CARE BY AIR

There is a serious car accident in northwest Cape Girardeau County on an isolated country road. It will take at least 45 minutes to reach by ambulance. The victim is in immediate need of advanced medical care.

This kind of situation is not hopeless. There is an alternative. Helicopters specially equipped for medical purposes provide an alternative for emergency situations which cannot wait for ground transportation to arrive.

Cape Girardeau is the home of two such services -- LifeBeat at Southeast Missouri Hospital and the Air Evac Lifeteam at the St. Francis Medical Center.

"We fly at 120 miles per hour in a straight line from point to point," said Jim Prince, a pilot of LifeBeat. "That's why we can often get somewhere twice, even three times as fast as ground ambulance services."

Air Evac came to the St. Francis Medical Center from West Plains in July 1987. LifeBeat found a landing pad at Southeast Missouri Hospital in August 1987.

"Originally there was much concern that the community would not be able to support two air ambulances in the same community," said Rodger Huffman, lead flight nurse and base manager of the Air Evac Lifeteam in Cape Girardeau. "Now, we could not conceive getting by without the services of both."

Air ambulances can be summoned to the scene of an emergency by any emergency personnel depending upon the extent of the incident and weather conditions. Both helicopter teams hold frequent training sessions, to teach emergency personnel and first-responders how to aid in the safe landing of the helicopter.

"The only thing that really prevents us from going anywhere is bad weather and mechanical problems," said Terri Kerr, lead flight nurse for LifeBeat. "If we get a call from the proper authorities, we will do everything in our power to get there as soon as possible."

The premier benefit of air ambulances is the time they can save a patient in critical condition.

"Say there is a serious accident somewhere in North Cape County, which requires extrication," said Kerr. "By the time emergency crews arrive and get that person out of the car, a lot of time will have passed. If the patient has serious trauma injuries, it further compounds the situation.

"In the medical profession, we call the hour after the accident first occurred the `Golden Hour,' in which the patient has to receive advanced medical attention," she continued. "If you spend 20 minutes getting to the accident and 30 minutes getting that person out of the car, much of that time has elapsed. That's where we come in."

Air ambulances also are equipped with advanced life support equipment, including a heart defibrilator, heart and oxygen-level monitoring equipment and intravenous medication and other drugs.

A flight crew consists of a pilot, a flight nurse and a paramedic. The LifeBeat crews are hospital employees. The Air Evac Lifeteam works out of St. Francis Medical Center for the mother-company in West Plains.

Flight nurses and paramedics are required to have at least two years of critical care experience in an ambulance service or emergency room setting. Air Evac requires its flight nurses to have at least five years of emergency room experience, two of which must be in a critical care environment.

For LifeBeat, the pilot must have at least 2,000 hours of helicopter flight time before he can fly with the hospital. LifeBeat has four pilots: three have been with the hospital since the program started, the last joined the crew in 1989. The LifeBeat team also consists of 26 medical personnel and a mechanic.

The Air Evac Lifeteam has three pilots, three flight nurses, one full-time paramedic, a mechanic and six or seven part-time flight nurses and paramedics. The staff must meet minimum training and experience requirements before they are hired, and go through 36-40 hours of continuing education annually.

The LifeBeat helicopter itself is leased from a company in St. Louis, but is locally serviced on a strict schedule. Right now the helicopter is parked on the roof of the parking garage next to the hospital. When the new clinical services building at Southeast Missouri Hospital is complete in April, LifeBeat will be relocated to the eastern edge of the addition, along with its offices and living space for the crew.

The Air Evac Lifeteam owns four helicopters and two light airplanes that it uses for services throughout Southern Missouri and Southern Illinois. Only one helicopter is stationed at St. Francis Medical Center.

Both services follow strict guidelines when it comes to weather conditions in which they will fly.

LifeBeat is a member of the Association of Air Medical Services, which has established weather minimums for its aircraft. The standards can be adjusted somewhat locally, Kerr said.

"Those conditions, in addition to a few local stipulations, far exceed (Federal Aviation Administration) minimums for flying," said Kerr.

"The conditions we consider it safe to fly in are for the benefit of the crew and the patient," said Kerr. "It won't help anyone if we go out in bad weather and get stranded."

A couple of weeks ago when a thick blanket of fog covered the Cape Girardeau for three days, both helicopter services were grounded.

In a situation where a helicopter is unavailable for assistance, ground ambulances will be dispatched immediately. In many cases when air ambulances have been dispatched to emergency scenes, a ground ambulance will be en route or at the scene to assist the flight crew, Kerr said.

But air ambulances aren't only dispatched to emergency scenes. They also serve as a speedy transport service between hospitals for patients who are critically ill or have been notified that they are a transplant recipient.

"We have a list of people throughout the area who are on waiting lists for an organ transplant," said Huffman. "Those people wear beepers so that the hospital can immediately notify them that they have a donor.

"When they get that call, they only have a few hours to get to the hospital and receive the transplant," he continued. "So we will go to where that person is, pick them up and take them to Cape Girardeau, St. Louis, Memphis, or wherever the organ might be."

Both hospitals also have aided law enforcement in searches for crime suspects or missing persons in the past.

The major difference between the Air Evac Lifeteam and LifeBeat is that Air Evac primarily is a private service, with more than 15,000 members throughout its service region.

For a nominal annual fee, a person can be assured that an Air Evac helicopter will be there in an emergency situation, or the company will arrange for other ground transportation to a hospital in case of bad weather.

"For people who live in rural areas a long way from a hospital, this can be a very valuable service," said Huffman. "For someone who is a long way from a medical center, it could make the difference between life and death."

Members of the Air Evac Lifeteam aren't directly billed for the service -- only their insurance companies are billed.

"Membership is not a requirement for us to go out and get someone or transport someone to another hospital," said Huffman. "It is just an added benefit."

LifeBeat is dispatched from Southeast Hospital by trained communicators, many of whom are certified emergency medical dispatchers. The dispatchers will get out specialized coordinate maps when sending a crew to a scene of an emergency.

Air Evac is primarily dispatched from the main office in West Plains, but can be dispatched by local law enforcement or emergency medical personnel.

The Air Evac crew works a 24-hour shift. The pilots start work at 6 p.m., the medical crew starts at 7 a.m.

Jim Damron, the lead pilot for the Air Evac Lifeteam, said that pilots are required to have at least eight hours of uninterrupted rest in the first 16 hours of their 24-hour shift.

The LifeBeat crew works 12-hour shifts, "which sometimes turn into 16-hour shifts," said Kerr.

"If we get to our destination and the weather turns bad, we wait it out until it clears," she said. "If we get called a few minutes before our shifts end, we're not going to turn a call down just because it's about time to go home."

Some days, the helicopters will make five or six flights; other days, they won't go out at all. If either air ambulance service is backlogged with calls, they will do their best to refer to other area services, including each other.

Nonetheless, there is someone on duty at both offices 24-hours a day, seven days a week.