Sometimes Anchorage Daily News' site is a little strange, and you may have to register, so I'm going to bend the rules a bit and post the article......
From Anchorage Daily News
Every flight an emergency
Alaska air ambulances contend with distance and bad weather in getting to patients quickly
By ANN POTEMPA
Anchorage Daily News
Published: March 8th, 2005
Last Modified: March 8th, 2005 at 02:27 AM
On a Saturday morning before most people are up, a man lies in Bethel's hospital waiting for an air ambulance that's delayed.
The 23-year-old has a stab wound in his belly, the result of an early-morning fight. The 4-inch knife blade cut deep, and the man needs surgery in Anchorage.
On the same Saturday in February, paramedic Matt Loudon gets the call. He works for Aeromed International, an air ambulance division of the Yukon-Kuskokwim Health Corp. that keeps paramedics, nurses and pilots on call 24 hours a day to transport people in rural Alaska to doctors in cities. In 2004, Aeromed crews flew more than 1,400 missions.
But Loudon's flight this Saturday is delayed several times. At first, weather holds him back. Fog hangs low over Ted Stevens Anchorage International Airport, cutting visibility to less than a quarter-mile.
Later, while taxiing toward the runway, the pilots hear a disturbing sound from the right engine and turn the plane around. Back in the hangar, pilot Perry Breitenstein discovers that ice has built up on the engine blades in the minus-5-degree cold.
"I'm too scared to fly like that," Breitenstein says.
Just after 7 a.m., a new set of pilots prepares a faster Learjet that can make the flight from Anchorage to Bethel in about an hour. Forty minutes later, Loudon and nurse Joel Reitz grab their gear and head out one more time.
"Bethel flight, take three," Reitz says. This time it's a go, and the Lear takes off before dawn breaks.
AMBULANCE VS. AIRPLANE
This flight to Bethel was one example of how unique medical emergencies in rural Alaska can be. After a stabbing in Anchorage, a call to 911 would result in the dispatch of an ambulance at high speed down city streets. In the average call last summer, Anchorage paramedics got to the patients in just more than three minutes after the call for help, said Soren Threadgill, chief of emergency medical services with the Anchorage Fire Department. In December, the average patient made it to the hospital within 26 minutes.
In rural Alaska, emergency response has a whole different feel. Response is timed in hours, not minutes, and calculated in air, not road, miles. Airplanes often carry more drugs and medical equipment because paramedics must work with patients -- and their sometimes unpredictable conditions -- much longer than ambulance crews do, said Loudon and Aeromed nurse Jennifer Adams.
Aeromed is one of several companies that fly patients to hospitals in Anchorage or cities in the Lower 48. Providence Alaska Medical Center and Alaska Regional Hospital each have medical flight services that use helicopters or airplanes.
Once Aeromed receives an assignment, a crew of two -- one nurse and one paramedic -- get ready to fly. Pilots are called in to staff one of two types of aircraft: a Cessna Citation II or a Learjet. The Citation II is slower than the Lear but can land on shorter runways, said Brooks Wall, Aeromed's director.
During an average emergency under normal conditions, the plane is ready for takeoff within 35 minutes of the initial phone call, Wall said. Even so, the crew still needs to fly to patients, spend time on the ground preparing them for flight and then returning them to the appropriate hospital. The flights add critical time: the Citation II can travel from Anchorage to Bethel in one hour, 15 minutes. A trip to Barrow can take two hours, Wall said.
BUSH EMERGENCIES
Aeromed transports patients throughout Alaska and even internationally but is based in Anchorage and Bethel.
Before joining the Anchorage crew, Loudon worked out of Bethel and flew to surrounding villages. Getting to patients required ingenuity. In Nunapitchuk, northwest of Bethel, Loudon would arrive by airplane, climb on a four-wheeler for a drive to the river, get on a boat to go down-river, then take another four-wheeler to the clinic. After he got to the patient, he had to do everything in reverse, carrying the patient on a trailer or backboard placed on the ATV.
The risks of flying come with the job. Loudon, Adams and Holly Demmert, an Aeromed paramedic, all have children. Demmert said it makes her nervous to fly so often knowing she is raising a little boy.
"I can't put myself in a situation where I can't come home to this little guy," she said during a recent shift.
But Demmert continues flying, saying she's "playing the odds" but doing so with safety-conscious pilots. She said paramedics don't routinely tell pilots the patient's condition in an effort to remove the emotional part of their decision on whether it's safe to fly.
