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SW Aviator Feb/Mar 2001
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Air Ambulance
Ride-along with Aero Care

Story and photos by Jay Wischkaemper

When my friend Paul Sadiq invited me to ride in the King Air 90 he flies for Aero Care, it didn’t take me long to accept the invitation. The only catch was that he didn’t know when we would go. He knew when he was on duty, but flying a mission was another issue. Some shifts, the airplane never leaves the ground. It didn’t matter. I could wait.

With a medical school in the city, Lubbock is a major regional medical center. Two hospitals, one of them connected with the medical school, offer some of the most extensive and respected medical services between Dallas and Phoenix. A burn unit, trauma center, and two world-class neo-natal units act as a magnet for patients from hundreds of miles around. Both hospitals operate a network of smaller hospitals and clinics as distant as 150 miles away. Critical care patients from those hospitals are shuttled to the main facility. To do that requires dependable, speedy transportation. That’s where Aero Care comes in.

Aero Care is operated by Covenant Medical Group, but is a separate entity. Patients are delivered to both hospitals. The fleet consists of two BK117 helicopters for the shorter runs, normally up to 150 miles, and the King Air for longer missions. The King Air will be called on to fly the shorter hops as well if both choppers are busy.

Aero Care employs eight pilots to fly the helicopters, plus four King Air pilots. All missions are flown single pilot. Originally from England, Paul came to West Texas to learn to fly. While training, Paul met Tracey, they were married, and the rest is history. Paul obtained American citizenship about six months ago. Now if we could just teach him the English language.

Aero Care pilots work 12-hour shifts, with Paul’s shift starting at 6:00 am. I arrived at the facility a little early, only to learn that the King Air had just left on a mission to Seymour, Texas. Seymour is within range of the helicopter, and under normal circumstances would have been a helicopter mission, but the weather was IFR in Lubbock. Since the helicopters are strictly VFR, the only available option was the King Air. Weather was acceptable in Seymour, and the 600-foot overcast presented no problem getting back to Lubbock.

The aircraft returned by 8:00 am, and the crew quickly set about readying it for the next call. Air ambulance pilots are multi-talented, including the ability to be their own line crew. After fueling, the plane was pushed into the hangar, and Paul began a thorough preflight. Not only are the normal items checked, but also items such as setting trim tabs and radio frequencies are attended to, so when the next call comes everything is ready. Every second might count. The medical crew restocked medical supplies that had been used on the previous flight. Now, when the call came, all the crew would need to do was board the plane and go.

At 10:00 am, the crew quarters phone rang. It was for Paul. A possible mission was developing. A premature baby needed to be transported from El Paso, Texas to Lubbock’s neo-natal unit at Covenant.

Paul hurried to dispatch to get the details. Two dispatchers are always on duty. In addition to arranging for the flights, they keep in constant contact with the helicopters, and as much contact as distance permits with the King Air. The first issue was whether the flight was possible. Paul checked El Paso weather, it was fine. Lubbock weather was still IFR, but with a 600-foot ceiling it was flyable. The final decision that a flight will go is left to the pilot, and the decision is never questioned.

A neo-natal transport involves some additional issues. The normal two-person Aero Care medical crew is replaced by neo-natal specialists from the respective hospital. Only one Aero Care medical crewmember will make the flight. In addition to the nurses, special equipment must be loaded on board the aircraft. The normal stretcher is replaced by an incubator for the baby. Each hospital uses a different unit, and there are different units for the helicopter and the King Air.

The entire staff jumped into action to reconfigure the King Air with the incubator. In addition, the medical crew was bringing some equipment specific to this situation. The Covenant crew arrived at 12:30 pm. The additional equipment was quickly loaded onto the airplane and secured to the incubator. The crew was loaded. We were ready to go.

By this time, the weather was VFR. At the same time we were being pulled out, the helicopter was scrambled to pick up a patient in Lockney. Quickly, the helicopter crew sprang into action. One of the crew manned the tug while Jerry strapped into the pilots seat to run checklists. Movements were deliberate, but not hurried. You could tell this was something they had done hundreds of times. As the tug stopped, I heard the whine of the jet engines as the rotor blades started turning. Aero Care-1 was airborne within five minutes of the call.

