Care in the Air
October 7, 2011 · No Comments
Helicoptor Flight Crews Handle All Circumstances
Five minutes. From the warning bell in crew’s quarters to lift-off from the tarmac, that’s all the CALSTAR flight crew has. Even if they have been jarred from a deep sleep, the pilot and two flight nurses are up, dressed and flying off in five minutes or less.
As they strap into their helicopter seats, do they know where they are headed and to what kind of situation? "Sometimes. But usually we don’t get that information," says Tim Castelli, a CALSTAR flight nurse. "What we get are general directions—dispatch may tell us to head toward Fairfield
or Dixon, for example. So, we just lift and point."
Once in the air, the pilot contacts dispatch again to receive actual latitude and longitudinal directions and the name of a ground contact.
"At first we’re in flight mode—getting clearance from the tower and talking with dispatch—and the closer we get to the scene we then shift to a medical mentality," says Ernie Acebo, CALSTAR flight nurse. "If we know we will have a pediatric patient, or a burn or hypothermic patient, we can make special preparations in the aircraft."
Flight rescue has been called to assist for a number of reasons, but usually it’s because of ground traffic delays, the accident is far from a trauma center, or because they can provide additional medical interventions at the scene.
As for what kind of medical situation awaits when they do land, frequently "we may have to open the ambulance door to see if it’s a pediatric patient or an adult, if it’s a car crash or a gun shot wound," says Castelli. "So we have to be equipped to handle anything. If it were a perfect world, flight nurses would always know if they are headed to care for
a child or multiple injuries, so we could get set in our frame of mind."
Either way, the crew is trained to handle all circumstances: they are Certified Critical Care Registered Nurses, Certified Flight Registered Nurses, and certified in Pediatric Advanced Life Support, Advanced Cardiac Life Support, and Neonatal Resuscitation.
CALSTAR has 10 bases throughout California; Northern Solano County is served by a base located at Vaca-ville’s Nut Tree Airport. From here, a three-person crew could be called to the Delta waterways or Lake Berryessa, from Fairfield to Winters or Woodland in Yolo County. Some flights have even gone as far north as Fort Bragg.
"We do whatever we can to save a person, to get them to a trauma surgeon. Our goal is to be overhead the scene ASAP," Castelli says. In large emergencies, CALSTAR could receive backup flight rescue assistance from other CALSTAR bases, or helicopters from REACH or the California Highway Patrol, based in Contra Costa, Napa or Sacramento.
Most times, the flight crew is on scene for only minutes. "We keep the engine running, load the patient fast and do all interventions in the aircraft, so as to not delay the time to the trauma center." Other times, take-off will be delayed. "There could be extenuating circumstances, such as a combative patient. Each case is different."
Castelli has been a flight nurse for 10 years, but it wasn’t his original career path. As a nursing student at UC Davis, he saw the helicopters landing at the nearby medical center and became curious about their mission. After going on a "fly along," he was sold on the concept.
Although the medical cases can be uncertain and the hours long—he works two 24-hour shifts a week—the work continues to challenge him, because "every call is unique."
Acebo has been in the emergency response field since 1988, and finds his work incredibly rewarding. "People who respond to emergencies are confident in their ability to make a person better, or at least not let them get worse. Something awful happened to put them in this situation; we’re going to do the best we can to get improvement."