BY JANIS QUINN

AirCare, the emergency helicopter service of the University of Mississippi Medical Center, arrives from a scene response back to the Wallace Conerly Critical Care Hospital on the UMC campus.

While the sight of an emergency helicopter landing beside a busy highway or in a pasture is fraught with drama, it's not always the safest way to get emergency care to trauma victims.

AirCare, the helicopter belonging to the University of Mississippi Medical Center, began transporting patients to the Medical Center in 1996. It went to hospitals that requested the service, never to the scene of a wreck on the highway or other trauma scene unless there were mass casualties.

But now with a $6,800 grant from the Central Mississippi Trauma Region, the Medical Center is training law enforcement officials, firemen, paramedics and other first responders to prepare landing sites for the helicopter to make patient transport by air as safe as it can be for patients, the flight crew and the public at large. Since April, AirCare personnel have trained more than 600 local first responders within 60 miles of Jackson — the outside limit for scene responses.

"If it's beyond 60 miles, it takes the helicopter 25 minutes to reach the scene. By that time, the victim will have been removed from the scene. We don't want anyone waiting on the helicopter for emergency care," said Donna Norris, AirCare's chief flight nurse.

Since mid-September when the policy changed, AirCare has landed in a pasture in Scott County to bring the victim of a car crash back to the Medical Center; on Interstate Highway 55 near Durant to an accident scene that killed two people and injured one; to U.S. Highway 49 South between Florence and Star where a log truck had overturned trapping the driver in the cab; and at accident scenes near Utica and Crystal Springs.

"We're certainly not trying to replace the first responders," said Norris. "Our purpose is to support ground ambulances, paramedics and firefighters who all go a great job." In fact, AirCare won't land within 20 miles of Jackson because ground ambulances in the area can get to the scene and back to the Medical Center within the time framework trauma care dictates.

The Medical Center's original emergency helicopter, LifeStar, did scene responses, and helicopters out of Tupelo and Hattiesburg also landed at scenes in the area. AirCare's original policy of landing only at hospitals grew out of safety concerns as well as the recognition that guidelines for determining the appropriate level of trauma for air transport weren't consistent over the region and resulted in some unnecessary flights.

But all that has changed, Norris said, and the new policy recognizes that sometimes scene responses are necessary.

"In automobile accidents, we'll typically make a scene landing when the paramedics know that someone who is trapped in a vehicle has injuries that require treatment at the University," Norris said. "In such cases, time is critical."

The Medical Center's emergency department is the only Level 1 trauma center in the state, the only center with enough depth of medical staff to treat multiple trauma.

Norris explained, "If it's a severe trauma case, and the paramedics on the scene know the victims are going to require treatment at University, it doesn't make sense for them to take them to another hospital first. They need to get here quickly." The helicopter can make what would be a six-hour round trip by ground in two hours.

AirCare is a flying intensive care unit that is equipped with everything needed to stabilize and treat a patient. It has a ventilator, vital signs monitor, heart monitor, intravenous pumps for IV medication. The flight crew can bring blood to the scene if the victim has had major blood loss. "The replacement of blood is a huge factor in multiple trauma," Norris said, "and we can start a transfusion right there."

Only paramedics can request that AirCare land at the scene, but certain criteria must be met. Ground emergency crews must clear a landing zone that is 100 feet long and 100 feet wide.

Before landing, the helicopter circles the area to make sure the landing site is safe. "We've trained people on the ground to look for power lines or tall signs that may present an obstacle to landing. They scour the area for debris like plastic garbage bags and drink cans that could be an impediment and make sure we have a smooth surface to land on," Norris said.

City leaders throughout the state are trying to make it more convenient for AirCare to land in their cities. In Pelahatchie, for example, city leaders made a concrete landing pad. Other communities are identifying areas in the county that will be mutually agreed-upon landing areas such as football fields, baseball fields and other community property.

AirCare, the emergency helicopter service of the University of Mississippi Medical Center, arrives from a scene response back to the Wallace Conerly Critical Care Hospital on the UMC campus. Until recently, AirCare landed only at hospitals but will now land at an accident scene if necessary.

February 2007