A Day in the Life: Lifenet, NY
Nov. 13--When LifeNet critical care nurse Kyle R. Williams was 14 years old, he spent a day shadowing a family friend who was a nurse anesthetist, watching him intubate patients in a hospital.
A small child was soon brought into the emergency room, the doctors and nurses doing their best to administer care. Then a helicopter landed, and out came a medical crew who took control of the scene.
Mr. Williams said the roles had suddenly switched -- hospital staff members were asking what the flight crew needed to help the child, not the other way around. He watched as the crew later whisked the child away in the helicopter.
"And that was it," he said. "I was hooked."
From that point forward, training to become a medical air service crew member was the ultimate dream. And for the last 16 years, Mr. Williams has been living that dream as a flight nurse. In the last three of those years, he has worked with the LifeNet of New York operation at Watertown International Airport.
Mr. Williams works with 12 other members, including three other flight nurses, four paramedics, four pilots and one aviation mechanic who helps maintain the crew's helicopter -- a EC-135 chopper equipped with satellite tracking, dual GPS, radar and an autopilot function.
The LifeNet crew flies patients from Jefferson County and parts of Oswego, Lewis and St. Lawrence counties to various hospitals in the Northeast, most commonly Upstate Medical University in Syracuse.
Overseeing the crew is Dr. Maja Lundborg-Gray, medical director for the emergency department at Samaritan Medical Center.
Dr. Lundborg-Gray was involved with a previous medical flight system based in Watertown until the early 2000s. Years after that system shut down, she entered discussions with Colorado-based Air Methods, LifeNet's parent company, on bringing an air medical base back to the Watertown area.
Air Methods subsequently erected the new base at the airport in 2012. In the years leading up to that, however, the Marcellus non-profit Mercy Flight Central was the primary air medical service for the area. The service utilized a small, fixed-wing airplane and a helicopter to transport patients from the north country.
When competition between Mercy Flight and LifeNet skyrocketed by 2013, the former received fewer calls and ultimately ended its service that same year. Being the dominant medical air service in the region, the local LifeNet crew answers an average of 22 calls per month. Since the base became operational, the crew has completed 955 lifesaving flights. Air Methods spokeswoman Christina D. Brodsly said all flights are considered life-saving because of the services provided. Once the patient is delivered to a hospital, the receiving physician determines the status of the patient. LifeNet cannot keep track of living or deceased patient information because of patient privacy laws, Ms. Brodsly said.
Along with the Dexter base, LifeNet operates a fixed-wing medical plane out of Potsdam Municipal Airport.
A DAY IN THE LIFE
For each crew member, the day starts at 6 a.m. Once at the base, crew members will be briefed on weather, safety and new developments from the previous day, if necessary. Equipment must also be checked, including the systems within the helicopter. Then it's about staying alert for the moment a call comes in.
The time in between calls is not wasted, however. When daily base duties are finished, Mr. Williams said crew members are constantly reviewing guidelines and educating themselves on new material.
Flight paramedic Jeffrey E. Simons said training never truly ends for crew members.
"Even if it's a bad-weather day and we're not able to fly, there's still training to do," Mr. Simons said. "We're developing new treatments, doing a lot of research. Guidelines are updated frequently, so it keeps us on the cutting edge."
But the crew is always in a heightened state of awareness.
"Your goal is always to be ready for the flight. You're ready to go, in your flight suit, at 6." Mr. Williams said. "We don't fly sprained ankles. We only do the critical flights, so our average day here is generally someone's worst nightmare in another setting."
In the typical settings of ground-based jobs, Mr. Williams said paramedics and nurses have separate skills that usually do not cross professions. But with LifeNet, paramedics and nurses are trained to the same level.
In hospitals, he said, a nurse traditionally will not intubate patients, whereas a paramedic will intubate in the field on a regular basis. Those who join LifeNet as critical care nurses are trained to intubate, however. Conversely, paramedics are taught to run critical care drips or run a ventilator, which are left to nurses in typical medical settings.
