Monday, June 19, 2017

Life Flight team delivers emergency service by air

Life Flight pilot George Kuba
 Life Flight paramedic John Jankowski
 Life Flight Nurse and Program Director Jerry Splitt
 Life Flight Medical Director Dr. David Schoenwetter

DANVILLE — Lisa Haas barely remembers being on a helicopter.

She came to briefly after she had been loaded onto the chopper following a horrific Christmas Day crash just outside of Kulpmont in 1988. The then-14-year-old had been riding in a car with three other friends, and the 16-year-old boy who was driving took the curve too fast, she said.

Haas suffered broken ribs, a broken collarbone, head trauma, she was bleeding internally and her spleen was removed in surgery. She barely remembers events from that day. The brief times she was awake she felt cold — and afraid.

But the 43-year-old Coal Township woman is forever grateful a Life Flight helicopter was there to get her to the hospital.

“Not until I was older and I thought about it, (I realized) I was alive because of a helicopter and someone was there to man it on Christmas Day,” she said. “I’ve often said if it wasn’t for that Life Flight, I wouldn’t have made it.”

Whether it’s flying trauma patients from a highway crash or transporting an ill infant from one hospital to another, Life Flight and its crew — a pilot, paramedic and a flight nurse — tend to the patient in life-critical situations and guide the aircraft to the waiting facility in a fraction of the time it would take on the ground.

“I’m humbled every day, month after month after month since I’ve been doing this, there are people who are alive because of Life Flight,” said Dr. David Schoenwetter, medical director of Geisinger Health System’s emergency medical services, of which Life Flight is a part. “It’s almost routine. Their ability to get people to the right care — that’s what Life Flight is all about.”

That is especially beneficial in rural areas, where the nearest trauma center can be counties away.

“In February of this year, we hit a milestone,” said Jerry Splitt, Life Flight’s program director.

The service transported its 60,000th patient.

Seven helicopters, five bases

Geisinger’s medical helicopter program has come a long way since it started out at the Danville hospital with one helicopter in July 1981. It now operates seven helicopters out of five bases in the health system (two of the helicopters are backups), employing a staff of more than 100 on a $15 million budget. Geisinger’s Life Flight helicopters travel roughly half of the state, responding to emergencies or transporting patients from one hospital to another.

Despite its name, Life Flight also provides critical care ground transport in vehicles staffed by a paramedic and flight nurse who can provide advanced life support, for incidents in which the helicopter cannot fly due to inclement conditions.

“A lot can happen in the back of an ambulance,” said Splitt, a registered nurse and paramedic who also covers shifts on the helicopter as a flight nurse.

The program started with a single-engine Alouette III helicopter, but later moved on to a twin-engine aircraft. Life Flight now has five twin-engine EC145 helicopters, one at each of the bases, and two slightly less roomier BK 117 helicopters as backups.

Based at Geisinger

Geisinger’s Life Flight helicopters are based at Geisinger Medical Center, State College, the Wilkes-Barre/Scranton International Airport, Williamsport Regional Airport and outside Minersville in Schuylkill County. While they are closer to patients in the Geisinger coverage area, Life Flight services the entire Valley.

At the medical center, helicopters that are bringing in patients land on the roof, and the patient is taken down the nearby elevator to the emergency room or the operating room, Splitt explained.

“There is a huge focus on clinical staff,” he said. “We have some of the most certified staff.”

Splitt started with Life Flight as a part-time dispatcher in 1985, when he was in college. In 1988, he became a paramedic and left for a few years. He returned to the program in 1993 as a flight nurse and has been in a leadership role since 1998 and program director the past few years.

The program used to contract out for helicopters, pilots and maintenance. Geisinger had less control over the personnel and the aircraft. In 2012, the program was brought all in-house, and Life Flight obtained an air carrier certificate.

Now the Federal Aviation Administration office in Harrisburg oversees the program, and Geisinger owns the helicopters and employs the pilots and mechanics.

The program now essentially is its own airline as defined by the FAA. “We used to rely much more heavily on outside agencies,” said Tom Weir, associate chief administrative officer whose responsibilities include Life Flight.

“As we got larger, it became more imperative that we do things on site and do them more rapidly.”

The helicopters themselves cost millions of dollars — the last one purchased cost $7.9 million — and they have a useful life of about 20 years, Splitt said.

Weir said the program is a major investment in very advanced technology and people. The 24/7 program invests a lot, too, in training and education.

“All our crew require licensing and education throughout the year,” he said. “They all need to function together.” 

Kids remembered most

Most of the flights — 65 percent — are transports from one hospital to another, while the other 35 percent of the calls are to accident scenes.

“Unfortunately, the kids are the ones you remember the most,” said Life Flight paramedic John Jankowski. “It’s like that with all medicine. The very critical inter-facility transfers are the most challenging.”

He said that could be a heart patient with an open chest hooked up to a machine to keep him breathing.

“They don’t like to move patients like that, so you know he’s on the brink (when they do),” said Jankowski, who had to obtain additional certification to work on Life Flight.

Pilot George Kuba, who usually flies out of the Minersville site but was filling in at the medical center site on Thursday, said the flight crew nurses and paramedics are versatile.

“They work in the ER, ICU, then (at an accident scene), they’re crawling into a vehicle,” Kuba said. “When they’re not with a patient, they’re helping me look out for obstacles.”

Jankowski said the pilots, many of them former military pilots, as Kuba is, are very detailed.

Kuba never flew in combat, even when he served with the Army National Guard in Bosnia in 2002-2003, when he was in an administrative role.

But he served with the Guard for 22 years as a pilot and has been a pilot since 1987.

Does anything scare him?

“Birds scare me,” he said then amended his comment. “I don’t get scared. I call it alert.”

GPS, ‘night sun’

The helicopter has GPS to guide the pilot around mountainous terrain or around obstacles such as flocks of birds and to find the landing zone, and the crew has night vision goggles for night flying and landing. A “night sun” 40 million candlepower spotlight also illuminates the landing zone at night, if needed. It allows the crew to see details on the ground from 800 feet up in the air, Life Flight Safety Director Pete Carros said.

Schoenwetter said that as medical director, a big part of his role is to oversee staff education and credentialing.

“We want crews to be safe and patients to be safe,” Splitt said.

He said that in the program’s nearly 36 years of operation, there has never been an injury to a patient.

“We’ve had some damage from some hard landings,” he said.

Because of the risk involved in transporting patients by helicopter, safety is a primary focus. That’s why there is emphasis on continuing training.

Carros said there is certain gear Life Flight is required to have, such as for terrain awareness that will warn pilots of obstacles.

“Next year, we are going to be required to have a black box, a flight data monitor, that records voice, video, equipment,” said Carros, a U.S. Navy trained pilot who covers some shifts and takes the helicopters on maintenance flights.

He said the Life Flight program includes a lot of structure and protocol. Part of his job is to ensure the crew does not drift away from standard protocol.

More Information:

How many aircraft in the program?

Today, the program operates seven helicopters. Five bases operate 24/7 and the remaining two are backup helicopters.

How many vehicles (ground support)?

One primary vehicle and one backup. Children’s Miracle Network is a major contributor to the ground vehicles.

What is the number of staff?

Rough numbers:

30 Flight Nurses
30 Flight Medics
10 communications specialists
10 mechanics
20 Line pilots
1 full time director of safety
2 administrative assistants
10 employees who are the leadership team, and also contribute in covering front line duties (covering shifts)
2 Emergency Medicine Physician medical directors.

And cost of the program?

The annual operating budget for the entire program is about $15 million.


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