Since Aeromed was formed in 1997, it has reported a few accidents involving hard landings, difficulty braking and planes struck by birds. None has caused injury or death to passengers or crew, Wall said. But air ambulances have crashed in Alaska. In 1985, a Learjet crashed en route to pick up an expectant mother in Juneau, killing two nurses and two pilots.
Aeromed paramedics tend to patients with all types of needs. About half the time, the crew is picking up a person with heart or respiratory problems or broken limbs, often linked to a snowmachine or four-wheeler accident, according to Aeromed reports. These accidents can be prevented, Loudon said, yet they happen over and over.
"Nobody's wearing helmets," he said.
While working in Bethel, Loudon flew out to villages where children had fallen into water. In one case, a boy fell into a lagoon holding sewage. That boy lived, Loudon said, but children involved in other incidents did not.
"You're talking about distances and time, and by the time we get there, the patient is too sick to save," Loudon said. "It's heartbreaking to see a patient and know that, most likely, that person is not going to live."
Sometimes the heartbreak comes when family members want to fly with the patient but can't. There's not always enough room in the small plane for everyone, or the passengers cannot afford the trip.
A patient's trip in an Anchorage road ambulance can cost between $450 and $550, depending on the level of care provided, plus $12 per mile traveled, Threadgill said. An air ambulance flight has a much greater price tag. A patient needing an Aeromed flight must pay a base rate of $4,000 plus $22 per mile. That means a one-way flight from Bethel to Anchorage costs $12,756, Wall said. Aeromed can bill private insurance or government coverage, like Medicare or Medicaid, which typically pick up 80 percent of the bill, and the patient is responsible for the balance, Wall said.
Aeromed doesn't charge a parent flying with a young patient to the hospital. But the parent and patient must pay for their travel home, Wall said. That means patients might have to fly alone from their small village to the big-city hospital.
"It's like going to the moon for some," Loudon said.
GOLDEN HOUR
Just before 9 a.m., the pilots land the Learjet on Bethel's runway. Aeromed paramedics based in Bethel pick up Loudon and Reitz and take them to the hospital.
"Hi, I'm Joel," Reitz says, leaning down next to the patient's face. "We're going to take you to Anchorage."
Reitz pulls back the gauze on his stomach, looking at the stab wound. Loudon and the other paramedics start attaching leads so they can monitor his blood pressure, heart rate and other vital statistics during the flight. The patient says he's in pain, and Loudon gives him a shot of morphine.
Just more than an hour later, they're in the air again, flying back to Anchorage. Throughout the flight, Loudon monitors the man lying beside him. He reaches out to touch his shoulder, asking if he's nauseated, in pain, too hot. The man is groggy from his medication and isn't quick to answer. Loudon also can smell alcohol. The patient had arrived at Bethel's hospital with a high blood alcohol level.
"It will be bumpy coming into Anchorage," Loudon tells him. "And that's very normal."
The city is covered with clouds, but there's a window opening up over the runway. The plane slips through and lands just after 11 a.m. An ambulance is already waiting for them and takes the man to Alaska Native Medical Center, where he'll have exploratory surgery. By 11:40 a.m. -- about seven hours after the fight back in Bethel -- a hospital team is working on the man.
Loudon, who has given a patient chest compressions on the back of a dog sled, said rescue workers new to Alaska need advice: "Throw everything you know about medicine out the window. Things don't happen here like they do everywhere else."
Nurse Adams, Loudon's former crew partner, said rescuers everywhere else talk about the "golden hour": the best chance for survival and minimizing injury or illness means getting the patient to the hospital within 60 minutes of the initial call for help.
Adams said that rule doesn't apply here.
"In Alaska," she said, "it's the golden 24 hours."
Daily News reporter Ann Potempa can be reached at 257-4581 or apotempa@adn.com.
--------------------------------------------------------------------------------
Aeromed International, a division of Yukon-Kuskokwim Health Corp., is Alaska's largest fixed-wing air ambulance service.
In operation since 1997.