"We upscale them so both riders are working the same level," Mr. Williams said. "Having those two expert minds working together is really what defines us as a critical care team."
FILLING THE GAP
Luke Gasowski, clinical base supervisor for LifeNet, said the air service fills an emergency care gap created by the vast rural areas in the north country.
Mr. Gasowski noted that critical care access is more than just basic or even advanced life support provided by the typical EMS structure. In rural areas, this becomes difficult. Ground services do the best they can, but a higher level is needed when time is of the essence.
"When you're out quite a ways away, it's quite a hike, and time matters," Mr. Gasowski said. "Every minute without oxygen to a cell could mean that cell dies, could mean it doesn't recover as well as it would have if the physiology behind what's going on was corrected sooner. So there's not only the access and level of care that we provide but the speed of getting the patient to the person that can do what needs to be done."
All four pilots who work at the LifeNet base have military experience out of Fort Drum. One of the pilots, Scott C. Hines, said having a Fort Drum service record is vital to understanding north country weather patterns.
"We're familiar with the (north country) weather patterns and the different stuff we run into here -- the mountains, the weather and the lake effect patterns," Mr. Hines said. "We have to keep an eye on it and pay attention as to what's going on."
Mr. Hines said snowstorms are the biggest challenge for the pilots, as they can keep the crew grounded if they are bad enough.
But Mr. Hines said the chopper is equipped with more advanced technology, including advanced GPS and radio systems, than what is normally found on the military aircraft he used to fly.
On the medical side, Dr. Lundborg-Gray said the challenges that come with the job don't necessarily go away with experience.
"I think every single patient that enters an aircraft is a challenge," she said, adding that she is in constant communication with the crew if they need assistance. "These are the sickest of the sick, and when I get phone calls (from the crew), I usually have to pause before I answer my phone call, because I know that they're highly trained and if there is a question, it's a specific question that's time sensitive, and I need to be on my game to answer it."
SOMETIMES GRUELING DAYS
Mr. Williams said staying alert and ready for an entire shift can be taxing. Regardless of how late into a shift it is, crew members need to stay consistent in how they administer care.
"If you wake up at 3 a.m. and you're heading out to your fifth flight, it's maintaining a level of awareness to make sure you're doing all your safety checks, that you're not getting tired and complacent, that you're going to provide that patient on the fifth flight of your day at 3 a.m. the same quality of care that you did at 7 a.m. a few days before."
Mr. Williams's personal best was six flights in a single 24-hour shift. He noted that flight time from Watertown to Syracuse is 30 minutes, so if the crew is called to a scene a half hour north, it takes an hour get to Syracuse, and another half-hour to get back to base. A high amount of flight time can take a toll on the body, he added, so crew members need to stay rested and hydrated.
Still, Mr. Williams said, every day on the job is like his first day 16 years ago.
While it's not often that crew members receive feedback from the patients they care for, Mr. Simons said it goes a long way when patients are appreciative.
Strokes are one of the most common emergencies the crews respond to because of the immediate treatment they require at hospitals. Mr. Simons cited a particular stroke patient who later came to the base and personally thanked personnel after he made a full recovery.
"That really solidified how important this resource is to the area," he said.
Mr. Williams agreed. "As you're working," he said, "you're thinking there's little chance (a patient is) going to come out intact. Six months later, this guy knocks on your door and says, 'Hi, remember me?' And you're speechless. You know you made a difference there."
The Chopper
Type: EC-135
Max speed: 155 knots
Main rotor diameter: 34 ft
Max gross weight: 6250 pounds
Communications: Radios equipped with 32 CTCSS tones to allow direct communications between flight personnel and communications centers, emergency personnel and hospitals.
Night Lighting: Controlled high voltage searchlight with additional floodlights
Medical Equipment: Onboard equipment provides specialized airway support, cardiac pacing, and advanced physiologic patient monitoring, and expanded pharmacologic modalities.
Transport capabilities: Helicopter is configured to transport one patient.
Copyright 2016 - Watertown Daily Times, N.Y.
