Tuesday, June 7, 2011

Beyond money....Why this job matters.

I don't fly the line much anymore, but I did in Charleston this past weekend. After not seeing the familiar faces for a while, it was nice to catch up. On Saturday evening, I got toned out for a 2yo near-drowning in Myrtle Beach right after arriving at work. The good news about that trip was that the kid was moving and fighting and puking during the before-takeoff-check for the flight to MUSC. A kid crying in a helicopter is a very good thing...

No sooner did I land and begin fueling after dropping off the kid, then my nurse for the night walks up with a phone in her ear and says, "balloon pump".

We don't do many of these.

The Intra-Aortic Balloon Pump is a fascinating device that helps the damaged heart move blood through the body, most importantly to the heart muscle, and of course the brain. A damaged heart leads to a downward spiral, in which the heart isn't moving enough oxygenated blood to itself, and so becomes progressively weaker and more damaged. Then the good blood doesn't go to the brain and other parts, and pretty soon it's all over but the crying. The neat thing about the balloon pump is that it helps a weak heart by inflating a small balloon that has been inserted up through the leg-pipe into the big pipe near the heart at just exactly the right time with each heartbeat. A pressure of 40 over not much is then increased to perhaps 70 over alive. While the pump is working, doctors and nurses can strategize and a patient can rest and recover. That's the good news about the pump. The bad news is that it is top-heavy and 148 pounds, awkward, on wheels, and connected to the patient by a relatively short set of lines and leads. Moving a sick guy from a hospital bed to a stretcher, and then wheeling him out of a hospital to a helicopter can be a real goat-rope. At best it's time consuming and labor-intensive. At worst you can lose control of the pump-patient connection and start pulling things you ought not to.

Any of these patients is going to have a whole crowd of drugs flowing, and when you walk into the room and see all the stuff hanging and running in and around a balloon pump guy, it's breathtaking. As machines get unhooked and switched, and alarms begin to go off, it sounds like a four year old kid playing with a keyboard. Beep, Boop, Bomp Bomp...Beep, Boop, Bomp Bomp. If you want to gain some extra respect for a nurse and paramedic, go watch them prepare a balloon pump patient for a ride.

Sidebar: If you are wondering why we are talking about balloon pumps on a helicopter blog, you should understand that helicopter aviation is by it's very nature a support business. Offshore pilots learn the oil and gas production business, and tour pilots become great public speakers; we exist to make other businesses better. As a flight-lead in the 160th, I took shooters to the objective so that they could accomplish the mission.

So there we were at the Georgetown hospital ICU, and I met - again - a really cool doctor. Young Dr. "Scott" stood with us the entire hour-plus that we unhooked and rehooked lines, wires, pipes, and tubes, and entertained me with stories from his past. As a youngster Scott was an enlisted man in the Air Force, and worked crash-rescue. And now he is a Doctor of Osteopathy. That's an American success story if ever there was one. He was going from trading war stories with me to commenting on patient care and condition and what we might do to improve both, without missing a beat. Some people just exude competence, confidence, and cool, and it is a real pleasure to be in their presence. Scott is like that.

When we finally got ready to roll, Scott said, "I'll drive the pump". I walked along right behind him and to his right, with my left hand on the leading edge of the stretcher. He walked backwards, keeping a nice smooth pace; my job was to prevent the stretcher from getting out of formation; first tugging then braking. It was a real road-show, and you will rarely if ever see a ER doctor pulling his load (sorry, I had to say that)in the way that Scott did last Saturday night around 1:00 AM. Kishma watched the drugs run and the monitor report, Brian pushed from the back end, and kept track of the ventilation pump doing the breathing, and we moved down through the hospital, through doors, elevator, and parking lots.

When we got to N909 LickinChicken(LC), so named because that month and year are sad and special to us, we discussed how to get patient and pump into the back of the volkswagon bus all at once without dropping or pulling something. A little prior planning goes a long way at this juncture, and Scott and Brian each lifted about 75 pounds of pump from ground level while a helpful hospital nurse and I and Kishma loaded the stretcher.

The patient on this flight was a guy we really wanted to help. He is a firefighter who collapsed in front of his buds while fighting a fire near Myrtle Beach. He died right there and got resuscitated twice. His heart was tired and quitting. The rescuer needed to be rescued. It was a pleasure and honor to serve a man who has been serving his entire working life. He couldn't talk to us, but we talked to him. We had his back.

So we took him to the big house. The Ashley River Tower is where hearts go to heal. I hope the best for our guy. So do the dozen or so uniformed firefighters from Charleston FD who met us on arrival. They all wore a look of concern and compassion and Kishma gave it to them straight. God Willing...

So it was a long night. There was another kid to go get around 4:30, but the weather got in the way and I had to go back and a ground trip ensued. I drove home to Savannah with the sun, tired but happy with my nights work.

safe flights...

Tuesday, May 10, 2011

Returning the Favor and Keeping the Faith...

A few years back Les and I took the BK to Beaufort to the airshow, and watched a young Blue Angel pilot burn it in. We went looking for him, and landed and walked the ground where he died. It was a significant emotional event for me, and for Les too I suspect. After that happened I kept thinking about his parents - what was going through his mom's head. They were at the show and watched their son die. I thought about something Les said to me as we flew over the path his jet cleared on the way in. Les opined that Kevin rode the aircraft in to avoid letting it kill people on the ground. You may remember some time after that a Navy guy punched out of a jet out West that killed a man's family on the ground. It was ugly. It's what happens when you eject out of several ton's of metal moving at several hundred miles an hour over a populated area. So anyway, I am thinking that this mother is absolutely crushed, and has nothing to comfort her. So I wrote her a letter.

