Tuesday, June 7, 2011
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.