO DISCUSS OPTIONS WITH THE HOSPITAL. OUR DEST WAS THEN CHANGED FROM ANC TO AED (ELMENDORF AFB). THE FO THEN COPIED THE AED ATIS WHILE I REQUESTED PERMISSION TO LAND FROM BASE OPS. WE LEVELED AT 14000 AND I ASKED THE FO TO READ THE AED ATIS TO ME. WHEN THE FO READ THE LCL ALTIMETER SETTING AS 28.89 I ASKED HIM TO RECHK THE ATIS (WHILE I LISTENED). THE LCL ALTIMETER WAS 28.89! I RESET MY ALTIMETER AND BEGAN A CLB BACK UP TO 14000. I ASKED THE FO TO NOTIFY ATC OF OUR INTENTIONS AND TO TURN OFF ALL NON-ATC COM RADIOS. WE PROCEEDED TO AED AND LANDED. POST-FLT: WHEN I ASKED THE FO HOW HE COULD HAVE MISSED THE LOW ALTIMETER SETTING. HE REPLIED 'THE ATIS AT MRI LACKED THE NORMAL PHRASEOLOGY; ALTIMETER LOW LOW 28.89.' CONTRIBUTING FACTORS: FATIGUE - - THE FO WAS OUT OF HIS NORMAL SLEEP CYCLE. HE WAS FILLING IN WHILE THE FULL TIME NIGHT MEDEVAC FO WAS ON TIME OFF. WE HAD FLOWN ANOTHER FLT SEVERAL NIGHTS BEFORE AND THE FO SAID THAT HE HADN'T DONE WELL WITH ALL THE SCHEDULE SWAPPING. I ALSO HAD NOT SLEPT MORE THAN SEVERAL HRS IN THE PREVIOUS DAY OR SO. ALTHOUGH WE WERE LEGAL TO FLY AS THE FARS ARE CONCERNED WE WERE FATIGUED. PHRASEOLOGY: I LEARNED IN A CONVERSATION LATER THAT DAY WITH AN ATC CTLR THAT THE USE OF THE PHRASE 'ALTIMETER LOW LOW' IS NO LONGER REQUIRED WHEN RPTING ABNORMALLY LOW ALTIMETER SETTINGS (PRETTY STUPID; HUH?). I BELIEVE THAT; IF THE FO HAD HEARD 'LOW LOW' THIS ALTDEV WOULD NOT HAVE HAPPENED. ACFT CONFIGN: THE COM RADIOS USED BY THE MEDICAL TEAM ARE IN THE COCKPIT. THE MEDICAL CREW MEMBER MUST KNEEL BTWN THE PLT SEATS; TALK ON A HAND MIKE; AND LISTEN ON THE OVERHEAD SPEAKER. THIS SYS WORKS QUITE WELL NORMALLY; BUT DURING TIMES OF HIGH COCKPIT WORKLOAD IT CAN BE VERY DISTRACTING. WE; OF COURSE; ONLY ALLOW THIS KIND OF COM TO GO ON ABOVE 10000 FT. THERE IS NO COCKPIT DOOR TO ISOLATE THE FLC FROM THE NOISE AND CHAOS THAT HAPPENS IN THE BACK OF THE AIRPLANE DURING A MEDICAL EMER.