As with everything else in the Sunshine State, Hurricane Irma temporarily benched west-central Florida’s Bayflite air ambulance service. It wasn’t just the unflyable hurricane-force winds that grounded Bayflite’s three H135s. Irma’s unpredictable storm path also kept this air medical service (AMS) and its parent company Air Methods guessing as they tried to prepare for the storm.
“Well in advance of Irma’s landfall, Air Methods set up an emergency operations/control flight center in Fort Myers (also in west-central Florida) at its LeeFlight base,” said Matt Turner, Air Methods’ area manager for Central Florida. Air Methods used the LeeFlight AMS base to stage resources brought in from outside of Florida, for deployment in the state pre-storm and post-storm. A fixed-wing Pilatus aircraft was also brought in to help transport patients before Irma hit.
“Irma then turned west and was headed directly at us, so our regional leadership quickly decided to change direction even as we were in the middle of implementing our plan,” said Turner. “So we evacuated all our local assets, because no-one knew whether Irma was going to go up the east coast, west coast, or right up the middle of the state.”
Staying one step ahead of Irma’s changing path, Bayflite moved north to Air Methods’ base at Bob Sikes Airport in Crestview, Florida. This base is located well up in Florida’s western panhandle just about 100 miles east of Mobile, Alabama. “We evacuated our staff and assets up to Crestview, which proved to be far less vulnerable to Irma’s wrath,” Turner said. Mark the score: Bayflite 1, Irma 0.
As soon as Hurricane Irma passed through Florida, Bayflite and its Air Methods’ sister services scrambled to get back into the air. “We had to do damage assessment surveys at our three bases in Brooksville (Hernando County), Tampa (Hillsborough County), and North Port (Sarasota County),” said Turner. “We had to make sure that they all had power, internet, and running water, to ensure that it was a safe return to service,” Turner said. The company also checked other Air Methods bases it uses, such as Air Methods’ LifeNet 5 AMS base at Bartow Municipal Airport in Bartow (Polk County), Florida.
As it turned out, the LifeNet 5 base sustained serious damage during Irma and required immediate repairs. “Our Air Methods crew members showed up and asked, ‘What can we do to help?’” Turner said. “We worked with them to find alternate locations for the LifeNet 5 AMS crew to fly from, and moved LifeNet 5's operations from its original building that had suffered storm damage to another one. Granted, we had to power the second Bartow building with a generator due to the power lines being down, but we were soon back in operation.”
Even today, Turner can’t get over how Air Methods’ people (including those with Bayflite) stepped to get this air ambulance service back into operation. “They came out to help, even though many of them had no power at home and serious damage/debris issues to deal with,” he said. “Our people came to work nevertheless. They got Bayflite and our sister Air Methods’ AMS units operational and back to doing what we do best, which is transporting patients safely from incident scenes to hospitals, and from one hospital to another in Central Florida. It was truly an amazing, inspiring team effort!”
A Key Player
Using its three bases plus the LeeFlight and LifeNet 5 bases, Bayflite’s 75-80 roster of pilots, flight medics, flight nurses, maintenance technicians, and administrative staff provide intra-hospital/scene-hospital AMS coverage through west-central Florida. “We are split about 60/40 between intra-hospital and scene transport flights,” said Turner. “Our AMS area covers about 3 million residents in 15 counties.” The service flies about 2,600 patients annually, and by 2011 (the last time an official tally was done) had flown 50,000 patients in total.
Bayflite’s three H135s, and the two H135s (formerly EC-135s) flown by LeeFlight and LifeNet 5, are IFR- and NVG-capable. “Although our bases are not utilizing IFR, we do rely on night vision goggles for many of our operations at night overland, and overwater,” Turner said. “Being in Florida, you can count on doing a lot of overwater flights to move patients efficiently.”
These Air Methods’ helicopters are equipped with modern medical technology. Their onboard equipment includes end-tidal CO2 monitors, intravenous infusion pumps, LUCAS portable chest-compression systems, portable ECG and pulse oximeter monitors, transport isolettes, plus ventilators for neonatal, pediatric, and adult patients. “As well, we are authorized to carry blood and blood plasma on our aircraft,” said Turner. (Bayflite was the first Florida AMS to be granted this right.) “When we arrive at an automotive accident scene, our flight crew can begin administering blood and plasma right in the car. We really bring the trauma center right to the accident scene.”
In terms of personnel, each Bayflite helicopter is crewed by a pilot, a critical care flight medic, and a critical care flight nurse. “We’ve found that the skills of flight medics and flight nurses complement each other very effectively,” Turner said. “Flight medics have the ‘street level’ approach that allows them to deal with trauma head-on, while flight nurses add a depth of knowledge and skill that enhances treatment in their aircraft heading to the hospital. It’s a very good life-saving mix.”
According to Bayflite, its AMS crews can treat multisystem traumas in adults and children; advanced cardiac-care cases (including intra-aortic balloon pump patients); and people suffering from serious burns, strokes, and obstetric crises. Whatever their injury/illness, all patients are flown to the nearest appropriate receiving facility, whether Bayflite/Air Methods has a partnership or affiliation with them or not.
