Dec 04 2014

When Every Second Counts - ShandsCair is There Posted 9 years 355 days ago ago by Admin

 

Blue and orange whizzing by is a familiar site in Gainesville, Florida. On a fall Saturday, it can be a University of Florida football player flying down the field. In the spring, it’s often a Gator going for a thee-point goal during March Madness®. However, most of the time it’s something even more vital than NCAA sports that’s flashing by—it’s a ShandsCair ambulance. Those road warriors are a welcome site for anyone needing urgent care. Moreover, residents of the college town can look up and often see those same colors landing at one of Gainesville’s hospitals in the form of a ShandsCair helicopter. The patient aboard may be a local citizen, or they may have been transported from as far away as Pensacola or Miami—without refueling—to receive timely treatment at UF Health Shands Hospital.

Helicopter history

ShandsCair has been operating helicopters and medical transport for 32 years, so they are HEMS veterans. The operation was very different back in 1981, when they commenced with just a fixed-wing program catering to the transport of premature infants. The need was soon realized for a full-service air medical operation in November of that year. Emergency helicopter transports commenced a month later, when a Bell 206 Long Ranger was purchased to begin rotary operations. ShandsCair proved to be a needed, well-utilized service that soon required replacing the Long Ranger in favor of a larger airframe. The decision was made to purchase an Airbus Helicopters AS365 Dauphin.

The Dauphin remained in service until 2004, when a new Agusta A109 Power aircraft replaced it. That helicopter served the community until 2012 and amassed over 4,000 hours during its service.  What they learned from operating the A109 was that their capability was limited by the size of the aircraft for missions needing more space, such as bariatric cases. After much consideration, the program returned to an Airbus Helicopters airframe when two EC135s were delivered in 2012. ShandsCair 2 went into service in February of that year, followed shortly by the delivery of ShandsCair 3 in November.

Due to both increasing demand and the continual need to advance in-flight patient care, three years ago the planning phase began on the purchase of a state-of-the-art EC155 medical helicopter. It was delivered this year, factory-fresh from France. While waiting for delivery, an additional EC135 was brought in for a year and a half to replace the ageing Augusta 109 that was retired.

Medical missions

 ShandsCair is by no means a small operation. To keep the wheels and rotors turning, there is a staff of over 100 in various roles and locations. The administrative team ensures that every part of the operation runs smoothly. It is headed by Medical Director Dr. David Meurer (Adult/Pediatrics), and includes, among others, Dr. Michael Weiss (Neonatal) and Program Director Staccie Allen. The complex undertaking completes approximately 4,700 transports a year, split between three helicopters, one fixed-wing jet, four ground transportation ambulances, and two medical discharge vans. Most of the road services and ShandsCair 1 operate out of the main base in Gainesville. A joint base with Marion County Fire Rescue in Summerfield, Florida, is where ShandsCair 2 is housed. ShandsCair 3 is based at Doctors’ Memorial Hospital in Perry, Florida.

In addition to UF Health Shands Hospital, ShandsCair regularly delivers patients to Tallahassee Memorial Hospital and other domestic locations. They also average five international fixed-wing flights yearly, utilizing a partnership with University Air Center at the Gainesville Regional Airport.

ShandsCair's medical flight crews differ from a traditional crew of one flight paramedic and one flight nurse. While standard flight staffing is available for missions, ShandsCair's medical team ensures that they have a heavily diversified specialist medical crew available for specific mission types. The medical crews consist of 52 medical professionals in various disciplines. Specialist flight crews are available for neonatal, pediatric transport, critical care, respiratory, cardiac, and advanced trauma missions among many others, further enhancing the diverse mission capabilities of the program.

Training

The medical teams at ShandsCair undergo rigorous training to obtain and maintain medical flight certifications. Each medical flight crew member is required to have previous emergency medical and advanced life support training as well as advanced pediatric, trauma, and neonatal resuscitation certifications. Additionally, all flight crew members must have taken the U.S. Department of Transportation Air Medical Crew National Standard Curriculum and they attend further annual training. The medical team also has access to training from UF Health Shands Hospital medical professionals on a weekly basis.

Med-Trans

ShandsCair has maintained an existing partnership with Med-Trans Air Medical Transport for many years. That Lewisville, Texas-headquartered company owns and operates the two EC135 aircraft in the program under a hybrid model where they supply the aircraft, pilots, and mechanics under their part 135 certificate. They contract with the hospital for medical staff and direction.

The EC155 works under a traditional model with the same staffing and maintenance arrangement provided by Med-Trans, with the exception that the aircraft is owned by UF Health Shands Hospital. Why this remarkable aircraft was chosen, and how it was modified, is worth a closer look.

The Airbus Helicopters EC155

In 2011, the search began for a more capable airframe that would suit all of ShandsCair’s diverse requirements. The decision was made to stay with the Airbus Helicopters brand, but opt for the newest and most efficient aircraft—the EC155. This allowed ShandsCair to gain back the service capability previously offered when the program utilized the AS365 aircraft, and it also enables dual-patient configuration if needed in a mass casualty event.

Before the aircraft was delivered this past May, it was outfitted with a medical interior provided by Metro Aviation. This interior includes an ECMO machine for treatment of neonatal diaphragmatic hernia, a Propaq MD monitor defibrillator, and multiple I.V. pumps that allow medical teams to insert chest tubes and arterial lines in flight.

It was also fitted with a Spectrum Aeromed stretcher, which assists the flight crew in handling larger bariatric patients. The new stretcher offers 22 inches of useable width, up from 19 inches, allowing for much wider patient girth than possible in other airframes. The Spectrum Aeromed stretcher is also fitted in ShandsCair's fixed-wing aircraft.

With the addition of the EC155, ShandsCair was not only able to increase the type of patients they could assist, but they also expanded the service’s response area. The EC155 has a 332-gallon useful fuel load, which increases their response range from 192 miles in the EC135 to 360 miles in the EC155. With a cruise speed of 150 to 155 knots, the aircraft can travel considerably further without the need to refuel enroute.

All this means that ShandsCair transports more patients with more lifesaving technology within the “golden hour.” In the world of critical care, that can make a critical difference for many lives.