I hate to be a Buzz Kill but I've seen the lack of Trauma Care/Protocols in Puerto Rico.
For everyone either working or on vacation in Puerto Rico here's my best advise;
Purchase or have OCONUS(Int'l) Air Ambulance Coverage as Puerto Rico is considered by some carriers as International.
I've seen 3 run-of-the-mill trauma cases that ended with unbelievably bad outcomes, (1 death and 2 ended up maimed/crippled, all separate incidents).
If injured while in the U.S. Islands; get stabilized and then Medivac'd to Miami ASAP, (this also applies to the USVI, St Thomas, St. John & St. Croix).
I wish Rosey Roads was still Active, as their hospital was able to stabilize trauma cases and their Navy Docs were good and the airfield was a 3 min drive to the waiting hot turbines
, (for those that had Mil Access/Bennys).