I told her, amongst other things, that Les and I decided that Kevin deliberately stayed with that jet to avoid hurting anyone.

Was it a kind sentiment or the truth?

God only knows.

We - the Meducare family - also bought Kevin's parents flowers on the first anniversary of his death. She did write me back and tell me what that letter meant to her.

Why am I telling you this? Because Jeanne just told me that during her visit to the Beaufort airshow yesterday, a Blue Angel on a golf-cart rode up to her and asked if they were Omniflight. She said yes. He went away and came back with a signed picture of the team/aircraft. It said thanks for what we do.

The favor has been returned and the faith has been kept.

Wednesday, March 30, 2011

Concerning a Crash

The only thing I can add about Patrick, Claxton, and Diana's crash in Georgetown is that I knew two of them, and liked them. Patrick was a retired marine, had moved to the Myrtle Beach area and bought a home, had recently had a baby, and was a "motivated troop" when it came to aggressively pursuing flight opportunities. On independant bases, all involved know that flight volume equals job security, and the conventional wisdom is that it takes 30 flights a month to stay in business. Patrick set about ensuring that Conway performed enough transports to keep the base open. He was a capable pilot, had a great sense of humor, and was very popular.

I briefed him on base manager duties when he assumed that position. As we in Charleston shared radio nets with the Conway team, we knew what they were doing, when, where, and in what weather conditions. Some of the flights they pursued caused us to "raise our eybrows" at each other in Charleston, and on one occasion one of our pilots even tried to raise a "safety" flag. But at the end of the day we tended to our business and Conway tended to theirs. I regret this now. As a guy with 10 years of experience in this business, I should have seen where things were headed and raised my voice to bring attention to the situation. The night that Patrick and his crew crashed, Charleston pilot Tim Lilley was in Greenville, stuck for weather, and monitored them leaving Charleston toward Conway. Tim called Pat on the 800 radio, advised him that he had just checked weather and seen a storm moving into their path. Tim suggested they stay at the Charleston crew quarters, since they were going to be empty all night. Pat refused and advised that they were heading home. They never made it.

The investigation on that crash is not yet complete, so no definitive answers can be given, but the initial report does state that the aircraft flew toward an area of convective activity (or words to that effect). Witnesses on the ground saw the aircraft fly overhead at low altitude just prior to the crash. The training point to emphasize here is that we never have to press on. If someone on the ground could see the aircraft, persons on the aircraft could be assumed to be able to see the ground. An off airport landing is better than pressing on into a bad situation. We as AMRM instructors want to drive this home, and we want to drive this point into medical crews as well as pilots. While the pilot should be the first to realize that a bad situation is developing, sometimes we get tunnel vision, or fixation, or suffer some other lapse. Perhaps we succumb to perceived pressure from "above" to "get er done". Regardless, someone on that aircraft needs to speak up and call a halt...

Putting a Chinook in the water, or not...

After getting signed off to instruct Amphib Two, which is what the video is showing, I had a couple of guys with me out in a river near Fort Smith/Fort Chaffee. I was having each guy do three evolutions of landing to the water with the ramp open (which is actually quite a bit different than landing on the water with the ramp up), onloading a combat rubber raiding craft or CRRC, flying a pattern, and putting the boat back in water for another go. So I had, if memory serves, Marie's husband up front and we are getting it done. As it was night, I noticed clearly the port position light was occasionally disappearing under the water, but I didn't consider the ramifications. This was a level one SA failure. As it happened we were also training crew chiefs to perform the ramp duties. Oh, and the guys in the boat were training too. (Bad call, never have more than one piece of a complex operation in training). As we were at JRTC, which was in Chaffee then, we had a generic miles gear kit installed, with a wire running up the right sponson, and into the forward compartment where, as luck would have it, an engine control box lived. The wire broke the seal on the compartment door, and allowed air to escape, which allowed water to flow in thru the open drain ports at the floor of the compartment. This was getting ready to be a problem. The first problem though was that we were too deep, and the ramp opening was too close to the water. The boat made a run for the chemlights taped to the ramp opening, and ran a soldiers head right into the ass end of the aircraft. He went swimming. The boat made a go around, and the FEI made it about half way thru explaining this when we lost comms with the back. Water got into the ICS box near the ramp. I took the controls, lifted the aircraft (now pretty heavy with a belly full of water pouring out of a hundred and something drain holes) to a 30 foot hover, and tried to get control of the situation. Then the number two engine began to decelerate with a torque split and a drop in rotor. That was the water getting into the N2 control box in the compartment on the front of the sponson. We were in a trick.

It was at that moment that a piece of training that I got in the IP course saved the day. As a younger pilot, I had been conditioned to pull the cyclic rearward after losing an engine, as this is what you do when you "get one" in the traffic pattern. My instructor in the IP course took to giving me engine failures at a OGE hover, and I got the habit of accelerating in my muscle memory. So that night, at Fort Smith, as that motor drifted downward I just stood on the beep with my thumb and moved forward thru ETL. We got pretty close to the water. I declared an emergency with the Fort Smith tower, and freaked him out when I did a run on landing with "fuel" pouring out of the aircraft all over the runway. We were done for that night.

Safe flights boys!