Performs more than 1,500 missions a year
Flight crew includes pilot, nurse and paramedic
Aeromed's fleet of four jet aircraft includes:
1 Lear 36A-RX for extended range
Speed 518 mph
Range 3,000 statute miles
Can fly up to 6.5 hours without refueling
2 Lear 35As
Speed 518 mph
Range 1,800 statute miles
1 Cessna Citation II
Speed 400 mph
Range 1,400 statute miles
Source: www.aeromed.com
From Anchorage Daily News
Every flight an emergency
Alaska air ambulances contend with distance and bad weather in getting to patients quickly
By ANN POTEMPA
Anchorage Daily News
Published: March 8th, 2005
Last Modified: March 8th, 2005 at 02:27 AM
On a Saturday morning before most people are up, a man lies in Bethel's hospital waiting for an air ambulance that's delayed.
The 23-year-old has a stab wound in his belly, the result of an early-morning fight. The 4-inch knife blade cut deep, and the man needs surgery in Anchorage.
On the same Saturday in February, paramedic Matt Loudon gets the call. He works for Aeromed International, an air ambulance division of the Yukon-Kuskokwim Health Corp. that keeps paramedics, nurses and pilots on call 24 hours a day to transport people in rural Alaska to doctors in cities. In 2004, Aeromed crews flew more than 1,400 missions.
But Loudon's flight this Saturday is delayed several times. At first, weather holds him back. Fog hangs low over Ted Stevens Anchorage International Airport, cutting visibility to less than a quarter-mile.
Later, while taxiing toward the runway, the pilots hear a disturbing sound from the right engine and turn the plane around. Back in the hangar, pilot Perry Breitenstein discovers that ice has built up on the engine blades in the minus-5-degree cold.
"I'm too scared to fly like that," Breitenstein says.
Just after 7 a.m., a new set of pilots prepares a faster Learjet that can make the flight from Anchorage to Bethel in about an hour. Forty minutes later, Loudon and nurse Joel Reitz grab their gear and head out one more time.
"Bethel flight, take three," Reitz says. This time it's a go, and the Lear takes off before dawn breaks.
AMBULANCE VS. AIRPLANE
This flight to Bethel was one example of how unique medical emergencies in rural Alaska can be. After a stabbing in Anchorage, a call to 911 would result in the dispatch of an ambulance at high speed down city streets. In the average call last summer, Anchorage paramedics got to the patients in just more than three minutes after the call for help, said Soren Threadgill, chief of emergency medical services with the Anchorage Fire Department. In December, the average patient made it to the hospital within 26 minutes.
In rural Alaska, emergency response has a whole different feel. Response is timed in hours, not minutes, and calculated in air, not road, miles. Airplanes often carry more drugs and medical equipment because paramedics must work with patients -- and their sometimes unpredictable conditions -- much longer than ambulance crews do, said Loudon and Aeromed nurse Jennifer Adams.
Aeromed is one of several companies that fly patients to hospitals in Anchorage or cities in the Lower 48. Providence Alaska Medical Center and Alaska Regional Hospital each have medical flight services that use helicopters or airplanes.
Once Aeromed receives an assignment, a crew of two -- one nurse and one paramedic -- get ready to fly. Pilots are called in to staff one of two types of aircraft: a Cessna Citation II or a Learjet. The Citation II is slower than the Lear but can land on shorter runways, said Brooks Wall, Aeromed's director.
During an average emergency under normal conditions, the plane is ready for takeoff within 35 minutes of the initial phone call, Wall said. Even so, the crew still needs to fly to patients, spend time on the ground preparing them for flight and then returning them to the appropriate hospital. The flights add critical time: the Citation II can travel from Anchorage to Bethel in one hour, 15 minutes. A trip to Barrow can take two hours, Wall said.
BUSH EMERGENCIES
Aeromed transports patients throughout Alaska and even internationally but is based in Anchorage and Bethel.
Before joining the Anchorage crew, Loudon worked out of Bethel and flew to surrounding villages. Getting to patients required ingenuity. In Nunapitchuk, northwest of Bethel, Loudon would arrive by airplane, climb on a four-wheeler for a drive to the river, get on a boat to go down-river, then take another four-wheeler to the clinic. After he got to the patient, he had to do everything in reverse, carrying the patient on a trailer or backboard placed on the ATV.
The risks of flying come with the job. Loudon, Adams and Holly Demmert, an Aeromed paramedic, all have children. Demmert said it makes her nervous to fly so often knowing she is raising a little boy.
"I can't put myself in a situation where I can't come home to this little guy," she said during a recent shift.
But Demmert continues flying, saying she's "playing the odds" but doing so with safety-conscious pilots. She said paramedics don't routinely tell pilots the patient's condition in an effort to remove the emotional part of their decision on whether it's safe to fly.
