- Associated Press - Saturday, May 20, 2017

MITCHELL, S.D. (AP) - Calmly, yet with a certain intensity, flight nurse Audrey Smeenk absorbs the information coming across her radio.

A special tone sounded, alerting her that someone is need of an air transport. And since she’s on call today, it’s her job to respond.

Because it could cost somebody’s life.

“Time’s a ticking bomb for our patients,” said Smeenk, who has been a flight nurse for Avera Careflight for two years, and a nurse for seven. “It’s amazing that we can do our jobs and provide the service that we do quickly. And it’s so rewarding to start somebody’s heart back up or get a breathing tube in, knowing they’ll have another day to live.”

Smeenk is one member of a three-person core team that responds to each flight request. The core team consists of a flight medic, a flight nurse and a pilot, who have 15 minutes to grab their gear and get into the air. The pad, located on the rooftop of the Avera McKennan hospital in Sioux Falls, isn’t far away, but they jog, sometimes run, to the helicopter.

And these trips to the helipad are increasing, as “trauma season” hits full swing.

The summer marks one of the busiest times of the year, which means more flights, including the Mitchell area.

And when flight paramedics and nurses hit the sky, they have one goal in mind: save the patient.

“Our biggest focus is providing critical care transport,” said flight medic Chad Jones, who has been a flight medic with Avera for eight years. “And then our second focus is to act as quickly as we can.”

This is a daily occurrence for Smeenk, Jones and everyone who is part of the Avera Careflight crew, which averages 2.4 calls per 24 hours. Working in 12-hour shifts, the crew can travel up to 125-mile radius of the Sioux Falls base with the helicopter - formally called Eurocopter EC-145, and described by Jones as the “cadillac of EMS helicopters.”

Of the flights from Sioux Falls, the helicopter, also referred to as the roto-wing, makes 1,000 flights. The other 800 flights are completed by Avera’s fixed-wing aircrafts, or King-Air 200, which can travel further distances.

All flights are tracked, and hospital officials have created a top-20 list in the Avera coverage region for calls and flight requests. Mitchell is No. 3, according to Anna Vanden Bosch, the Careflight clinical care manager with Avera.

The average number of patients transported from Davison County is approximately 90, but overall, there are approximately 1,800 flights per year out of Sioux Falls. There are two bases, in Sioux Falls and Aberdeen, which allows for areas such as Mitchell to be dually covered.

And with each flight, the same adrenaline rush hits the crew, Vanden Bosch said, even after 10 years on the job.

“It’s pretty awesome to think inside this little tiny box how you’re going to provide care to those patients,” Vanden Bosch told The Daily Republic (https://bit.ly/2qjtY6S ).

This “little tiny box” Vanden Bosch refers to is the limited space in the back of the helicopter filled to the brim with medical supplies and equipment.

There’s always one medic and one nurse that respond. Sometimes a respiratory therapist tags along if needed, according to Jones. And it’s his job as a medic to make the call as more details spill from the radio signals.

Though space is limited, Jones said, the helicopter can still carry all of the necessary supplies, which includes a cardiac monitor, radios, medicine, blood, oxygen tanks, to name a few.

“I like to say this is like an ER room with wings pretty much. Everything you get in an ER, we have to be able to do here,” Jones said, referring to the helicopter.

The helicopter flies at 150 mph, and cuts time - in comparison to driving - in half, which is “dramatically cutting down your out-of-hospital time,” said Lee Bollock, the director of emergency services at Avera McKennan.

But it comes with a price. The cost of an emergency air transport often exceeds $10,000, Bollock said. It does not fluctuate or decrease depending on type of care provided.

There are four full-time pilots trained for the roto-wing aircrafts, and two full-time mechanics. For fixed-wing aircraft, which has dual-pilots operating, there are 17 full-time pilots. For medical personnel, there are 13 nurses and 13 paramedics, each trained specifically for air transport.

And training is no easy task.

For flight medics and nurses there is a 12-week minimum orientation into the Avera Careflight program, according to Bollock. The flight nurses and paramedics must be certified within two years of hire in flight-specific certifications.

And for the equipment on board, Vanden Bosch said she expects the crew to know to memorize the feel and location of everything.

“We have to know those bags inside out and with our eyes closed. You never know when you’re going to get there in the dark,” she said, referring to the bags the medics and nurses take to the patient. “You better know what’s in that bag and where it’s at when you’re sitting in a ditch and its dark. You better be able to grab in it. We literally do that.”

But on top of training, Bollock and Vanden Bosch said each of the flight medics and nurses often have extensive backgrounds in urgent care.

The pilots, on the other hand, have no medical-specific training, but are very experienced in flight and most of the time have military backgrounds.

Bollock has been the director of emergency services for three years, and it’s an area he enjoys a lot.

“There’s really no better feeling than saving somebody’s life. You can’t really top that. And I try to instill that into these guys, too …” Bollock said. “We get to make a difference each and every day, and it drives me and it drives a lot of other people.”

Seeing that drive, Bollock said he is very confident with the staff and the flight services provided by the pilots, mechanics, medics and nurses.

“They’re very passionate about what they do and it makes them really good professionals,” he said.

Vanden Bosch estimates that about half of the calls transported by the Careflight team are cardiac-related. This could be anything from heart attacks to full cardiac arrests.

But no matter what the emergency, the flight crew is equipped to handle it - no matter where it is.

Each core team member, with countless flights under their belt, have landed in all sorts of locations, including golf courses, people’s front or back yards, the interstate, exit ramps, cow pastures and baseball fields.

And with each take-off and landing, the same adrenaline rush hits, Smeenk said, and it’s “amazing.”

“It’s almost like a piece of heaven,” Smeenk said, referring to flying. “And you know you’re so close to God … It’s the best feeling ever to do this job. I can’t explain. It gives you goosebumps and a lot of joy in my heart.”

Each call brings a different experience, but Smeenk, Vanden Bosch and Jones all agree that it’s the positive outcomes that are the most memorable, and the families will often find the crew later, expressing their gratitude and a hug, or two.

It’s not always a positive outcome, but luckily for the Careflight crew, it was estimated that less than 10 percent of the patients die while being transported, Vanden Bosch said.

“There’s that urge and fight to fight for that patient, because you don’t want to lose them,” Vanden Bosch said. ” … But every single one of us, at the end of the day, you see a lot of bad but it’s good.”


Information from: The Daily Republic, https://www.mitchellrepublic.com

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