Mission Hospital Mountain Area Medical Airlift

MAMA’s Eurocopters serve mountainous regions of North Carolina, Georgia, Tennessee and South Carolina.

By Brent Holman
ATP/CFI/Helo. Bell 206L, Airbus A320

Eurocopter EC135 MAMA 1 flies from Mission Hospital’s main helicopter base at Asheville NC. In the background is Looking Glass Rock in North Carolina’s Pisgah National Forest.

Moments after Dutch Fridd, lead pilot of Mountain Area Medical Airlift (MAMA), reached the front of the line at the government office, ready to conduct a simple transaction, the office clerk said with sincerity, “You saved my brother’s life. Thank you.”

Minutes before, in casual conversation that included the subject of employment, Fridd had identified himself as a MAMA team member. The clerk’s declaration of gratitude was really a general plaudit to the team at MAMA—at the time, he didn’t know that Fridd was actually the pilot on the fateful day that his brother was airlifted to Mission Hospital in Asheville NC after his accident.

In a greater sense, the clerk’s comments were a collective statement of appreciation from the citizens of the mountain communities of western North Carolina, northern Georgia, northern South Carolina and eastern Tennessee that depend on MAMA in times of desperate trouble, when they need help the most and when minutes count.

“We don’t get noise complaints” Fridd says very matter-of-factly. “The citizens here in the mountain region are very happy to have us around and realize the service we provide. We are very appreciated.”

Mission Hospital—more than a century of service

For over 2 decades MAMA, based in Asheville and Franklin NC, has served the remote mountainous regions of the state, as well as parts of Tennessee, South Carolina and Georgia. Mission Hospital in Asheville, itself established over 125 years ago, recognized the need to provide rapid transport to its main facility for critical care patients in the mid-1980s and set about developing a program to serve that need.

Tom Cowan, Mission’s director of regional EMS, explains that the Asheville facility is the main referral hospital in the region as a result of its advanced capabilities. “Getting people here is the key,” Cowan continues. “The helicopter is the first link to the community.” The mountain areas of the 4 states MAMA serves are remote and difficult to access.

As Cowan points out, some places where MAMA operates can take ground units more than 2 1/2 hrs to reach—that same distance can be covered by helicopter in 25 min, greatly enhancing a patient’s chances of recovery.

In 1986, Mission Hospital contracted with Rocky Mountain Heli­copters to provide helicopter emergency medical services (HEMS) from a base which they would establish at the hospital in Asheville. Starting that September with a leased Eurocopter BO105, Mission Hospital became one of the first HEMS providers in the state.

The program and its mission continued to grow over the years, and, following a corporate merger, Air Methods in Englewood CO became the operator for Mission Hospital. MAMA considers continuous improvement and innovation a hallmark. Dutch Fridd was a leader in the development of night vision goggle (NVG) capability in HEMS with work on developing an STC for the BO105 in 1999.

MAMA’s flight program was the first FAA approved HEMS to use NVGs. Later, the hospital concluded that aircraft ownership was in its best interest and in 2000 purchased its first helicopter—a Eurocopter EC­135—continuing its service and support contract with Air Methods.

In 2004, MAMA expanded its service area westward, establishing another helicopter base in Franklin NC with a Eurocopter BK117 dub­bed MAMA 2. RN/Paramedic Johnny Grindstaff is MAMA’s air medical supervisor and a long-time team member, having joined MAMA soon after it was launched.

According to Grindstaff, ownership “allows better control and management of the helicopter and the equipment.” Today, MAMA is a hospital-based HEMS provider that owns the aircraft, facilities and equipment, and provides its own employees for the air medical crew. Air Methods is contracted to provide Part 135 certification, pilots and mechanics to Mission Hospital.

Flying the mountains today

Mission Hospital Dir of Regional EMS Tom Cowan credits MAMA’s helicopters as the “first link to the community.”

MAMA currently operates a Euro­copter EC135 and BK117 from 2 bases in North Carolina. The EC135 is based at Mission Hospital in Asheville and the BK117 flies from a satellite base in Franklin. A team of 8 pilots, 3 mechanics and 24 flight nurses and paramedics staff the 2 aircraft.

In addition to HEMS work, MAMA accomplishes, Mission Hospital offers the helicopters to local law enforcement and SAR teams when needed to aid in search missions. MAMA also provides its helicopters as a public relations tool for the hospital and as the centerpiece for training with other EMS agencies in the area. As a result, the 2 MAMA aircraft fly an average of 1200 hrs per year combined.

Mission Hospital itself is renowned in the area for its expertise as a cardiac treatment and stroke center, in addition to its role as the regional Level II trauma center. In fact, many of the transports that MAMA’s helicopters accomplish are directly related to cardiac care or stroke treatment.

Mission profiles vary seasonally too, with interfacility transports ac­counting for a large percentage of flights in the summertime. Medicare and Medicaid insurance programs cover the largest percentage of MAMA’s patient population and 100% of the operating budget is recovered from insurance billing.

“We operate in the black,” according to Grindstaff. Many of the flights MAMA conducts replace the long travel time that would be required from surface transport, operate from remote landing zones and involve multimode transport before the patient is loaded aboard the helicopter.

Safety is always the primary consideration for any launch, but MAMA is generally airborne within 3–10 min of initial call-out. Flights average 15–20 min each way, and the majority include an off-airport remote landing. Local responders are trained to provide GPS coordinates and assess and secure the landing zone for the helicopter’s arrival.

MAMA’s Asheville facility helipad is at 2200 ft MSL. (L–R) Aviation Service Mgr/Lead Pilot Dutch Fridd, Pilot Bryan Neal, Air Medical Supervisor Johnny Grindstaff, Flight Medic Brian Krickham, Flight Nurse Chuck Parris, Lead Mechanic Karl Esbenshade and Communications Specialist Penny Ponder with MAMA 1, the unit’s Eurocopter EC135.

Mission Hospital sponsored the development and certification of an IFR/GPS approach to the helipad at the Asheville facility, which is at 2200 ft MSL. Of the 8 pilots staffing MAMA’s bases, 4 are retired US Army in­struc­tor pilots. When recruiting pilots, Fridd looks for “a diversity of flight experience,” which is beneficial to the variety of challenges in weather, terrain and mission complexity a pilot will face when flying for MAMA.


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