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Risking Lives to Save Them: On Board a Medical Rescue Chopper
03/21/2013   Reported By: Patty B. Wight

One of the most dangerous jobs in the U.S. is working aboard a medical helicopter. Many are for-profit companies, which critics say can put pressure on crews to make decisions on whether to fly based more on finances than on safety. A medical helicopter accident in here in Maine 20 years ago spurred the creation of a statewide nonprofit rescue helicopter company called LifeFlight. Patty Wight has this profile of an organization that's taken steps to assure safety.

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LifeFlight helicopter

A LifeFlight helicopter returns to Central Maine Center in Lewiston after responding to a call.

Working as a crewmember of a medical helicopter is intense. To be ready for any acute medical emergency that comes your way, you need to take care of the daily basics - like eating.

"I am going to have cheddar, ham, onion and peppers," says LifeFlight nurse Sam Schaab, who is ordering an omelet at the Central Maine Medical Center cafeteria in Lewiston. CMMC is where one LifeFlight crew is based; the other is in Bangor. But the emergency calls they get take them across Maine and to other New England states - and sometimes, Canada.

"Because we never know where we're going to be or when we're going to be there," he says. "We eat as frequently as we think about it, - because it really stinks to be in Vermont at 3 o'clock in the afternoon and you haven't eaten breakfast or lunch yet, which is what happened to me last week."

LifeFlight's Sam Schaab en route to a callLifeFlight responds to about 1,500 critical medical calls a year - from blunt trauma and cardiac events to burns and poisonings.

"I think people really would be surprised at the level of care that we're able to provide in a helicopter at 150 miles an hour," says Schaab (left, en route to a call.) "I think lots of times we're looked at as just a vessel that transports patients."

A LifeFlight helicopter is more like a mobile intensive care unit. On board there's IV pumps, ventilators, and monitors, not to mention medication and blood units. They even have an incubator for babies. All of this - plus a pilot, a nurse, a paramedic, and up to two patients - fit in a space about the size of a Smart Car. And they're ready to go at a moment's notice.

"When we get a flight a request, we're blinded to the nature of the call," says flight paramedic Jeremy Nadeau says the crew is only told whether the patient is inside a facility or outside, and how much the patient weighs. Not knowing who is hurt, or how badly - takes some of the emotion out of the decision to accept or reject the request, based on flight conditions, including weather.

If they do accept, there's an additional safety measure that gives a crew member veto power. "It's a three-to-go, one-to-say-no policy," Nadeau says. "At any time, any crew member can turn the flight around." No questions asked. Nadeau says it happens a lot. The flight takes off, the weather deteriorates and someone gets a bad feeling.

But on this day, the weather is fine and the crew accepts the trip. Within minutes, the LifeFlight helicopter, piloted by Pat Giarrizzo takes off. "Okay, got two to fly, doors are secure, you all set back there?"

Once they're in transit, they find out the nature of the call. "LifeFlight 2 going for a 91-year-old female, 150 pounds," they're told.

The crew learns that a woman is having a heart attack at a rural hospital which isn't equipped to put a stent in her heart, so LifeFlight will bring her to CMMC. In just over 15 minutes, the chopper is on the ground and nurse Sam Schaab greets the patient.

"Did they tell you you're having a little bit of a heart attack?" he asks.

"Yup," she responds.

"Where we're taking you, they're going to put you on a table, go in and see what's going on and fix the blockage," he tells her. "And then you can have dinner."

After a quick assessment, they load the patient for the trip back to CMMC, where doctors are waiting.

"We're part of the fabric of the system, but you might consider us the glue," says Thomas Judge, the executive director of LifeFlight, and one of the people who created it 15 years ago.

LifeFlight was born out of a tragic medical helicopter accident in 1993, when a for-profit company decided to fly in bad weather, and the helicopter crashed in Casco Bay. The paramedic, nurse, and patient died. The pilot survived. "That was a show stopper for many years," Judge says.

Judge says safety standards for helicopter EMS vary across the country, but the creators of LifeFlight say they created a system that revolved around patient care and safety, versus the bottom line. LifeFlight accomplishes that in a number of ways. It's an independent non-profit with physician oversight. A separate foundation raises money to provide the best safety equipment - like twin-engine helicopters and night vision goggles.

It has also set up monitoring equipment across the state to give pilots more accurate weather data. And lifeflight has cleared landing areas in the remote North Woods, to ensure they can provide the same access to care to anyone across the state.

"No one wants to think of the bad things that can happen in the world and the uncertainty that things can go wrong," Judge says. "But they do trust - and we've done studies around this - that someone will show up. They never think about what that actually means and how complicated it is."

Air medical service can have a high burnout rate. The work and the hours are intense. But paramedic Jeremy Nadeau says he chose this job precisely because of the intense level of care he can provide.

"I've been present for some pretty horrific - and pretty amazing - things in people's lives, and to be that close to it and to be able to intervene and help is a privilege," Nadeau says. "And you can't explain it unless you do it."

It's something the LifeFlight crew does 24 hours a day, 365 days a year. As the crew relaxes after their first call, another one comes in. The weather is still good, and they decide it's a go.

Photos by Patty Wight.


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