- Associated Press - Sunday, November 22, 2015

PIERRE, S.D. (AP) - When the CAT scan results came back showing some bleeding in his mother’s brain, paramedic Joe Melligan knew she needed to get to a neurosurgeon as quickly as possible.

The problem was that Avera St. Mary’s Hospital in Pierre, where the Fort Pierre man’s mother was taken after suffering severe injuries in a car accident, doesn’t have a neurosurgeon on staff. The nearest hospital with a neurosurgeon was more than 220 miles away in Sioux Falls.

Because of his job, Melligan had a good idea of how important time was to his mother’s situation. A few minutes could have made a world of difference. That’s why he told the hospital to call his employer, Medical Air Rescue Company, to arrange transport to Avera McKennan Hospital in Sioux Falls.

Melligan’s mother was the first patient the Rapid City-based company flew out of its new Pierre satellite base.

“You don’t expect that,” Melligan told The Capital Journal (https://bit.ly/1WZD5ot ).

His mother was in the air and headed to Sioux Falls 28 minutes after the hospital called MARC. Melligan estimated his mother was first seen by a neurosurgeon about an hour and forty-five minutes after being diagnosed with a brain bleed.

That is precisely the service the company is trying to provide, General Manager Paul Renfro said. He spent 20 years in emergency medicine as a nurse before going to work for MARC.

“Our model is to put the aircraft where the patient originates,” he said. “We’re going to cut time to care by an hour.”

During an emergency, which most patients needing air transport are in the middle of, every second counts, said Flight Nurse John Schoenfelder. He is one of the MARC medical crew members now based out of Pierre. Schoenfelder said the faster a patient can get to the highest level of care needed for the situation, the more likely the patient is to survive and have fewer complications.

“Time is everything,” Schoenfelder said.

Avera St. Mary’s Hospital Chief Medical Officer said the time it takes to get to the emergency room is the most important piece of time for patients. He said nine out of 10 times a patient can be stabilized in the ER before transportation to the next level of care is needed. In that case transportation time is less of a factor, Holland said.

Still, Holland said, having more options to transport patients is a good thing and the hospital would likely use the service.

“If there’s a team with the right skills in town, that’s good; we’ll use them,” he said.

MARC’s goal is to have its medical crew at Avera St. Mary’s preparing to transport the patient within 10 minutes of getting a call, said Jay Johnson, the company’s regional manager. And MARC’s Pierre base isn’t just serving Pierre, he said.

“We’ll go anywhere that people call us that has an airport that can service a King Air,” Johnson said.

He said the plane needs a 3,600-foot paved runway. The Pierre-based King Air and its crew can get to Gettysburg in 10 minutes, and to Miller or Eagle Butte in 18 minutes, Johnson said.

Before MARC opened its Pierre base, patients needing air transport often had to wait for a plane to come from Rapid City or Sioux Falls which can take up to 40 minutes.

Those wait times have been shortened in recent years by improvements in communications technology, Holland said. And for rural hospitals such as Eagle Butte having a nearby air ambulance service that can quickly move a patient should be a good thing, he said.

“Absolutely, this may be a good option for them to transport patients,” Holland said.

MARC became the only organization to operate an air ambulance full time out of Pierre on Nov. 5. The move has been in the works for a while. The company bought a house in Pierre to house its pilots and medical crew, Renfro said. The company’s newly retrofitted Beechcraft King Air will be stored in a Mustang Aviation hangar at the Pierre Airport.

The company was founded in Rapid City in 1982 and started out as a Life Flight contractor for the hospital there. MARC has since expanded to providing fixed-wing air ambulance service from four bases: one in Valentine, Nebraska; one in Pine Ridge; the new base in Pierre and its home base in Rapid City.

Renfro said MARC’s goal is to be able to add to the medical services available in central South Dakota, working with existing health care providers rather than competing with them.

“We seek to work with others,” Renfro said.

___

Information from: Pierre Capital Journal, https://www.capjournal.com

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