While this was happening, our King Air was also being pulled out of the hangar. Paul started the engines and called for clearance. He had filed direct. The clearance he received was anything but direct. No reason to argue about it now, that could be dealt with after takeoff. The remaining checklist items were completed on the way to the runway, and we were ready to launch. Paul asked the tower if they had a particular heading for him to fly to intercept the airway. The controller recognized the problem with our clearance, and came back with the words we wanted to hear, “Cleared direct El Paso.”

Paul had filed for 16,000. The winds going westbound were higher at that altitude, so he opted to stay at 10,000. Fuel burn would be a little higher, but the time would be less. The GPS read 190 knots.

Upon our arrival at El Paso, the specialized equipment was unloaded from the King Air to the ambulance, and the medical crew accompanied it to the hospital. Paul and I finally had time for lunch. The folks at Superior Aviation provided a ride to a local restaurant. The nurses were to call us when they left the hospital. That call came 20 minutes after we returned to the airport from lunch.

As the ambulance pulled up to the plane, the baby was having problems with her oxygen level, so we waited while the medical team stabilized her. Then, our tiny patient and all the equipment was loaded into the King Air. The rhythmic beeping of the monitoring equipment could be heard throughout the flight.

This time, the requested clearance came immediately, “Direct Lubbock, maintain 17,000.” Surface winds at ELP were light out of the west, so a downwind takeoff was offered. Paul wisely declined, since with all the equipment and a couple of extra bodies on board, we were still heavy. The few minutes of taxi time gave an opportunity to run through the checklist. Safety is never sacrificed for speed. We were ready at the end of the runway, and immediately cleared. Air ambulance flights are normally given priority handling.

We climbed out of ELP at 1,500 feet per minute. There were some clouds in the teens, and it became evident that 17,000 would not clear them. Paul’s request for 19,000 was instantly approved. Ahead was an area of clouds with a slight depression directly on our path. We flew through the cumulus canyon to almost clear skies on the other side. The GPS read 235 knots. Not as much as we might have hoped for, but not bad. By the time we leveled off, it showed a little over an hour to Lubbock.

We were cleared for lower 50 miles out. Since it was at pilot’s discretion, Paul remained at 19,000 until the GPS showed we were 18 minutes out before beginning the descent. We were given priority clearance to land. One hour and twenty minutes after leaving ELP, we taxied up to the Aero Care hangar.

As the baby was being unloaded, the helicopter was firing up for another mission. This time it would go to Aspermont. It was now 6:30 pm. Lee was the King Air pilot again. He fueled the plane, shoved it into the hangar, and sat down to wait. After 30 minutes of paperwork, Paul went home. Two days later he would do it again.

Professional flying is about more than the money you make. The left seat of a 747 may be the ideal for many pilots, and obviously that’s where the money is, but there are some things bigger than money. As I thought about that little baby, I wondered if 10 years from now she might be a healthy child playing on her school playground, with no memory of this flight that made the difference of whether she lived or died. Someday, years from now when she boards an airliner with a highly paid captain at the controls, will she think about the very first flight she ever took? A flight captained by no less capable and caring hands. Hands willing to give up the prestige of the airline job for the service to humanity provided by these unselfish crews. Hands that do more than get people from point A to point B. Hands that save lives, and that sacrifice to do it.

To Paul, and the rest of the Aero Care crew, it isn’t a sacrifice. Cruising at 19,000 feet on the way back, Paul commented to me, “I’m very lucky to be doing a job that I love, and working with such great people — and they actually pay me to do this!”

It’s one thing to go home at night and look at your pocket book. It’s another to go home at night and look at your heart.

