Journal Express, Knoxville, IA

June 14, 2013

Mercy One gets new craft, service exceeds expectations

Slideshow offers views inside

Steve Woodhouse

Knoxville — The Mercy One helicopter stationed in Knoxville was replaced with a new, top-of-the line model - the same as the one based in Des Moines - last month. Since the service started in Knoxville on Nov. 15, 2010, its utilization has exceeded the expectations Mercy had when the decision was made to expand. 

Dennis Cochran, Flight Program Manager for Mercy, said the biggest difference between the new aircraft and the former one is the size of the interior cabin. The new, four-rotored aircraft also flies faster. Other features allow stretchers to roll into the craft, the ability to handle more specialty cases (such as OB, pediatric and neonatal) and up to three attendants can fit into the back. 

The aircraft belongs to Air Methods. Mercy has an agreement with Air Methods in which it pays for service. Pilots and mechanics are employed by Air Methods, while the medical personnel are employed by Mercy. 

One of those pilots, Ryan Winter, has been with Air Methods since 2008 and has been flying out of Knoxville for a couple of years. He was inspired to become a helicopter pilot after watching an "Operation Prom" event while in school. When he saw a helicopter land on the football field, he knew he wanted to fly them himself one day. There is not much difference between flying this craft and the previous.

"They handle similar to each other," Winter said. 

As for Technician Sara Meyers, who joined the Mercy One crew in March, there are differences between serving in a hospital emergency room and being part of an air rescue team. 

"You rely on your partner a lot," Meyers said of her new position. She is still training. Assisting in her training is fellow crew member, Sarah Tripp. 

"Your doctor's not beside you," Tripp said. She has served with Knoxville's crew since its inception in 2010. Treating a patient in the air is a more unstable environment, one with fewer resources available for treatment. 

"It's never the same thing," Tripp said of responding to calls. She got into flight nursing because she wanted more of a challenge. Having a different environment is a plus for her. Tripp said she gets to "do what (she loves) and in a helicopter." 

Meyers has always had the goal of serving with an air rescue team. This is something she has also worked toward.

Working thousands of feet in the air has its differences, but turbulance is not an issue with the new aircraft.

"This thing powers through it," Winter said. "You don't feel it as much as you would in an airplane." It includes an anti-vibration system to try to allow for a smooth ride, even in windy weather. 

 Though none of the crew could specify a single, truly specific defining moment in their work with Mercy One, Tripp said that it always nice to see someone they had rescued come back and say hello. Too often, the survival rate of those Mercy One crews treat has higher deaths than rescues. 

The best feeling for these crew members is when they see someone they have helped resuming normalcy. It leaves them with the knowledge that they were there for these patients when they needed them the most, and a difference has truly been made by their work. 

Cochran said that their situations, as crew members, put them in the situation of the last time a family member will see a loved one alive. Sharing such an intimate moment with these total strangers is a humbling experience, Cochran said. They have the responsibility to do everything they can to help their patients facing dire circumstances, and acting as a "bridge" between family members and patients. 

"That's when you go home at night and give your parents a call," Tripp added. They are reminded every day that you cannot take your family for granted. 

When emergency situations involve a child, the crew admits that they would not be human if that did not affect them and their response. Though it makes their job more difficult, they remember their training and get to work before everything sets in. 

A seat, up front in the cockpit with the pilot, is available for a family member. Decisions on whether or not to allow a family member are made on a case-by-base basis. The crew factors in weight already inside the aircraft and the condition of the family member. 

Mercy One rotates its crews between Knoxville and Des Moines. The differences between responding in the more urban setting of Des Moines, versus Knoxville, which serves the southeast cooridor of Iowa, is the trips can be a little longer. Cochran believes, too, that responding to calls in the rural area makes the experience more like providing an ambulance service, whereas in Des Moines, the helicopter seems like more of an extension of the hospital. 

When not responding to a call, the crew spends their time keeping up with training, updated protocols and continuing their education. Air Methods and the Federal Aviation Administration requires continued training. 

Winter said Air Methods has annual training that requires a number of take offs and landings for pilots to be certified. This includes night runs, during which he utilizes night-vision goggles. Inside the aircraft is well-lit to allow the medical team to do their job well, even at night. 

Protocols are always on the cutting edge, according to Cochran. There may be two or three modifications made each month and the protocol book is two to three inches thick. 

"They have to be on top of their game," Cochran said of the crew. Without a physician to make an assessment of a patient, they have do it themselves. If they incorrectly assess the situation, they can't function properly. 

Cochran admits that there is "down time" in the trailer at the Knoxville Municipal Airport. Movies have been known to be watched. Working out of the Mercy One trailer in Knoxville is similar to working out of a fire station, in which personnel are there, ready to respond. If they get called out, they return when the call is complete to resume their assigned duties. It is rare for a flight crew to "just be sitting," according to Cochran. 

While the crew gets a great deal of recognition and credit for saving people's lives, the crew is adamant that they cannot do it all alone. Without local rescue teams, police and fire officials, and hospital personnel, they could not do what they have been able to do.

"We're one spoke of many in a wheel," Cochran said. If local first responders were not there to start caring for someone in need, they could not continue it. 

Tripp described the process the crew goes through each time they are called out. When they first arrive, they assess the scene to ensure the safety of the aircraft and everyone involved would be preserved with the landing. 

If a patient is still trapped, they do a primary assessment and get information from local first responders. Mercy One crews do not have the equipment to extricate people from vehicles, that must be done by local teams. 

When a patient is free, he or she is loaded onto a cot. They assess what will be needed before the patient can be loaded onto the helicopter and transported to the hospital. Tripp said the crew tries not to be on the scene for any more than 15 minutes, or longer than 20 minutes at the hospital. 

Upon arrival at the hospital, or whatever the end point may be, the crew shares the information about the patient they have, which includes the chain of care, describing what has been done to help the patient before their arrival. Even if a patient appears to have died, crew members do not legally have the authority to end treatment and pronounce anyone dead.

"We don't ever stop," Cochran said. "We have to be under direct physician contact." 

There are times patients may not be loaded into the helicopter. There are also times doctors will say they have done all that they can for a patient. Tripp said those tough situations exist, but they always offer as much help as they can. 

The additional helicopter in Knoxville has allowed Mercy One to respond to hundreds more emergencies than it would have otherwise. Between November 2010 and April 2013, there were 2,004 requests for the Knoxville-based helicopter and 1,114 patient transfers. There were at least a couple hundred more requests not included in which the requests were rescinded. 

"The aircraft's been far busier than we ever anticipated," Cochran said. They started smaller because they didn't think they would have many calls for the helicopter. 

Cochran said things have gone well in this environment. It has strengthened the hospital's customer relations without taking any business away from the Des Moines air service. The transports made by the Knoxville crew would not have been done if the aircraft was not here.