MedFlight of Ohio’s crews of specially trained flight nurses and paramedics are the “Top Guns” of emergency and critical care medicine. They are called to transport the “worst of the worst” when seconds count.
At any time of the day or night, a crew from MedFlight can be called to pick up a critically ill patient across town or even another county.
However, they are most often called to save the life of someone nearby. On a Sunday, the MedKids specialty team of two neonatal-pediatric nurses was requested to transport a premature baby from Athens to Children’s Hospital in Columbus. High winds in Columbus kept the helicopters on the ground that day, but the staff was able to use a King Air 90 airplane configured for medical transport to reach Athens. After transferring equipment usually found in a hospital neonatal intensive care units into a waiting ambulance at the airport in Athens, they rushed to the hospital to pick up the newborn whom they took to the airport and then to Columbus Children’s Hospital.
“The patient was too small to be managed by their hospital. The baby would have died in the next 15 minutes if the MedKids crew would not have been there. The team was able to stabilize the baby’s airway and blood pressure and complete the transport,” said MedKids team leader Kathy Warlick, a registered nurse.
“MedKids is one of very few dedicated neonatal-pediatric teams like it in the country and the only one in the state. Within 15 minutes of a call, we can be in a helicopter, airplane or mobile intensive care unit and on the way. MedKids is a very conscientious group, if a child is sick, the whole family is sick. You need to treat everyone. So there is a lot of parent interaction, and we try to bring a parent when we can,” Warlick said.
Employing five helicopters, a fixed-wing airplane and six mobile intensive care units on the ground, MedFlight, with its eight bases statewide, provides a one-stop shop for nearly 8,000 runs annually. The Ohio State University Medical Center and Grant/Riverside Methodist Hospitals are owner members of the program, along with Akron General Medical Center as a sponsoring member. The OSU hospitals received more than 2,000 patients in its emergency department and other critical care areas last year from MedFlight.
“If you need us, we can get to you somehow,” said MedFlight helicopter pilot Dan Hovermail.
All requests for transport are received at MedFlight’s state-of-the-art communications center located in its main base on the north side of the OSU airport. The base also serves as administrative offices, a maintenance facility and a home to the airplane, three MICUs and a helicopter.
For physicians and emergency service personnel, choosing the most appropriate mode of transport is as critical as their patient. The helicopter is used for rapid transport direct from the scene of an accident or for a transfer between hospitals when seconds count. The helicopters are based in Columbus, Marysville, Wellston, Coshocton and Lodi, Ohio.
A MICU is used for patients that need a transfer to another hospital, but are more stable and can endure a longer time outside of the hospital. MedFlight bases its MICUs in Columbus, Wooster, Nelsonville and Marion, Ohio.
The airplane, based in Columbus, is used for long distance transports, typically between states. However, it can occasionally be used at times when the helicopters are grounded by bad weather. A jet aircraft can also be accessed quickly when a request is made to transport from another country to the United States.
All three modes of transportation are equipped and staffed the same, but there is a large difference in cost. A typical 50-mile transport would cost approximately $3,800 in a helicopter, $2,500 in the airplane, and $1,300 to $1,800 in a MICU. While these costs are usually handled as a hospital charge is for a patient, MedFlight works hard to educate physicians about how to use the most appropriate and cost effective mode.
However, the helicopters are what most people associate with this kind of medicine.
As students see MedFlight helicopters fly over campus on a regular basis, few stop to consider what those on board might have just gone through. Pilots are often faced with landing in areas surrounded by trees, light poles and power lines and other places not accustomed to helicopters landing. After landing on scene, it is not uncommon for a flight team member to climb inside of the crumpled wreckage of a car. They do this to begin assessing their patient’s ABC’s: Airway, breathing and circulation, even as they are being extricated from a vehicle.
While their green Eurocopter BK117 helicopters are probably best known for swooping down to pick up accident victims, these missions are only a small part of what they do.
About 70 percent of helicopter transports are from one hospital to another one that can provide more appropriate care, the remaining 30 percent of the transports are the scene flights, said Todd Bailey, director of marketing for MedFlight.
Many of the hospital-to-hospital transports originate from rural facilities that cannot offer the same resources as a large urban hospital. Accordingly, the helicopter base located in southeastern Ohio in the small rural town of Wellston is one of the busiest in the country, completing more than 1,100 flights in 1999.
“MedFlight is an incredible resource that affords everyone in the region the same resources as they would have if they lived in Columbus,” said Dr. Howard Werman, MedFlight medical director and associate professor of emergency medicine at OSU.
Cambridge is one community that benefits from MedFlight’s services. Located an hour east of Columbus, Cambridge’s 113-bed hospital, Southeastern Ohio Regional Medical Center, covers most specialties, but cannot meet the needs of patients requiring the highest level of critical care. Cardiac patients are the most commonly transported, but SORMC also sends those requiring advanced trauma care, neurosurgery, and large amounts of blood to Columbus, Sarap said.
“Most of the time it is a life or death difference,” said Dr. Mike Sarap, chief of surgery at SORMC.
Sarap said that MedFlight MICUs and helicopters transport patients from SORMC almost every day. When it is available, the helicopter based in nearby Coshocton can arrive at the hospital in 10 minutes. After being briefed with the patient’s history and then loaded through the BK117’s clamshell doors in the rear, a Columbus area hospital is only a short, 25-minute flight away at 150 mph.
“The quality of MedFlight’s crews provide patients the most expert care they can receive. I have monitoring equipment in my helicopter that some smaller hospitals do not have. We have the best equipment on the market and we get certain new things first, before some hospitals,” said Sally Betz, director of the trauma program at the OSU.
Betz, who has also worked as a flight nurse since 1988, said that working with MedFlight has made her more innovative in emergency situations which require rapid decisions and actions.
“You are stabilizing and resuscitating the patient, it isn’t like in the ER where if you have a problem starting an IV you can have somebody help you. It is only you and a flight paramedic up there, you have to get the job done,” Betz said.
