Saturday, June 25, 2011

Angels in the Air

You see them criss-crossing the sky. Medical helicopters buzzing overhead like hummingbirds juiced up on performance enhancing drugs, racing to an accident scene. They arrive to an accident site of horrific carnage, angels of mercy that often mean the difference between life and death for the unfortunate.

What is it like to be that person, that angel, that can mean the difference between life and death?

I was fortunate to spend a day with the crew of Life Flight 1 to find out.

Life Flight 1 is one of five air ambulances that serve Vanderbilt Medical Center in Nashville, one of the premier hospitals in the country. Life Flight 1 is based at the Lebanon Municipal Airport 20 miles east of downtown Nashville. Vanderbilt has four helicopter bases strategically positioned around Nashville as well as a fixed wing aircraft that is based at the Nashville airport. In total, they employ 40 crew members and 12 pilots.

I arrived at the crew base at 7:00 a.m. to meet the crew that was coming on duty. There I met flight nurses Chris Rediker, Kim Toungette, pilot Jim Holt, and mechanics Alan Warden and Terry Jones. The first thing that was apparent in our introductions was the professionalism of the crew. They spent a few moments describing what we would be doing that day and then proceeded to take me out to the helicopter for a safety briefing.

Mechanic Alan Warden, Flight Nurse Chris Rediker, Flight Nurse Kim Toungette, Pilot Jim Holt, Mechanic Terry Jones
During the safety briefing, it became apparent that the helicopter we see gliding gracefully through the sky is a high risk operation. I was told what to do in the event of a hard landing and the evacuation procedures. After the briefing, I knew how to knock out the windows and, unless the aircraft was on fire, to take a moment to "wind my watch". This meant that it would be good to wait until the rotor was through spinning before I tried to exit. I was told what would happen if I was riding if front with the pilot and there was an imminent bird strike. I also knew about a "sterile cockpit", meaning that no one talked when the pilot was taking off and landing, which are the most high risk legs of any flight.
During the take off and landing procedures at an accident scene, the pilot involves the flight crew to survey the landing zone. It was interesting to me that any member of the flight crew could waive off a landing at a landing zone if they did not feel comfortable with the safety of setting the aircraft down. The fight crew is involved with the pilot to observe and spot any hazards on take off and landing, such as wires or overhanging tree branches. If any member of the crew deems the landing zone at an accident scene unsafe, they will find an alternate landing area. Safety is paramount during a flight operation, first for the crew, then for the patient.

Pilot Jim Holt doing a pre-flight walk around
Once the safety briefing was complete, the flight nurses essentially take apart the  the back of the aircraft as they inventory their equipment and supplies. As Chris Rediker aptly described the back of the helicopter, it is a flying emergency room. There are very few functions that cannot be performed in the back of the helicopter that cannot be performed in a hospital emergency room. The design of the back of the helicopter is exquisite and with the care of the patient as the priority.

The patient stretcher is on the left, and although mounted to the floor, can be moved for access by the nurses. Three flight crew can ride in back with the patient. The duffel on the stretcher carries medical supplies. A heart monitor is mounted on the left wall. Oxygen, in liquefied form, is carried under the aircraft. Patients are loaded in from the back.

As Chris and Kim did their inventory and went through their checklist, Chris told me that they want to standardize their procedures and preparation since they never know what they will await them when they get to an accident scene. "What we try to do is have order in the helicopter, because the world we go into is chaos," said Chris.

Once on the scene of an accident, the flight crew will take over the treatment of a patient from the first responders. They will do necessary procedures on the ground, such as intubation, before loading the patient onto the helicopter for transport. Doing some procedures on the ground is easier for the nurses rather than having to do them in the air. Although the helicopter is state of the art, there are still space limitations, not to mention that the aircraft can encounter turbulence during the flight.

Nashville from the north, ten miles out
We made a run from the base to Vanderbilt Hospital mid morning. The air frame, an EC-145 is powered to twin 750 horsepower engines and is an amazing machine. On this flight, I rode up front with the pilot, Jim Holt. Holt has 42 years flying experience in helicopters and is a consummate pilot. Seeing the controls up close and all the things a pilot of a helicopter has to pay attention to, I was glad I was riding with someone of his experience. As he spooled up the engines and we lifted off, he said the take off would be "squirrely" because of a strong tail wind. I did not realize the effect the wind would have on a helicopter, but it is a factor. Holt deftly maneuvered the helicopter into the wind and we quickly ascended to our flight altitude of 2500 feet. 
Life Flight 1 often has to fly across the airspace of Nashville International airport. I was surprised to learn that their flight has priority over any other aircraft, even Air Force 1, and often will fly right across the middle of the airport during peak flight times. According to Holt, they have a very good working relationship with the Nashville controllers, and the tower will direct them to an appropriate altitude, often landing or taking off planes under their flight.
  Downtown Nashville from 2500 feet
Holt is a calm, professional presence in the cockpit. There were several storms building in intensity during the flight, and he was attentive to those as well as all the other responsibilities of flying the aircraft.
  On approach to Vanderbilt Medical Center. The helipad is in the center of the picture

We will land on the helipad on the right. The hospital can handle two helicopters at once. Patients are taken into the hospital via the ramp on the right of the helipad. The flight operations center is directly under the helipad where you see the windows.
Getting ready to land.
The safety aspects of the helipad are numerous. There is a fire suppression system that sprays fire retardant foam. There are speakers that can be heard over the roar of the helicopter to communicate with the crew should communications outside of the helicopter be necessary. The guiding principal of the Life Flight operation is safety.

Holt adroitly set the helicopter down in the swirling winds, after after a brief stop, we were on the way back to the crew base.

After take off, we swung over the Vanderbilt football stadium on out turn out. If you look closely, you can see our shadow at 4:00 from the logo at the center of the field.
Once back to the base, I had an opportunity to visit with Flight Nurses Chris Rediker and Kim Toungette. I asked them why they chose to do this line of work, and they both said they wanted the challenge and the ability to improve themselves as professionals. That is a striking characteristic of all the people that I met on this day. They are professionals in the truest sense of the word. They are constantly seeking to improve their craft and deliver the best care to the patients they serve. Their work is challenging, and they thrive in meeting the challenges they face.
In the front passenger's seat
This brief time with these professionals makes me appreciate even more so the service they render. The next time I see a Life Flight helicopter cruising over the trees, I will have an understanding of what the crew is flying to do.
For those that need them, they are Angels in the Air. 


1 comment:

  1. So, so cool! It's always fascinating to see people who are truly dedicated to their craft, no matter what it is.