LifeFlight: Taking to the Skies to Save Lives
In 2013, LifeFlight cared for 1,446 people: an average of one patient transport every six hours
“As the plane was going down, my last thoughts were, ‘I hope my family knows I love them,’” recalls 56-year-old K. C. Ford.
Invited to Matinicus Island for a vacation weekend, Ford and three others boarded a single-engine Cessna for their return trip to the mainland on July 17, 2011. It was a beautiful summer Sunday. Mount Washington was visible in the distance as the plane ascended over Penobscot Bay.
Shortly after the plane inexplicably lost altitude and fell from the sky.
“It was surreal. One minute you’re sitting in the plane, and the next minute you’re in the ocean, asking, ‘How did this happen?’” Ford and her flight-mates survived by hanging onto a piece of debris in the icy ocean. An hour later, the first wave of help arrived: “When the people of Matinicus heard that the plane went down, they came speeding out to find us on their lobster boats.”
From Matinicus, Ford was taken by another small aircraft to Knox County Regional Airport in Owls Head, then to Penobscot Bay Medical Center in Rockport, where a LifeFlight helicopter was waiting. Nurse Missy McCann and paramedic Frank McClellan stabilized her for the trip to Central Maine Medical Center (CMMC) in Lewiston. Pilot Dave Burr got them safely there. Ford had a severely broken back and a torn aorta.
The body’s largest artery, the aorta is responsible for supplying blood to the abdomen, legs, arms, and brain. When the aorta is compromised, the results are frequently catastrophic.
“Without LifeFlight,” says Ford, “I would have died.”
Ford spent ten days in the intensive care unit. Her orthopedic surgeon, Dr. Michael Regan of Central Maine Orthopaedics, dealt with complications from her broken back, including leaking spinal fluid. It would be four months before Ford could return full time to her work as an admissions officer at Colby College, and more than a year before the Waterville resident was physically recovered. Despite this, Ford is grateful. “When you think about what other people do for strangers, it is stunning and humbling. It is the goodness in people—the kindness—that stays with me.”
Ford is one of more than 16,000 individuals who have benefitted from the services of LifeFlight. Described as “Maine’s Flying Hospital,” LifeFlight was founded in 1998 to provide transport for gravely ill and injured patients from every community and hospital in Maine. LifeFlight is often asked to bring patients like Ford from smaller Maine medical centers to those that provide trauma care or other specialized services such as stroke management. Eighty-three percent of their calls are for transport between facilities.
LifeFlight crews also pick up patients directly from the scene of an accident, and other non-hospital locations, and have the ability to provide transport on the ground as well. LifeFlight crews have responded to snowmobile accidents in Jackman, pulled heart attack victims off the slopes of Sugarloaf, and airlifted individuals with broken legs from Monhegan. They have worked with patients of every age, from premature infants to centenarians.
In 2013, LifeFlight cared for 1,446 people: an average of one patient transport every six hours.
Before LifeFlight, patients in some parts of Maine did not have easy access to the cardiac, neurosurgical, and trauma care available in the state’s population centers. Executive director Tom Judge was one of the original LifeFlight architects. He saw the problem as an issue of social justice. Judge, a resident of Port Clyde and a paramedic who has 35 years of experience in emergency medical services (EMS), remembers the process: “We were trying to put this puzzle together, so that you would receive the same level of care if you lived on State Street in Bangor, Main Street in Lewiston, or Congress Street in Portland.”
LifeFlight has been successful at moving the puzzle toward completion. “We are delivering the tertiary care or trauma center right to the patient’s bedside—whether they are in the woods, on an island, by the side of the road, or in a community hospital,” says Judge. “We bring the technology, skills, and expertise to support what is being done
In addition to having a high-quality community hospital system, and three trauma centers (CMMC, Eastern Maine Medical Center in Bangor, and Maine Medical Center in Portland), Judge points out that Maine is home to an exceptional emergency medical services system. “EMS is one of the unsung heroes. 260,000 times a year, a 9-1-1 dispatcher picks up a phone for a medical emergency—that is every 45 to 60 seconds somewhere in the state of Maine.”
“We meet people at the tectonic plates of their lives,” says LifeFlight medical director Dr. Norm Dinerman. “I often refer to emergency medical services as the biologic court of last appeals, where God sits in judgment and Darwin is the foreman of the jury. Our job is to argue the most passionate physiologic defense on behalf of our patients.” A native of New York City, Dinerman spent almost a decade at Denver General Hospital’s “Knife and Gun Club,” an emergency department so named for the pervasive urban violence that faced health care providers.
