SPECIAL UNIT PROFILE
University of Michigan's 3 EC155s set new standards in helicopter medical care.
By Woody McClendon
ATP/Helo. Challenger 604, Bell 222/412, Eurocopter AS350B3
Survival Flight crewmembers with University of Michigan's 1st EC155. (L–R) Pentastar Aviation Rotorcraft Site Mgr Jeffrey Dowdall, EC155 Captain Mark Newlands, RN/Paramedic Jeff Pietch, Resident MD Eric Wei and RN/Paramedic Dave Roberts.
The military defined the principle of the golden hour during the Vietnam War. Thousands of US soldiers and marines are alive today because helicopters flew them to a trauma center away from the battle, where doctors successfully treated wounds that in earlier conflicts would have doomed them to certain death.
After Vietnam, that same principle lay behind the founding of the civilian aeromedical business. Today thousands of victims of violent accidents and the sudden onset of life-threatening illness live happy lives because a helicopter flew them to a hospital that could save them.
In the early 1980s, hospitals all over the US set up helicopter operations, expanding the geographical scope of their patient care and extending trauma care assets to save more lives. But in the early 1990s, when HMOs began dictating reimbursement rates, many of those hospitals found themselves trimming programs to survive, and helicopter programs were often the victims.
Today's aeromedical business has a very different face. Helicopter companies whose profit plans are based on flight volume focus on traffic first and patient acuity second. The number of helicopters dedicated to the aeromedical sector has increased, but most would argue that the higher aircraft population has not necessarily translated into more trauma victims being saved.
But within the new shape of the aeromedical community a few helicopter programs have survived at major medical centers. Staffed with highly trained nurses and, in some cases, even physicians, they focus on one purpose—to transport the very sick and injured to the care they need.
Survival Flight's team approach
Jeff Dowdall (L) points out features of the EC155's fenestron and explains how the shroud reduces the aircraft's noise signature while also protecting the fenestron blades from external damage.
The University of Michigan Health System is a world-class teaching hospital complex and medical research institution. Its helicopter program, Survival Flight, not only held on through the dark days of contract medicine, but has flourished, its annual flight activity straining its fleet resources year after year.
Mgr Critical Care Transport Denise Landis explains how Survival Flight has remained successful despite changing times.
"We have to manage 2 challenges every day," Landis says. "The first is internal. We're close partners with our colleagues in the hospital, who look to us to transport patients to them. They have confidence in us, knowing our teams can take care of their most acute patients and fly them safely to the medical campus.
"The second is external. We manage all aspects of the patient transport process, the helicopter, the crew, maintenance and flight operations, and the medical crew, their competence, the equipment they need for their mission, and the entire transport system of communications, dispatch and flight following.
It has to be safe, consistent and deliver the same high level of service for our partners in the hospitals day in and day out."
According to Landis, the answer to both challenges is proactive management and giving every member of the Survival Flight team ownership of its operations. Nurses work closely with their counterparts in U-M's 3 hospitals to maintain their skills and knowledge to the highest standards.
Flightcrews work closely with the almost 100 hospitals in Michigan where Survival Flight personnel have assisted with the building of heliports. And they coordinate with local authorities, reaching out to handle public relations events and even turning those occasional citizens with noise complaints into fans.
Today's aeromedical community single-mindedly pursues call volume over patient acuity. Some see the industry's record high fatal accident rate as a tragic side effect, but Survival Flight and its few remaining partner hospital programs not only focus on patient needs first—they also set the bar for safety, quality of care and community involvement.
Survival Flight's record of success over nearly 30 years has positioned it to take a significant step forward—re-equipping its fleet with the latest-generation helicopters. Three Bell 430s have served Survival Flight well for 12 years, according to the pilots and medical staff, their flawless safety record a tribute as much to management's uncompromising focus on accident prevention as to the aircraft itself.
Thales dual EFIS displays are the centerpieces of the EC155 cockpit. Dual WAAS-capable Garmin 430s are located in the center console, along with primary nav and comm radios. The Eurocopter vehicle and engine management display (VEMD) is on the pilot's side of the panel along with a systems MFD. To their left is the Technosonic radio system and the Honeywell King weather radar.
But, with the 430 approaching obsolescence and a whole new generation of aircraft and patient care equipment available, the time was right to search for a replacement.
As they began the search, the pilots and medical crew set up task forces focused on the many aspects of acquiring a new aircraft. And, for the first time in what would now be the 4th generation of helicopters, hospital communications specialists joined the team, bringing their expertise to mission effectiveness and safety.
The 430 had required compromises. Flight across the state meant fuel stops. But hot refueling with a patient aboard was fraught with risk and called for the crew to be on high alert throughout the event.
And during the busy summer months, hot days played havoc with performance, often adding even more fuel stops and sometimes the occasional requirement to drop a medical crewmember. These and other compromises topped the list of factors to consider in the replacement helicopter.