Medevac on the Redwood Coast
From the Pilot’s Perspective

By Steve Clary

It is 2:37 am in Crescent City, a city of 8,000 souls on the Redwood Coast of northern California. A fast moving cold front driven by a strong Pacific low-pressure area off the coast of Oregon is causing the usual heavy rains and strong gusting winds one expects here near the ocean. The familiar beeping of my pager snaps me awake. Somewhere out there in the stormy darkness, a man is having a massive heart attack, and needs to be flown to the heart center in Medford, Oregon for surgery. The man’s condition is critical, and his need is immediate. He will not survive a two and a half hour ground ambulance ride through the rugged coastal mountain range. The man is now our patient, and I can have him on the ground in Medford in 25 minutes.

I contact the flight coordinator, and receive all pertinent patient information. I obtain a weather briefing, and file a flight plan. It’s nasty up there, with winds exceeding 40 knots at the surface, and known ice above 2000 feet. It is snowing in Medford with reduced visibilities in fog. At times like this, I am grateful for my hundreds of hours of training, and thousands of hours of experience. In the back of my mind is the knowledge that this man will suffer irreparable heart damage if not transported quickly; however, safety is never compromised. I will not be doing the patient any good if we don’t arrive at our destination.

I meet the ground crew in the hanger, and prep for the flight. The Cessna 421C is fully equipped for flight in known icing, and it’s pressurization allows me to assist the patient by keeping a sea level pressure in the cabin during our ballistic-arc flight to Medford. I am flight-ready in 15 minutes. The ambulance arrives with the patient, who is already under the care of my medical flight crew — two critical care ICU flight nurses. The patient is quickly loaded onto the aircraft while still inside the hanger, and then we are tugged onto the ramp. My medical flight crew is fully trained to FAA standards, and work with me in the operation of aircraft doors, hatches, and emergency equipment. After four years and over 575 missions together, the challenge and response between the nurses and I for engine start, and their readiness for taxi, proceeds with the finesse of a ballet.

Engine start, taxi, and run-ups are completed. I obtain departure clearance, and we launch into the storm. I lose ground contact climbing through 700 feet, and all is pitch black outside. As forecast, I start picking up light rime ice climbing through 2500 feet all the way up to cruise at 9000 feet. The rest of the flight is a trade-off between GOOD and BAD.

The ice is now moderate mixed, and I am constantly cycling the boots to stay ahead of it…BAD. I have a stiff tailwind, and am doing 265 knots over the ground…GOOD. I am in cruise for only six minutes before it is time to start down…GOOD. It has stopped snowing in Medford, and there is less than an inch of snow on the runway…VERY GOOD. Medford is now reporting a 100-foot overcast with 1/2-mile visibility in freezing fog…VERY BAD!

I must have had the heat set too high in the aircraft, as I found myself damp with sweat on touchdown. The patient thanked me for the “great flight” as he was loaded into the waiting ambulance. I return his thanks with a very professional “Thanks, just routine sir.”

Oddly enough, the flight was routine. Storms, wind, fog, forest fires, and wildlife on the runway are but a few of the challenges in this coastal area. It is not unusual to fly off of a 2800-foot mountain strip in the morning, and find myself on the ramp at San Francisco International in the afternoon. When asked why I fly twins in such a challenging area of the country, I can only answer that I get a certain satisfaction out of the challenge, and helping people in need. There is no doubt that I could be making more money driving around in a biz-jet, but I am not excited by that type of flying. I began flying in 1976 in the aviation program at Tempe High School in Tempe, Arizona. My first flight instructor instilled in me a desire to make my flying count for something, and I always strive to fulfill that vision.

All such thoughts now must be set aside, and my concentration returns to the mission at hand. My medical flight crew is arriving back at the aircraft. The nurses report that the patient is in surgery, and doing well. It is now time to get ready for the return trip, and once again launch into the black sky.

Steve Clary is a senior pilot with Cal-Ore Life Flight, based in Crescent City, California. Cal-Ore Life Flight is an award winning leader in medical transportation, providing prompt, caring and dependable ground and air transportation for people in medical emergencies. Cal-Ore Life Flight airlifts more patients from the Del Norte, California and Curry, Oregon counties than all other services combined. Cal-Ore’s aircraft transport patients to destinations throughout California, Oregon, and Washington and other states as authorized by the sending physician. For more information visit, or call 800-761-5183.

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