ARCH Air Medical Service Celebrates 30th Anniversary

• Paul M. Ross, Jr.
• 2009 Oct 5

JEMS recently caught up with the busy providers at St. Louis-based ARCH Air Medical Service, because the program celebrates 30 years of service to its Midwestern customers in 2009.

A look into the program's history takes us back to the days of the first commercial helicopter air ambulance programs. As the late afternoon sun faded from the Midwest sky in 1979, the clattering Sikorsky S-55 helicopter with "MARC" lettering stenciled on the fuselage landed at a rural hospital, and a flight nurse jumped out while the pilot scanned the pad from high above. This first flight of the Medical Air Rescue Corps program, transporting a high-risk pregnancy patient in the care of flight nurses, like recently retired longtime employee Holly Stumpf, preceded thousands of such helicopter air medical transports created over the following 30 years. During these early flights, staffing consisted of the flight nurse and pilot.

Founded by St. Louis University (SLU) Medical Center staffers, MARC became present-day ARCH -- the Area Rescue Consortium of Hospitals -- in 1987, as St. Louis'three trauma centers -- SLU, Barnes-Jewish Hospital and St. John's Mercy Medical Center -- partnered in a new, progressive air medical plan.

Fast forward to 2009. Longtime pilot Jeff Stackpole jockeys ARCH 8, one of the program's signature turbine-engine BK-117s, for a landing at the scene of a vehicle accident. Flight nurse Kelly Laughlin and flight paramedic Davey Davis begin field assessment of the trauma patient and package him into the aircraft for the flight to SLU Medical Center.

ARCH currently has 11 bases in Illinois and Missouri, including a fixed-wing program. It also has multiple aircraft and heavy demand. So the program, a subsidiary of Colorado's Air Methods since 2000, continues to build on its long tradition of service, helping a wide variety of patients obtain rapid access to the highest care levels available.

Air medical crew selection criteria and job satisfaction remain high, according to Laughlin, a 20-year nurse. "We have a standard of five years with an advanced ALS crew for the paramedics and ER/ICU years for the nurses, as well as dual licensures in adjacent states," she said. "I like the ability to provide quality care in an autonomous setting. That's where you can truly use your critical thinking skills, react on your feet, truly do all the components of critical care amidst the challenge of the environments we work in, it's all very rewarding."

Deployment of more powerful ARCH aircraft -- such as the BK-117 -- and advances in portable diagnostic and treatment equipment have contributed to a better-than-ever level of aerial care. Isolettes and intra-aortic balloon pumps (IABPs) are available for specialty team transport flights.

And flight medics get the opportunity to employ all this technology for the best potential patient outcomes. "The biggest reward for me is being able to help out people when they really need it, and at the same time being able to advance your skill set," said Davis, who is in his seventh year of air medical response. "I feel very fortunate to be here with ARCH; it's certainly an opportunity to work at a very high level in the ALS field."

Service offerings by ARCH go beyond air medical flight operations. Co-located at the downtown St. Louis headquarters is the ARCH Communications Center, handling dispatching and aircraft flight communications for air medical programs in Missouri, Illinois and Indiana.

Longtime pilot Dave Fails, ARCH's area aviation manager, weighed in with thoughts about 30 years of service. "Even with our good growth and being part of a corporate structure, we still maintain our focus on doing the small things right, and more importantly, maintain a focus that safety overcomes all other operational considerations," Fails said. "And certainly we do have a lot more competition than when we started. But we have not let the competition dictate the way we operate; we remain consistently focused on effective, safe operations."

ARCH crews work regularly with area fire and ambulance districts. One of the longtime users and cooperators is Eureka Fire Protection District (EFPD) southwest of St. Louis. EFPD Deputy Chief Scott Mullins, a seasoned paramedic, has responded on many of Eureka's incidents using ARCH.

"There have been countless times that I have called for ARCH to respond to a vehicle accident scene on the 11 mile stretch of Interstate 44 that lies within our district. They have always been efficient, effective and professional, and, at times, the only reason that people that have serious injuries have survived their accident."Mullins remembers one of many calls during which ARCH and ground responders' good teamwork provided the best potential outcomes. It was an incident with a victim who had driven off the interstate, falling down a 100-foot embankment.

"We initially placed ARCH on standby then requested they respond to the scene," Mullins said. "The patient extrication was accomplished using a rope rescue hauling system and, by the time the patient was packaged, the ARCH crew was down the embankment helping with patient care freeing up the district members to focus on the rescue."

Mullins says ARCH crews are not shy about asking if they can help. One example he gave involved a burn patient who had been injured when a can of spray paint exploded in a trash fire.

"At just the right moment, the ARCH helicopter was returning from a transport and noticed the ambulance warning lights below. They called the ambulance crew on the mutual aid channel and asked if they could be of assistance, and we immediately took them up on their offer and set up a landing zone," Mullins said. "The ground transport time for this particular patient to a burn center would have been well over 30 minutes, yet it only was about 11 minutes for ARCH."

Stackpole, who has nine years with ARCH, sees his impetus for pursuing a career in the rotary wing industry unchanged. "It's the same job today as when I started. It's flying -- which I enjoy -- and it's providing a vital service to the community. I'm privileged to do the job."

In addition to very frequent scene and interfacility flights, ARCH maintains a commitment to specialty transport services with its BK-117 "Kid Copter,"customized for neonatal and pediatric high risk patients. "The St. Louis area is very much a hub for pediatric transplant medical services with the great facilities here, and it is rewarding to be a part of that service offering," specialty team pilot Jeff Romer said. "It's a great job, a great mission."

He added that the company backs the decisions he makes as a pilot. "You are never questioned, never pressured to go on flights. And the BK-117 is such an all-around good aircraft, very durable, good power, range and ergonomics for effective operations," Romer said.

Former ARCH flight paramedic and program manager Matt Kasten, now working in a Midwest regional role for Air Methods' CBS division, sums up the commitment to quality in the program's community based model. "ARCH has seen plenty of changes over the years, but the constant has been maintaining our high standard of excellence in patient care and operations," he said.

The same approach likely positions ARCH team members for success in decades to come, building on a strong legacy from the past.

Paul M. Ross, Jr., BA, EMT-B, ICT4, is a St. Louis-based writer, photographer and Firefighter/EMT with 14 years in Western U.S. wildland firefighting/helitack operations and urban fire-rescue response operations. Log onto www.moyercreek.com for additional information.

Related links
Check out the "Specialty Vehicles" section of jems.com/ambulances for more on air ambulance programs.