In 1988, Dinerman moved to Maine to become chief of emergency medicine at Eastern Maine Medical Center (EMMC) and focus on the unique medical needs of his new home. Like Judge, Dinerman welcomed the opportunity to help create an air transport service in Maine—one of the few remaining states that did not have one. “Napoleon said that ‘geography is destiny.’ Maine’s geography presents challenges of topography, meteorology, and health care resources. It offers a platform for creativity.”
LifeFlight now has two helicopters, 26 medical professionals (paramedics and nurses with advanced training), and 14 pilots and aviation maintenance technicians operating out of CMMC and EMMC.
The Lewiston and Bangor crews are in continuous contact. They begin each 12- hour shift with a conference call, reviewing weather conditions, technical information, and possible changes to flight patterns. Thanks to equipment such as night-vision goggles, LifeFlight is able to offer care around the clock.
This morning, Lewiston pilot Karl Hatlemark directs the phone call with Bangor. Raised in Norway, Hatlemark was once a medic in that country’s military service. He left in 1986 for helicopter training in the United States and spent time as a bush pilot in Papua New Guinea before coming to Maine.
The voice on the phone from Bangor asks about weather conditions. “Yellow,” responds Hatlemark. There are snow showers near Mount Washington. Winds are 55 miles per hour, with gusts to 63.
Minutes after the conference call, the first request of the day comes in. Hatlemark is asked if he will take the assignment, based on flight conditions alone. He is not supposed to know about the patient’s age or severity of illness, as that might compromise his decision-making, and potentially put his crew at risk. It can be tempting to take all calls that involve children, for example, as many LifeFlight medical providers are themselves parents.
Hatlemark accepts the assignment, and more information is revealed. A 64-year-old woman with dementia has fallen down the stairs in her rural home. She is unresponsive. Her town is far away from the nearest neurosurgical team, which is concerning for a patient with a possible brain injury. The crew gathers, zipping their jumpsuits, and moves quickly toward the helipad behind CMMC. The helicopter seats four. Paramedic Dave White and nurse Heather Cady pull on their helmets and ready the equipment around the stretcher in the back of the aircraft.
Medical crew members are required to have three to five years of critical care or emergency services experience in a busy medical setting as a prerequisite to being hired. They complete an intensive six-to-eight month orientation before they are allowed to take primary responsibility for a patient in flight. Pilots, many of whom have served in the military, have thousands of hours of flight time under their belts.
According to aviation site manager Dennis Small (a pilot with 40 years of experience, 23 of them spent in the army as a result of the Vietnam draft), the helicopter carrying the Lewiston crew today is an Agusta A109. It moves at an average speed of 165 miles per hour and carries enough fuel for two hours and ten minutes of flight time. This will get a crew from Lewiston to Fort Kent.
The LifeFlight crew provides much more than simple patient transport. The helicopters carry machinery that enables crew members to manage ventilators and perform laboratory tests, such as arterial blood gasses. Crew members can intubate patients in respiratory distress using video laryngoscopy. Unlike ground ambulance services in Maine, LifeFlight also carries two units of whole blood. The blood is immediately available to patients and to support hospitals that may be experiencing a shortage of this valuable commodity.
Today, the LifeFlight crew is able to retrieve the patient from her home without incident, and the helicopter is back at CMMC within the hour. Cady and White help the emergency room staff move the patient from the LifeFlight stretcher onto a hospital gurney. They give a report of their assessment to the neurosurgical physician assistant before returning to flight quarters to await the next call.
The process has been seamless—and that is the goal. “LifeFlight is a thread in the tapestry of the health care system,” says Dinerman. “We’ve started with a paradigm that is antihierarchical, antielitist, antiauthoritarian, and antiheroic. We are a component, neither less nor more important than anybody else.”
Tom Judge agrees: “We end up with a unique perspective—not the only or most important perspective—but a unique perspective. We see a relatively small group of patients who are incredibly ill or injured, but we are the only health care provider that literally touches every community, hospital, and EMS agency in Maine. From our standpoint, our job is to glue things together.”
For K.C. Ford, LifeFlight did not merely help to glue her life back together. “To get to see your family again when you think you’ve lost them—to celebrate birthdays and Christmas, and small things like conversations on the phone—that’s a gift. It’s with me every day. I’m just an ordinary person and LifeFlight has significantly changed my life.”
Listen to the LifeFlight crew talk about their program and K.C. Ford’s story on the Dr. Lisa Radio Hour + Podcast.