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When the call came in last Friday—a motor vehicle crash outside Boston—the MedFlight crew sprang into action. Pilot Lynda Colarossi, and flight nurse-paramedics Michael Pepin, EMT-P, and Bill Cyr, RN/EMT-P, grabbed their helmets and headed for one of MedFlight’s twin-engine helicopters that reaches speeds of up to 130 miles per hour.
En route, the crew learned more about the victim, who would be transported to BWH’s Emergency Department for care. Pepin began preparing an IV, while Colarossi expertly navigated the helicopter and safely landed on an improvised landing site established on a side street at the accident scene. Pepin and Cyr rapidly assessed the patient, coordinating with the local paramedics already at the scene and transported the patient on a stretcher into the MedFlight helicopter.
As Colarossi lifted off and flew toward BWH, Cyr and Pepin checked the patient’s vital signs, started an IV, administered pain medication and kept him calm—not an easy task at an altitude of 2,000 feet amid the noise of the helicopter. An organized response was underway at BWH, and Security and Central Transport staff were on the helipad to help the crew transport the patient to the ED. There, the hospital’s trauma team, comprised of physicians, nurses and emergency services assistants, received the MedFlight crew and patient.
“This organized response is so typical of the Brigham,” Colarossi said, as Cyr and Pepin provided a succinct but thorough report of the patient’s status to the ED team. “The staff always are prepared for us when we bring a patient in. It’s a great hospital to come to.”
As a nurse who has worked in the BWH ED, Cyr knows his way around, and after a quick stop at Au Bon Pain, the MedFlight crew was on the way back to Hanscom Air Force Base in Bedford, where MedFlight is stationed, to wait for the next call on their 12-hour shift.
Missions like this are par for the course for the pilots and clinical staff of MedFlight, a nonprofit organization run by a consortium of Boston hospitals including BWH.
Ron Walls, MD, chairman of BWH’s Department of Emergency Medicine, said, “For many patients, the expertise of the flight crews and the time saved by rapid air transport quite literally spell the difference between life and death. These crews work in very challenging circumstances, and their skills are truly extraordinary and inspiring.”
MedFlight is a 24-hour-a-day, seven-day-a-week critical care transport system that brings the sickest patients to Boston hospitals. Although the first call this particular crew received last Friday was for a scene mission, most of MedFlight’s 3,000 calls per year are to transfer critical patients from a community hospital to a tertiary care facility, like BWH.
“About 80 percent of the time, we are transporting a patient to a hospital that has sophisticated services,” said Suzanne Wedel, MD, CEO of MedFlight, which has been operating for 22 years. “For example, we might need to bring a patient with a brain hemorrhage from a community hospital to BWH because of the sophisticated stroke service there.”
When a call comes in, communication specialists determine which mode of transport is needed: ground, jet or helicopter. Every crew consists of a pilot, nurse and paramedic, and each crew is trained to respond with any of the vehicles. MedFlight often uses helicopters, but may use a ground ambulance in inclement weather or a jet for longer distances, such as Nantucket. MedFlight has gone as far as Bermuda to transport patients.
“It’s all about coordinating logistics and ironing out those speed bumps behind the scenes before our crew arrives so that they get there safely and never know about these issues to begin with,” said Ken Panciocco, MedFlight’s director of Communications. “That’s our part of the job—they’re able to focus on patient care.”
Communication specialists also coordinate with security and physicians at the receiving hospitals to make sure the care transition is smooth. While on board a MedFlight vehicle, patients receive top quality care from experienced nurses and paramedics. “Our crews are highly trained,” Wedel said. “On average, our nurses have been in the field for 18 years, and paramedics for 17.”
Those new to MedFlight receive a three- to four-month orientation as a third person on the crew, and then they are paired with the most senior crew members for the next one to two years. “We do our training in the Boston hospitals,” Wedel said. “We have quite a few rotations at BWH, and we have wonderful preceptors there in both Anesthesiology and Interventional Radiology, among many other areas.”
About 90 percent of MedFlight’s budget comes from third party payors, with the remaining percentage contributed by the hospitals in the consortium and fund-raising efforts. MedFlight is part of the Northeast Air Alliance Critical Care Transport System, which includes the air transport systems from other hospitals in the region.
“The agreement among us is that we always send the closest asset and transport the patient to the closest hospital,” Wedel said. “There is no place for competition in critical care transport. It has to be cooperative and about what is best for every patient.”
Patients appreciate the attentiveness and skill of the crews. “We had a wall covered in thank you notes from patients we transported,” said John Pliakas, RN/EMT-P, who has been with MedFlight for nine years. “We also held a pediatric reunion last year for many of the children we transported.”
More pictures at www.bwhpikenotes.org/media