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Like an Angel Descending from the Heavens

A series of retrospectives called Our Stories has been airing on local news station WBIR. These have been very fascinating to watch ... triggering old memories and telling tales of things I did not know. The most recent one though, holds special interest for me:

(Dr. Robert) Lash was a licensed pilot and realized the advantages of aeromedical transport early on. In the 1970s, he'd often borrow aircraft to assist in emergency operations.

However, he dreamed of permanent air ambulances. In 1984, his dream came true with the delivery of the first helicopter ambulance to UT Medical Center.

It was outfitted through a design by Lash himself, who christened it Lifestar, an abbreviation for Life, Shock, And Trauma Aeromedical Rescue.

Be sure to watch the video that accompanies the story too.

In the years I spent in EMS, I came to herald the arrival of Lifestar as nothing less than a godsend. Calling her out was reserved for the very most dire trauma cases, ones that needed high level trauma care within minutes, and ground transport would take too long. In emergency medicine, there is this thing called the Golden Hour. When the human body is fubar'd, every second counts. For the greatest chances of recovery, the patient must be on the surgeon's table within one hour, and the clock starts at the moment of injury. After the hour expires, the patient declines rapidly. When you're a paramedic working in a remote county and the nearest ER is a 45 minute ride, even with lights and sirens, and the trauma center is a further 15 minutes beyond, the response of an aeromedical helicopter can make the literal difference between life and death.

On the scene of a major trauma, the actions of the Paramedic, EMT and any peripheral helpers - First Responders, Firefighters, LEOs - become a improvised dance at the direction of the paramedic choreographer. Everyone knows their roles, they simply wait to be told what to do. The medic is the decision maker, and the rest defer to him or her without question. In a major trauma, if the location is at all remote, or traffic conditions marginal to poor, the first decision to be made is whether to go by ground or by air. Most often, from scene reports via dispatch, if it sounds bad enough, the en route medic can have Lifestar go on standby. This gets the crew ready to go, up to the point of starting the helicopter engines. There are so many variables that can go into the decision, I cannot list them all here, but the decision is made within seconds.

Once launched, Lifestar will be on scene in its response area generally within 10 - 15 minutes or less. During that time, the ground EMS personnel work to achieve initial stabilization of the patient - ensuring a patent airway, initiating oxygen therapy and an IV, and divesting the patient of all their clothes. Firefighters and LEOs are charged with setting up the LZ - Landing Zone and ensuring its safety. Firefighters also standby with water hoses at the ready ... just in case. Sometimes the patient has to be transported by ground to the LZ, sometimes the helicopter can land right at the scene or very close by.

While working on the patient, the approaching thump-thump-thump of the rotors powered by Bell 430 dual Rolls Royce (Allison) turboshaft engines grows louder and louder, until you can feel the vibration in your bones. It seems to touch something almost primal. As it lands, the engine and rotor noise drown out all other sound, the medic must communicate with her team via eye and hand signals. Care must be taken to secure all objects from the rotor wash, not only can these become flying missiles and injure people, things can also get sucked into the rotor blades and render the helicopter useless.

The patient is packaged onto a Lifestar stretcher and carried to the waiting craft. Most often, it is a hot load, where the engines are running, and extreme care must be taken to stay away from the rotors. On occasion, if an extra pair of hands is needed, the Lifestar crew will tag the medic to ride along and assist. I never got that lucky. In the aftermath of the transport, the EMS crew most often goes to the trauma center anyway, to give their report, to pick up equipment that flew with the patient, to restock.

I did get to ride on Lifestar once. It was while I was in paramedic school. We each had a 8 hour shift to "ride along" with the helicopter crew. As my crappy luck would have it, there was only one call out during the whole shift, but that ride remains the ride of my life, one that I will never forget.

Wow. I didn't really mean to go on and on like that about this. But that's the way we EMS types are, we'll tell stories one after another after another. But Lifestar has a pretty cool web site, with photos and some of their own stories (which I know they like to tell ... I've heard some pretty amazing ones from those folks!), and more information about the Lifestar program. It's worth a look. There's also a link where you can donate a monetary gift to further the research and advances of aeromedical emergency and transport services. But I also happen to know that the guys and gals over there really like cookies too, if that's more your style. They do some amazing work, they deserve all the gratitude we can give them.


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