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Help From Above

Despite a recent crash, the medical transport helicopter team at the U. of C. Hospitals is among the nation’s leaders in safety and has rescued hundreds. Still, some critics say the skies are becoming too crowded.

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Photo: University of Chicago HospitalsAeromedical Network (UCAN)

The man wouldn’t stop screaming. Considering that a 500-pound beam of hot steel had fallen on his leg and about three-fourths of the leg was gone, he had every right to express his discomfort. The shreds of hanging skin and muscle looked like hamburger, burned so badly you could see the cracked femur underneath. His pulse was dangerously fast. He was on an Indiana steel mill floor, miles from the nearest hospital, and if his bleeding couldn’t be slowed, he was a goner.

A flight nurse in a maroon jump suit gave him a shot of morphine. A medical resident, dressed in a maroon shirt and khaki pants, undid the patient’s leather belt and wrapped it around his upper leg to use as a tourniquet. But the belt slipped off; it was too big. Another scream. Another ten milligrams of morphine.

The resident saw a paramedic standing nearby. “What’s the biggest needle you’ve got?” he asked.

The paramedic stared. “Fourteen-gauge. Why?”

“Give it to me.”

The paramedic handed it over, and the resident jabbed the needle into the belt to poke a hole. He slipped it high on the man’s leg and tightened. Perfect. The folks in maroon hustled the patient out and onto the helicopter. Soon the rotors began slicing through the air, faster, faster, until they were only a blur, and the helicopter started to climb. Then someone hit fast-forward and it darted into the Indiana sky and was gone.

Inside, zooming 200 feet over the lakeshore at 180 miles per hour, the pilot was flying with one hand. Behind him the resident and the nurse pumped the factory worker with fluids, and before long, the flow of blood slowed. The flight to Loyola University Medical Center in Maywood lasted roughly eight minutes; shortly after landing on the rooftop, the man was rushed to the ER, where doctors operated on his leg. He lived. Would an ambulance have saved him? “He could have bled to death on the way to the hospital,” the resident said matter-of-factly.

The guys in maroon are employees of the University of Chicago Aeromedical Network (UCAN). For the past 22 years, UCAN has operated out of the University of Chicago Hospitals complex, performing rescues and hospital-to-hospital transports with a safety record that has been the envy of many in the field.

But UCAN is also a leader in a field that has become controversial in the past decade or so. Since 1995, the number of emergency helicopters in the United States has doubled to more than 600, and the increased competition has coincided with an increase in helicopter accidents. Eighteen people died in crashes involving emergency helicopters in 2004-the most ever in one year-prompting The New York Times and The Wall Street Journal to report on helicopter safety, and the Federal Aviation

Administration to launch an air safety inspection. Though the number of emergency helicopters continues to rise, a recent study by Michael L. Slack, an aviation lawyer and former NASA engineer, showed that fewer than 5 percent of helicopter transports were medically necessary-the result, perhaps, of so many programs competing for flights and profits. It seems the definition of an emergency isn’t what it used to be.

“We’re getting to the point where the growth is excessive,” said Ira Blumen, UCAN’s program and medical director, in June of this year. At the time, UCAN had made more than 14,000 flights spanning 22 years without an accident. Widely known in the field as the author of an influential 2002 paper on helicopter safety, Blumen has spent 18 years building UCAN into one of the country’s top aeromedical programs. Twice a year, he sends his four pilots to FlightSafety International, an aviation training company, where they undergo motion simulator training and decision-making tests. He allows his pilots to say no to flights whenever they want. In October 2004, at the Air Medical Transport Conference in Cincinnati, Blumen won an award for contributions to aviation. He is obsessive about safety. “Anyone in the industry would tell you the same thing,” says Pat Petersen, executive director of the Salt Lake City–based Air Medical Physician Association. “UCAN is an exceptional program.”

Then, this past July 14th, with UCAN’s usual $4.5-million Eurocopter Dauphin AS 365 N1 helicopter in Texas for mechanical repair, its replacement vehicle was taking off from the rooftop of Porter Hospital in Valparaiso, Indiana-with an intubated intensive-care patient on board. Without warning, the craft lurched into a brick structure on the roof and fell about five feet. The helicopter landed on its right side, its tail hanging off the helipad. The cause of the crash remains unknown; a National Transportation Safety Board (NTSB) investigation is ongoing. None of the four people on board, including the patient, was hurt in the crash. The pilot was a Vietnam veteran with a perfect safety record; before his six years at UCAN, he had flown for Bank of America for 18 years without incident.

Most crashes don’t end this way. On January 28, 2003, Michael Russell, an army veteran with 12,000 flight hours to his name, was alone in the Agusta A109C he flew for Air Angels, an independent medical transport service based in West Chicago. Russell told air traffic control he planned to land at the DuPage Airport heliplex. Soon after, the controller saw a “flash of light” to the south of the airport, at which point he lost communications with the aircraft. Russell, 52, who had survived being shot down in Vietnam, had plummeted into a cornfield. He died instantly. The “dark night, low ceiling, and reduced visibility” all factored into Russell’s crash, according to an NTSB report, but the craft apparently had not malfunctioned. In the end, the report cited pilot error.

Both accidents spoke volumes. In the helicopter rescue field, not even one of the most vigilant programs in the country-nor the most seasoned of flight veterans-is immune to the dangers.

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