Mission Hospital Mountain Area Medical Airlift

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

MAMA 2, a Eurocopter BK117, is based in western North Carolina, in Franklin. Pilot Erin Emery, Flight Nurse Melody Starks, Medic Carrie Underwood, Flight Nurse John Sherman and Flight Medic Sharon Hinshaw at 3NR3 (Brevard NC).

At a minimum, 2500 hrs in helicopters is required to pass Air Methods corporate screening.

With that corporate hurdle met, headquarters will then forward the prospective applicant’s file to Fridd in Asheville for review and interviewing.

Once hired, new pilots attend ground training at Air Methods facility in Englewood CO, with eventual flight training completed on site at Asheville in MAMA’s aircraft. Recurrent training is an ongoing process throughout the year at both North Carolina bases.

Pilots complete 1 day or night of proficiency training each month in the aircraft and accomplish check rides every 6 months with one of Air Methods dedicated check airmen.

Once fully qualified and manning the schedule, flight time averages about 20 hrs per month for each pilot. The compensation package is very good for MAMA flight crew­members who are employed by Air Methods. Starting salary is in the mid-$50,000 range, with a 7-days-on, 7-days-off, 12-hr shift schedule that the pilots appreciate.

In addition to flying the aircraft, pilots have ancillary responsibilities and various projects that they lead. A typical day begins with check-in and a briefing about the daily situation with the medical crew and dispatchers—weather, restrictions, maintenance, MELs and the like. Pilots then preflight the aircraft and ready it for dispatch with anticipated fuel loading.

If no flights are on the horizon, project work begins. While on duty, crews are provided with separate bedrooms, a lounge area and eating facilities, all contiguous to the operations and dispatch center near the helipad.

Medical staff includes flight nurses and paramedics, some of whom have over 20 years of service with MAMA and Mission Hospital. Roy Barlow is a flight paramedic who joined MAMA 9 years ago.

“The work environment is constantly changing, and that’s the attraction,” he says. Turnover in the medical staff is low and the recruitment process competitive when openings exist. Grindstaff explains that “we have 50–60 applications for every medical position that becomes open.”

Preference is given to current Mission Hospital employees, with all applicants required to have at least 5 years’ critical-care nursing or paramedic experience.

Once selected, flight nurses and paramedics complete 12–16 weeks of classroom and ride-along training before becoming qualified to man a position on the flight team. In addition to state and hospital-required training for these practitioners, each will attend recurrent training specific to the flight mission and aircraft every 6 months.

MAMA began operations in Sep 1986 with a leased Eurocopter BO105 operating from the Asheville pad at Mission Hospital.

Medical flight staff are compensated at the same level as hospital-based nursing staff and EMS employees. Like the pilots, medical crew have ground-based duties like purchasing, training and re­search.

There are challenges for the medical practitioners on the crew, unique to the region MAMA operates in. As Grindstaff explains, “Altitude physiology is something most people don’t consider with regard to patient care.”

Because of the mountainous terrain, he says, “We operate from 800 ft MSL to over 9000 ft MSL on IFR flights.” Given the challenges, the medical crew finds the job satisfying.

“We’re very happy—we have everything we need to do our job every day” adds Barlow. Karl Esbenshade is in charge of maintenance for both MAMA aircraft and oversees 2 other mechanics, all employed by Air Methods.

“No 2 days are alike” proclaims Esbenshade, describing a job where most maintenance is performed “on the pad,” outside in the elements. MAMA’s maintenance team works a 2-weeks-on, 1-week-off schedule, with 24-hr callout.

The medical team expresses great appreciation for what Esbenshade and his crew accomplish. Grindstaff says, “To not fly a mission because of a maintenance issue is something the mech­anics take very personally.

They look at both these aircraft as personal ships—not just another aircraft in a fleet.” Esbenshade and his team complete all line maintenance, sheet-metal work, component changes and scheduled inspections locally.

Component overhaul is outsourced to the respective vendors and, while line maintenance items are stocked locally, most parts sourcing comes from Air Methods headquarters or direct from the vendor.

It is rare for either of MAMA’s aircraft to be out of service for more than a day, but when necessary a spare can be sourced from somewhere in Air Methods fleet. Esbenshade is justifiably proud of the work the 3 members of MAMA’s maintenance team accomplish outside, but looks forward to the possibility of a dedicated hangar one day.

MAMA’s machines

Nearly every mission MAMA flies involves a landing at a remote mountainous site. Responders on the ground are trained to assess and secure remote landing zones for MAMA’s arrival.

MAMA has flown Eurocopter aircraft since its inception in 1986 and continues that tradition, operating a 1998 EC135 and a 1989 BK117.

Both helicopters are equipped for their primary HEMS mission. Responsibility for EC135 aircraft specifications fell to Fridd and the pilots for the “front office,” while the medical crew laid out the requirements for the cabin—the result was an aircraft finely tuned to serve the citizens in the mountain area.

The EC135 is a Pratt & Whitney powered variant, equipped with high skids and single-pilot IFR certified. Avionics include 2 Garmin 430s that provide aviation communications, navigation and weather. Information is fed to a Bendix/King PFD and nav display.

Company and medical communications are via Technisonic TFM­550 radios, managed by a Northern Airborne Tech­nology NAT audio panel. Both the EC135 and the BK117 support company flight following with the OuterLink tracking system. The installation on the BK117 includes voice communication capability.

Sagem/SFIM provides the autoflight system and Bendix/King the radar altimeter on the EC135. Both helicopters are certified for flight with NVGs, although the BK117 flies only VFR missions. The MAMA medical team outfitted the back end of the EC135 to meet the needs of their patients and the work they perform.


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