SPECIAL UNIT PROFILE

St Vincent Healthcare HELP Flight—big sky lifesavers

Billings MT-based operation uses EC135 and King Air 200 for medevac services in Montana and neighboring states.

By David Ison
ATP/CFII. Embraer EMB120


HELP Flight pilots and nursing staff load a patient for extraction out of remote Elk Lake in the Beartooth Mountains.

Senator Conrad Burns (R-MT) once said about his beloved state, "We have a lot of dirt between light bulbs." Kidding aside, the State of Montana is a expansive place. In fact, according to the federal government, it's not even considered rural—it's still classified as "frontier."

If you've ever been to eastern Montana, you know that "sparsely populated" is an understatement. In a place with harsh weather and elongated distances, it's no surprise that air ambulance services have been a critical component of medical care within the state, connecting remote locations to exceptional healthcare.

And, since Feb 1974, St Vincent Healthcare of Billings MT has been providing such a service to much of Montana, northern Wyom­ing and the western parts of the Dakotas.

According to Tom Coble, the flight operations manager of St Vincent's Helicopter Emergency Lifesaving Program (HELP), the hospital, which is more than 100 years old, became the 2nd hospital-based helicopter operation in the state when it solicited the use of a helicopter for air ambulance purposes. When the operation began, in 1974, it had no formal organization—but 5 years later, in Mar 1979, things changed.

"We began the more organized HELP Flight, making our program one of the first 15 in the US," says Coble. Since then, air ambulance service has been a permanent fixture at St Vincent's in Billings.

Initial helicopter medical flights were conducted in a Bell 206B Jet­Ranger. In 1980, this was replaced with a Bell 206L Long­Ranger II, which was upgraded to a Long­Ranger III in 1983. In 1989, HELP Flight replaced the Bell 206L with an Aérospatiale (now Eurocopter) AS355F1 TwinStar.

It soon became apparent that a single helicopter was not going to be able to serve the more remote and rural parts of the region properly. In the late 1980s the hospital started to contract a Cessna 414 for patient transportation.

This was quickly followed by the introduction of a Cessna 441 Conquest II to supplement the operation.

Aircraft fleet upgrades

More than 50 people support the St Vincent Healthcare HELP flight operation, including pilots and medical and support staff.

In 1992, the fixed-wing fleet was replaced with a Super King Air B200. At the same time the helicopter type was changed to an MBB BO105LS. Most recently, in 1998, the helicopter program upgraded to a Eurocopter EC135 P1.

The Super King Air currently in use, painted in subtle St Vincent attire, is owned by the hospital but operated by Edwards Jet Center, a local FBO. The EC135 P1, clearly wearing the colors of St Vincent Healthcare and still looking virtually brand new inside and out, is owned and operated by Metro Aviation of Shreveport LA.

Most HELP Flight missions are interfacility transport. In fact, accord­ing to Coble, these flights from St Vincent's Billings to or from regional hospitals account for 85% of flight hours. While most flying is local, the King Air often flies to Denver CO, Salt Lake City UT, Seattle WA and Rochester MN, home of the Mayo Clinic.

The remaining 15% consist of air ambulance flying, such as rushing a trauma or other emergency patient to care, known as scene response. Flights of less than 135 nm are usually handled by the helicopter. For flights longer than this, or in bad weather, the King Air is dispatched.

Typically, HELP Flight operates 800–850 transports a year, evenly split between the fixed and rotary-wing aircraft. According to Coble, the EC135 averages 60–70 hrs per month, flying 100 hrs or more in the summer (known as "trauma season" to the local medical folks) and around 30 hrs a month in the winter.

This is due primarily to weather-related restrictions but partially to the lower activity levels of winter-laden Montanans. The King Air generally flies 70 hrs a month year-round as the aircraft is less limited by weather.

More than 50 employees support the HELP Flight system. In addition to Coble, there are 10 pilots (4 rotary, 6 fixed-wing), 7 adult/pediatric flight nurses, 7 adult/pediatric paramedics, 6 neonatal nurses, 4 respiratory therapists, 6 obstetrics nurses and 6 communication specialists.

There are 2 helicopter mechanics, who are technically Metro Aviation employees, while fixed-wing maintenance is handled by a large staff employed by Edwards Jet Center.

Lastly, there are 3 physicians who serve as medical directors to monitor the quality of care in each of the primary served specialties—adult/ pediatrics, neonatal, and obstetrics/ perinatal.

Operational/support systems

HELP Flight operations are split between 2 primary locations—BIL (Billings MT) and the hospital itself. The aircraft have a home in a heated hangar at the airport which is about 2 miles from the hospital. Also at the hangar are offices for pilots and maintenance personnel.

However, when the weather is good, the helicopter is usually perched on its helipad, which is able to support 15,000 lbs, atop the hospital. Not only is the strength of the helipad impressive—so is the fact that it is heated, as are the sidewalks that give access to it—obviously an important thing in Montana. It is also protected by a foam fire suppressant system permanently installed on the pad itself.

Most of the HELP Flight operational activity occurs at the hospital. Locked behind controlled access doors is the communication center. Within it is a plethora of screens, each providing a communication specialist with all he or she needs to monitor and communicate with the aircraft.

The communication specialist coordinates all the flights, helps to choose the right type of aircraft, notifies pilots, provides flight following, and coordinates all medical needs such as notifying hospitals and ambulance services.

Additional monitoring is conducted at Metro Aviation, where the helicopter's status and location can be monitored via satellite. Flightaware is used to assist in tracking the King Air, since it is almost always on a flightplan.

It is important to note that all operational control functions are maintained by Metro Aviation and Edwards Jet Center.

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