Since Aeromed was formed in 1997, it has reported a few accidents involving hard landings, difficulty braking and planes struck by birds. None has caused injury or death to passengers or crew, Wall said. But air ambulances have crashed in Alaska. In 1985, a Learjet crashed en route to pick up an expectant mother in Juneau, killing two nurses and two pilots.
Aeromed paramedics tend to patients with all types of needs. About half the time, the crew is picking up a person with heart or respiratory problems or broken limbs, often linked to a snowmachine or four-wheeler accident, according to Aeromed reports. These accidents can be prevented, Loudon said, yet they happen over and over.
"Nobody's wearing helmets," he said.
While working in Bethel, Loudon flew out to villages where children had fallen into water. In one case, a boy fell into a lagoon holding sewage. That boy lived, Loudon said, but children involved in other incidents did not.
"You're talking about distances and time, and by the time we get there, the patient is too sick to save," Loudon said. "It's heartbreaking to see a patient and know that, most likely, that person is not going to live."
Sometimes the heartbreak comes when family members want to fly with the patient but can't. There's not always enough room in the small plane for everyone, or the passengers cannot afford the trip.
A patient's trip in an Anchorage road ambulance can cost between $450 and $550, depending on the level of care provided, plus $12 per mile traveled, Threadgill said. An air ambulance flight has a much greater price tag. A patient needing an Aeromed flight must pay a base rate of $4,000 plus $22 per mile. That means a one-way flight from Bethel to Anchorage costs $12,756, Wall said. Aeromed can bill private insurance or government coverage, like Medicare or Medicaid, which typically pick up 80 percent of the bill, and the patient is responsible for the balance, Wall said.
Aeromed doesn't charge a parent flying with a young patient to the hospital. But the parent and patient must pay for their travel home, Wall said. That means patients might have to fly alone from their small village to the big-city hospital.
"It's like going to the moon for some," Loudon said.
GOLDEN HOUR
Just before 9 a.m., the pilots land the Learjet on Bethel's runway. Aeromed paramedics based in Bethel pick up Loudon and Reitz and take them to the hospital.
"Hi, I'm Joel," Reitz says, leaning down next to the patient's face. "We're going to take you to Anchorage."
Reitz pulls back the gauze on his stomach, looking at the stab wound. Loudon and the other paramedics start attaching leads so they can monitor his blood pressure, heart rate and other vital statistics during the flight. The patient says he's in pain, and Loudon gives him a shot of morphine.
Just more than an hour later, they're in the air again, flying back to Anchorage. Throughout the flight, Loudon monitors the man lying beside him. He reaches out to touch his shoulder, asking if he's nauseated, in pain, too hot. The man is groggy from his medication and isn't quick to answer. Loudon also can smell alcohol. The patient had arrived at Bethel's hospital with a high blood alcohol level.
"It will be bumpy coming into Anchorage," Loudon tells him. "And that's very normal."
The city is covered with clouds, but there's a window opening up over the runway. The plane slips through and lands just after 11 a.m. An ambulance is already waiting for them and takes the man to Alaska Native Medical Center, where he'll have exploratory surgery. By 11:40 a.m. -- about seven hours after the fight back in Bethel -- a hospital team is working on the man.
Loudon, who has given a patient chest compressions on the back of a dog sled, said rescue workers new to Alaska need advice: "Throw everything you know about medicine out the window. Things don't happen here like they do everywhere else."
Nurse Adams, Loudon's former crew partner, said rescuers everywhere else talk about the "golden hour": the best chance for survival and minimizing injury or illness means getting the patient to the hospital within 60 minutes of the initial call for help.
Adams said that rule doesn't apply here.
"In Alaska," she said, "it's the golden 24 hours."
Daily News reporter Ann Potempa can be reached at 257-4581 or apotempa@adn.com.
--------------------------------------------------------------------------------
Aeromed International, a division of Yukon-Kuskokwim Health Corp., is Alaska's largest fixed-wing air ambulance service.
In operation since 1997.
Performs more than 1,500 missions a year
Flight crew includes pilot, nurse and paramedic
Aeromed's fleet of four jet aircraft includes:
1 Lear 36A-RX for extended range
Speed 518 mph
Range 3,000 statute miles
Can fly up to 6.5 hours without refueling
2 Lear 35As
Speed 518 mph
Range 1,800 statute miles
1 Cessna Citation II
Speed 400 mph
Range 1,400 statute miles
Source: www.aeromed.com
