The Flying Ambulance

“...The helicopter symbolize(s) the victory of ingenuity over common sense.” 
~Montross, Lyn and Prouty, Ray, U.S. Marine Corps Helicopter Experience, p. 20.

You may recall that a few weeks ago, I was half drowned to death and the other half scared to death while going through dunker training.  (Click here to read about it.)  This week, I had my first LifeFlight shift and went on three helicopter flights.  LifeFlight is the UMass emergency medical helicopter program.  Each flight has a three-person crew consisting of a pilot, a flight nurse, and a resident.  I was a fourth person going along mainly to observe.

I will admit to being skeptical about the value of the emergency medical helicopter experience for residents in general, and even more skeptical about the wisdom of my physical presence on a helicopter.  UMass is one of the few EM residency programs in the country that requires residents to serve as flight physicians.  So I think it's fair to ask why, if being a flight physician is such a valuable experience for residents, more programs don't require it.  Not only that, why are some programs eliminating resident helicopter flying altogether?  The answer to the second question is because of the large number of emergency medical helicopter crashes that have occurred over the past several years.  (For example, click on the Program Highlights tab to see Indiana University's statement about why EM resident involvement in their air ambulance program was suspended.)

All of that being said, I came to this program knowing that flying on the helicopter was required, and it's obviously a bit late to back out now.  But as I strapped myself in for the first flight, I took the time to study how to open the emergency window exit.  Just a precaution, you know, in case I had to put my dunker training to use.

The flight itself was completely uneventful, and surprisingly enjoyable.  I had been worried about getting motion sick, but this was not an issue.  Our first transport was from an outside hospital (OSH) that had its own landing pad.  The patient was being transferred to UMass for more advanced treatment of a serious medical condition.  The resident and flight nurse helped the hospital staff prepare the patient, who was unresponsive, for transport.  We took the patient outside, loaded everything (patient plus equipment) onto the helicopter, and took off.  I went on two other flights, one for a patient who suffered trauma in a car accident, and the other a hospital-to-hospital transfer like the first flight.

Wherever we went, a crowd of onlookers gathered.  It amused me every time to see them shielding themselves from the wind created by the rotor downwash, which is a lot more powerful than I (and evidently they) had realized.  In addition, watching the upper level resident, I was able to appreciate why there could be some value in residents participating in LifeFlight.  When you're at a scene, there is no attending standing there telling you what to do; there is no team of nurses and techs to back you up; and you do not have the luxury of using much of the advanced equipment that is available in the ED.  Several of the program graduates have told me that participating in LifeFlight gave them tremendous confidence in their ability to handle emergency situations.

I still don't think that my education would suffer greatly if the residents were suddenly pulled out of the LifeFlight program.  However, I don't see the time spent working on LifeFlight as something that detracts from my education any more either.  I also have a better understanding of why the opportunity to fly is such a huge draw for many applicants to this program.