Saturday, December 06, 2014

New Yale-New Haven Hospital helicopter equipped for critical care in the air

Yale New Haven Hospital's SkyHealth crew, Shawn Bowe, a flight paramedic, pilot Mike Kelley, and Ivonne Recupero, a flight nurse on the helicopter pad at Yale New Haven Hospital Thursday, December 4, 2014.


NEW HAVEN >> Yale-New Haven Hospital can now treat patients on the fly, as it transports them from another hospital.

Its new SkyHealth helicopter, an EC-135 chopper, allows a critical care nurse and paramedic to perform procedures in the air, rather than having to wait until the patient arrives at the hospital.

“When you’re talking about using the helicopter for critical-care patients, people think it’s all about speed,” said Dr. Evie Marcolini, medical director of SkyHealth. But it’s not about getting to the hospital faster. It’s really about being able to provide care during transport from one hospital to another.

“If you take that patient in a ground-transport service … that’s over an hour’s worth of time where a patient doesn’t get that level of critical care,” Marcolini said.

With the copter, “You don’t have out-of-hospital time because the crew in the helicopter can do the same things as the [intensive-care unit] there or the ICU here,” Marcolini said. “When they’re not flying they work in ICU in emergency departments … It’s a higher level of care than our ground transport.”

Ambulance crews are unable to perform many procedures, such as managing ventilations, giving certain high blood pressure medications and transfusions that can be done inside the small but well-equipped helicopter’s cabin.

“We are flying about every other day, give or take,” said Don MacMillan, the coordinator of flight operations since SkyHealth took off in November. “Our main motivation was to provide that critical care that they would get here in the hospital [while] en route to our facilities.”

SkyHealth as an entity is less than two months old. It’s a partnership between the Yale New Haven Health System and North Shore-LIJ Health System on Long Island and transports patients to both Yale-New Haven and Bridgeport hospitals (Bridgeport is in the Yale New Haven Health System). Med-Trans of Lewisville, Texas, maintains the helicopter, provides the pilots and does the billing.

Med-Trans did not respond to a request for costs. A 2013 Stanford University study found that, for a hospital emergency helicopter to be cost-effective, it would have to have a 1.6 percent higher patient-survival rate than ground transport. Stanford’s report said the average cost of transport was about $6,500 in 2010.

“Last Friday, we had a patient with an aortic rupture that we transported,” said paramedic Shawn Bowe, although there was little need for in-flight care on that trip, he said.

Pilot Michael Kelley, an Army veteran, has more than 25 years of flight experience. During a short tour over the city from the top of the 13-story Yale-New Haven Hospital, the ride is smooth and quiet. It’s hard to tell when the helicopter has left the pad or when it’s touched down.

While it’s a tight fit, five people can fly along with a patient, who is brought onto and off the chopper through doors that open in the tail. “It’s built very nicely,” Kelley said. “It’s got redundant systems throughout everything.” It’s also got high-end GPS that “shows us where traffic is, where terrain is, where the weather is. It gives us full 360-degree awareness,” Kelley said.

So far, the helicopter has been used only to transport patients from one hospital, such as Lawrence and Memorial in New London, to Yale-New Haven or Bridgeport hospitals. Flights to the site of an accident or other medical crisis won’t be made for a while, Marcolini and MacMillan said.

“You could put a chest tube in if you went to a scene call,” said Marcolini, but the crew wants to get comfortable at “facility transfers” first.

The copter crew also can use the Y Access Line, so “any physician anywhere can call this hospital or any physician within the system and find a physician who will accept their patient,” MacMillan said.

Story and Photo Gallery:  http://www.nhregister.com


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