Two points worth noting: First, Bayflite transports patients regardless of their ability to pay. Second, Bayflite’s ‘weather minimums,’ which dictate whether the service will take or reject a call in poor flying conditions, are stricter than the FAA’s mandated minimums. “We set tougher weather minimums to protect the safety of our crews,” said Turner.
As for Bayflite relying exclusively on Airbus Helicopters H135s, Turner cannot say enough about this helicopter’s AMS capabilities. “The H135 is an industry workhorse,” he explained. “It has the power, range, and capacity to work well in Florida’s hot and wet weather conditions. Not only does the H135 have the room we need to carry our personnel and patients, but its reliability makes us comfortable about sending them on overwater missions. That’s not something we could do with a lower powered, less reliable AMS helicopter.”
A Brief History
Today, Bayflite is a community-based AMS, but that wasn’t the case when it was launched in 1986. Back then, the Bayfront Medical Center (now Bayfront Health) in St. Petersburg partnered with Rocky Mountain Helicopters to fly a single BK117 (precursor to the H135) to serve part of west-central Florida. Bayfront Medical Center’s management made the decision to launch its own AMS after becoming a trauma center.
“We were very much a hospital-focussed AMS,” said Turner. “We flew our first patient transport on 13 November 1986, moving a patient from the East Pasco Medical Center (now Florida Hospital Zephyrhills) in Zephyrhills, Florida, to the Bayfront Trauma Center. Our first scene transport occurred six days later.” The name ‘Bayflite’ was chosen after Bayfront asked the public to name the new AMS.
In its first year, Bayflite flew just 46 patients. That volume increased; Bayflite passed the 50,000 patients milestone in 2011, and continues to grow to this day.
Bayflite’s evolution to a community-based service occurred after Air Methods purchased Rocky Mountain Helicopters. Although that acquisition took place in 2008, Bayfront continued to run its AMS program directly until October 2015. This was when Air Methods became the sole owner/operator of Bayflite, with the carrier’s licenses being transferred to Air Methods. (Under the deal with Bayfront, Air Methods took over the management of Bayflite and responsibility for maintaining and provisioning its helicopters and running Bayflite’s three bases 24/7. The Bayflite brand is jointly managed by Air Methods and Bayfront.)
“Air Methods is honored to be a long-time partner of Bayfront Health and the Bayflite program,” said Mike Allen at the time. He is Air Methods’ president of air medical services. “The program has strong roots in the community, caring for critically ill and injured patients who need immediate, specialized care,” Allen noted. “Together, we devote ourselves safely and prudently to ensuring patients across 15 counties on the west coast of Florida have access to the highest quality, around-the-clock service.”
A Broadened Horizon
According to Turner, Air Methods’ takeover of Bayflite changed things for the better. This isn’t just a company line: He cites tangible reasons why Bayflite and its clients have benefited by being run by America’s largest AMS provider.
“We had been very successful as an AMS that followed the legacy ‘this is the way we’ve always done it’ hospital model, but at the same time we were isolated from the rest of the air medical industry,” said Turner. “Now that we’ve transitioned to Air Methods, we’re with a company that is leading change in the air medical business. The depth of resources that they have committed to training, education, and safety – we had no idea that we were lacking these things until we got access to them.”
Among Air Methods’ resources that Bayflite is now tapping into are complete H135 simulators for pilots; high-fidelity clinical simulators for medical staff; and safety expertise that has allowed Bayflite to implement an FAA-approved Level 5 safety management system (SMS). “This level of SMS is very similar to SMSs used by Delta and other commercial airlines,” he said. “We’re the only air medical provider that has achieved Level 5 SMS.”
Since becoming a part of Air Methods, Bayflite has also enhanced its operational controls to improve flight safety. This emphasis on safety now governs everything they do, including Bayflite’s return to flight on 13 September 2017 after Hurricane Irma had blown past.
“Everybody from the top on down got the big picture that we needed to return to service as soon as possible,” said Turner. “But at the same time, we shouldn’t just rush out there: We had to be meticulous in ensuring that everything was either ready to go or could be worked around safely.” This cautiousness led to Bayflite personnel ensuring that quiet spaces were available at all locations to allow crews to decompress between flights, ensuring that pilots could get adequate sleep even in this extreme situation, and having sufficient personal time to tend to their own Irma-related problems. Bayflite’s people did their best to be professional and thorough in getting back to work, despite the urge to throw caution to the wind and plunge back in.
“We were very deliberate in our recovery process, to return to service in the safest way possible,” said Turner. “We appreciate that our people want to get out there fast to save lives, but we have to make sure their lives are also safe as they do this.”
Today, Bayflite is back to flying intra-hospital and scene transport flights throughout west-central Florida. Even the worst that Hurricane Irma could throw at this AMS couldn’t keep it grounded for long.