A pilot, a paramedic and a nurse walked across the roof of Howard Regional Health System and climbed into a helicopter with a red, white and blue LIFELINE banner painted on the side. Jessica Furrey, the nurse, and Derek Jackson, the paramedic, climbed into the back half of the BK-117 helicopter while pilot Don Dombroski sat in the cockpit preparing for take off. The blades whirled around and the high pitch of the engine kicked in.
A few minutes later, the helicopter lifted from the ground with a gentle rock, then hoisted itself 800 feet above Kokomo. As Dombroski took the medical helicopter up, Furrey and Jackson could be overheard through the electronic rasp of the flight helmets' headphones as they talked about their helmet preferences, the weather and other casual chit-chat. The helicopter flew around the greater Kokomo area for about 20 minutes before Dombroski brought it back down on the hospital's rooftop. It was a leisurely trip for the team of three last week during their down time. They did not have to snap into action upon landing like they normally would.
Instead, they settled back into the comfort of their quarters, hidden behind a locked door within the bowels of the hospital's labyrinthine corridors. The apartment-like setup of the quarters included bedrooms, a living room and a kitchenette. On the refrigerator, the LIFELINE team members stuck dozens of photos of their families. "They get homesick being here for 24 straight hours," base supervisor Bill Summerfield said as he gazed from his seat at the kitchen table to the decorated freezer door. The quarters are a luxury to help the team members relax in their down time as they wait for the next call to come in before they have to fly off to save a life.
Dombroski, Jackson and Furrey are among 16 staff members at LIFELINE Critical Care's Kokomo base, which marked its fifth anniversary in October. The staff consists of six nurses, five paramedics and four pilots, who are all employees of Omniflight Helicopters Inc. contracted to fly the LIFELINE helicopters. The crew also includes one mechanic. The company originally had two helicopters at its main base at Methodist Hospital in Indianapolis, but in 2004, it decided to move one to Kokomo, Summerfield said. "Instead of waiting 20 [to] 22 minutes for a helicopter to get here, we figured we'd have one near where the people needed it," Summerfield said. At any given time, a pilot, a nurse and a paramedic are on duty, waiting to fly out on an emergency call. And the mechanic remains on call. Most days, the teams will fly out once, maybe twice, Summerfield said.
Even though a lot of their time is spent relaxing and waiting in their quarters, the team members are always clad in their flight suits, supplies in-tote, and ready for the emergency calls. When it's time to fly, the team takes the helicopter to emergencies all over Indiana. Many of the trips are in the northern half of the state where Indianapolis-based Clarian Health, LIFELINE's partner, has fewer hospitals. The helicopter can go about 330 miles without fueling, Dombroski said, letting the emergency team travel as far as northwest Indiana when needed. It is a 50-50 split between the types of calls the team receives. About half are medical, such as for heart attacks and strokes, and half are trauma, such as with accidents, Summerfield said. The type of injury or illness often dictates what hospital the helicopter will fly to. Much like a police or fire department, the calls come in at all hours, which is why employees rotate shifts that range between 12 and 24 hours. "Any time you can work two days a week and get paid full time, that's OK with me," Jackson said as he reclined in a leather sofa in the LIFELINE quarters at the hospital.
Every morning, the on-duty team goes through a safety briefing and then checks the helicopter's medical equipment. "We are a flying emergency room," Jackson said. "We can do everything they can, except for the X-rays and diagnostics and things like that." But working out of a helicopter is still radically different than working in an emergency room, said Furrey, a former ER nurse. "I used to be running for 12 hours straight," she said. "For a [LIFELINE] nurse, we have much more autonomy [than] working in a hospital. You're pretty much bound by physicians' orders." With fewer people to help out or give orders, the decision-making lies solely on the nurses and paramedics. "I love that aspect of it," Furrey said. "I'm very autonomous. I'm able to do for the patient what is in their best needs."
One of the main principles the LIFELINE teams focus on is the "Golden Hour," which means that after someone first experiences symptoms of illness or is injured, the teams have about one hour to provide medical care. By intervening within an hour, Furrey said, the patients are more likely to avoid long-term effects. But providing that help is much more difficult when there are two people and not a full emergency room staff, she said. "As a [LIFELINE] nurse, it's very difficult to go 'Oh, I don't have as many hands as I need,'" she said. "If you have a sick patient in the ER, everyone comes over to help you. In the air, it's just the two of us." The unsteadiness and cramped containment during the flight also provides its own problems while the paramedic and nurse are trying to keep a patient alive. Jackson said they will often perform procedures on the ground to avoid complications during the 15-minute flights.
The BK-117 at Howard Regional is a "Cadillac" compared to other, smaller medical helicopters, he said, but compared to the ambulances on the ground, even it is small. "The new ambulances are so big, they spoil you," he said. "... You can move around. Before we take off, we have to ask 'What's going to go wrong with this patient in 15 minutes?'" The 15-minute philosophy is what helps them decide whether medical work can wait until they land because of possible in-air complications, the least of which occasionally include motion sickness.
The LIFELINE employees' jobs require extra training and education, but they still have ample free time during which they read, watch TV or any other ordinary, relaxing activity. "This is the only job where you're encouraged to take a nap," Furrey said. "... It's the day you don't take a nap you will be flying down to Evansville twice." Dombroski said he is required by Federal Airline Association regulations to sleep after 14 hours. "After 14 hours, you turn into a pumpkin" according to the FAA, he said jokingly. The joking and playful teasing was in abundance with the group, all of whom said they were "like a family." "Everybody gets along. It's really amazing," Dombroski said.