EMS HELI PLT HAD PARTIAL ENG FAILURE AT VERY LOW ALT.

Narrative

MAKING AN ALT OVER AIRSPD TKOF OUT OF A CONFINED EMER SCENE; I ENCOUNTERED RAPID RPTS FROM ONE OF THE ENGS WITH A SIMULTANEOUS LOSS OF PWR. I LOWERED THE PWR AND CHKED AIRSPD AND ELECTED TO USE THE ALT TO ACCELERATE TO V/TOSS; AS THE AREA DIRECTLY AHEAD WAS NOT THE BEST ALTERNATIVE AND I COULD REACH V/TOSS BEFORE DSNDING BELOW CDP ALT. I WAS CLBING OUT AT REDUCED PWR BY 30 FT AGL. I CONTACTED APCH AND DECLARED AN EMER AS SOON AS ALL WAS STABILIZED. I ELECTED TO FLY DIRECT TO MY POINT OF ORIGIN WHICH IS MY BASE AT ZZZ. MY CHOICE OF EMER DEST IS THE REASON FOR THIS RPT. MY PERCEPTION OF THE SIT WAS THIS: 1) I HAD AN ENG PROB; YET COULD NOT IDENT WHICH ONE -- I JUST KNEW I COULD NOT PULL MAX PWR WITHOUT HAVING A MORE SEVERE PROB; AND I COULD NOT RELY ON 1 ENG. 2) I HAD MY CREW AND A PATIENT ON BOARD AND MY MAIN CONCERN WAS TO FLY THE ACFT AND SECURE THE SAFETY OF MY CREW; THEN THE SAFETY OF THE PATIENT. I HAD ELIMINATED THE FIRST PROB OF COMPRESSOR STALLS BY LOWERING THE PWR. I HAD AN UNRELIABLE ENG; YET ALL WAS UNDER CTL AT THE REDUCED PWR SETTING. I NEEDED TO DECIDE NOW WHERE I WAS GOING. MY CHOICES WERE ABC; 10 NM AWAY ACROSS HVY POPULATED AREAS. MIL AFB APPROX 5 NM AHEAD YET COORD FOR CONTINUED PATIENT XFER AND OTHER COORD PROBS; I PERCEIVED ZZZ COORD FOR EVERYTHING I NEEDED COULD EASILY BE ARRANGED WITH MINIMUM DELAY. I CHOSE TO PROCEED DIRECT ZZZ AND TO CHANGE MY DECISION ONLY IF THE SIT CHANGED. I FLEW OVER SPARSELY POPULATED; FORCED LNDG SUITABLE AREAS; STILL CLOSE ENOUGH TO MIL AFB; WITH INTENTIONS OF GOING THERE IF THINGS GOT WORSE. AFTER MAKING A SAFE RUN-ON; LOW PWR LNDG AND XFERRING THE CREW AND PATIENT TO AN AMBULANCE TO CONTINUE THE MISSION; I BEGAN TO REFLECT ON HOW IT COULD HAVE BEEN BETTER AND THE ONLY THING I CAN THINK OF AS MAYBE BETTER WOULD HAVE BEEN GOING TO MIL AFB WHERE THEY ARE PROBABLY BETTER PREPARED TO HANDLE AN EMER LNDG; AND WERE CLOSER TO THE OCCURRENCE SITE. I NEVER DISREGARDED THEM AS AN ALTERNATIVE AND LCL COUNTY FIRE AND EMS HAD MADE IT TO ZZZ BEFORE I DID.