In The Thick Of It...

It's fun to blog about HEMS. It's deeply satisfying to be in a room with flight teams discussing AMRM. I enjoy traveling and serving EMS pilots as a volunteer-member of NEMSPA's board. But nothing compares to actually doing the job of a HEMS pilot. It doesn't pay much, but it's emotionally rewarding.  It keeps me honest and filled with humility and respect for those with whom I serve.

Over the years there have been some remarkable flights. Flights in which great work led to good outcomes, and camaraderie, and laughs.

Once upon a time...

We are flying a woman from a rural hospital who has suffered an acute M.I. (heart attack). This lady needs to go to a cath-lab and get checked out right now. Or she is going to die. We rumble along in the darkness at two thousand feet with many miles to go, and it happens...

"Crap, she's in V-Fib!" My  nurse for the night, "Steve" (not his real name) exclaims...

The medic on board, "Terry" (not his real name) says, "Okay! I am starting CPR, get  ready to shock her."

What follows is a non-stop determined effort to keep this woman alive. Her heart is giving up - failing, but Terry won't have it. He talks to her, and us. "Come on lady, don't give up on us. You are going to make it!" The CPR alternates with repeated drug therapies and multiple shock events.

"Charging! Clear!" I take my hands off the controls. She jerks on the cot next to me. Compressions resume.

 I radio the com-center, "the guys are busy and can't talk now, the patient's in arrest, we are going to need help at the pad."

"Roger. Help at the pad"

I want to be helpful too, but I have to remember that my job is to fly the helicopter. "Calm down, do the job, ignore this drama."

Easier said than done...

We HEMS pilots can't let the impending death of a patient distract us, or cause us to do something different - or stupid. We have to fly the helicopter with the action inches away.

Not long ago, I heard an industry-leader state that we pilots should keep medical personnel "out of the cockpit." The problem with that idea is that our cabins are so small that not only are crew-members in the cockpit, so is the patient, and the cockpit is where the CPR happens!

Sidebar: For the record, I philosophically disagree with keeping crew-members out of the aviation side of HEMS - at arms length so to speak. But I understand that not everyone sees things as I do, and I understand why. That's a post for another day...

Terry is bent over at the waist, pushing on her chest. "Come on lady! Come on!" her heart runs through bouts of V-Fib, asystole, and occasionally short periods of  normal sinus rhythm, and still he works. Terry is burning up, sweating, breathing hard, CPR is hard work.

He says, "Guys, I'm sorry but I gotta fart!"  Steve and I answer at once, go ahead go ahead... 

Whatever it takes...

The fart is potent and floods through the cabin. I pull the vent knob and open my window. Whoa! It breaks the tension and we all burst out laughing.

Steve says, "Hey! she's got a rhythm!" She maintained that rhythm through the landing and being rolled to the cath lab.

She lived...