Oct. 20-26, 2000
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Pegasus helicopter is an air force in flight for life

By Dan Heuchert

"Clear blue and 52."In aviator-ese, those are near-perfect flying conditions: brilliant azure skies, 52-mile visibility. A beautiful October morning.

Photo courtesy of U.Va. Emergency Medicine
The Pegasus helicopter prepares to land at an accident scene on U.S. 29. Pilots work with on-scene rescuers to set up landing zones in areas free from hazards like trees and power lines.

At the Pegasus flight operations center, located at the Charlottesville-Albemarle Airport, dispatchers and flight crew members are tidying up their cozy quarters while taking turns attending to a demanding telephone. But they all seem to keep one eye to the sky and one ear tuned to the dispatch speakers, itching for a chance to fly.

On the wall, there is a framed graduation memento from a member of the Class of 2000 at Broadway High School in Rockingham County -- a handsome senior portrait, an engraved graduation announcement -- symbols of a happy passage in life.

Graduation would have been a completely different affair, however, without the services of Pegasus and the others who attended to the young man after he flipped his car and was trapped inside with life-threatening injuries. The local emergency crews responded quickly, and soon realized he would need the services of the U.Va. Medical Center, a level-one trauma facility equipped to handle the direst cases, and he would need them very, very soon. They called Pegasus.

As a result of the coordinated efforts of the local crews, Pegasus, and doctors at the Medical Center, "he survived what usually are non-survivable injuries," said flight paramedic Steve Elliott. In gratitude, he and his family delivered the framed graduation announcement.

It's impossible to count the number of lives the Pegasus program has saved, but air transport regularly cuts two-thirds off the time needed for ground transportation. "Clearly, there are patients who wouldn't have survived if they were transported by any other means," said Dr. Debra Perino, the program's medical director.

On this October morning, no call comes. It only makes the crew more anxious.

"If you work a shift or two without much happening, you know it's coming with a vengeance," Elliott said.

'Pega-Bus' hits the ground rolling

Like the mythological Pegasus, a horse with both wings and hooves, the Medical Center's Pegasus program is now equipped for ground travel.

Known throughout the region for its distinctive orange, blue and white rescue helicopter, the Pegasus emergency transport program this summer inaugurated a critical care ambulance, the first of its kind in the area. The $178,000 vehicle will take on missions that the chopper cannot, whether due to weather conditions, distance limits or prior calls. It will also handle many transports from doctor's offices and hospitals that are not equipped to handle certain patients' ailments.

Put in service July 9, the ground unit -- nicknamed "Pega-Bus" by crew members -- is already meeting initial projections of about 20 transports per month, said Pegasus program manager Mary Ann Himes Fields. And that's before winter weather makes flying more dangerous, and before word has gotten out to all of the outlying medical clinics and rescue units within the ground unit's 212-hour cruising range.

Until the Pegasus ground unit came online, ground travel was provided by either basic life support or advanced life support ambulances. The main differences between the classifications lie with the personnel who staff them. Advanced life support ambulances generally carry two paramedics, while basic life support units have two emergency medical technicians or one EMT and one paramedic.

The Pegasus unit will carry the same crew as the helicopter does: a nationally registered flight paramedic and a flight nurse.

"Basically, we're providing services and a level of care not available by any other means," said Dr. Debra Perino, the program's medical director.

The ambulance is much more spacious than the helicopter, and carries more drugs and equipment, including two generators for power.

"Really, this truck is a rolling ICU," said flight paramedic Steve Elliott.

There are even a few creature comforts, which can come in handy on longer trips. There's a TV/VCR combo with a stock of videotapes: some to entertain anxious children, and other instructional videos to prepare older patients for procedures they may undergo upon arrival at the Medical Center.

Currently, the ground unit is unavailable at night, but that may change in the future, Elliott said.

"The goal is that when a referring doctor calls us to come get a patient, we come and get the patient," Elliott said. "They don't care about weather conditions or whatever. Our goal is to be totally reliable for that need."

A Pegasus crew consists of an experienced pilot, a critical-care flight nurse and a nationally registered flight paramedic. The entire program includes an elite group of nine paramedics, seven flight nurses, four pilots, four drivers and two mechanics. The helicopter, a leased Bell 230 that once served as a corporate chopper before being refitted for medical use, flies about 800 missions a year -- 150 more than the national average, said Mary Ann Himes Fields, the unit's hospital-based program manager. It is on call 24 hours a day, with a service radius of about 120 miles.

There are risks involved in helicopter medical flights. The roughly 180 such programs nationwide have experienced three fatal crashes since Jan. 1 alone, with a total of 12 fatalities.

As of mid-October, Pegasus was nearing its 10,000th accident-free flight since the program's inception in 1984. That's due to a lot of hard work. Crew members travel around the region, instructing local police, fire and rescue officials, and even corporate land-owners in setting up safe landing zones away from potential hazards like trees, communications towers, water towers and power lines. There are regular safety meetings and reviews, both inside the unit and with outside rescue personnel.

During a flight, the helicopter generally circles the scene a couple of times before landing, and any member of the crew can call off a mission at any time, no questions asked.

"Safety is our No. 1 value," Himes Fields said. "We never jeopardize safety." Crew members' ground duties vary from serving as cooks and housekeepers, to stocking inventory and assisting mechanics at their airport quarters. They also teach courses in subjects like emergency transport and winter wilderness survival, and take regular trips to weekend festivals to meet the public, show off the equipment, pose for pictures and even sell Pegasus memorabilia.

Such events can have long-lasting effects. Flight nurse Scott Singel recalled one day when a squadron of Army Apache helicopters landed at the Charlottesville airport. A copter buff, Singel wandered over to check out the new arrivals. He struck up a conversation with one of the pilots, who turned out to be a former local resident. The Army pilot dug out his wallet and proudly shared a picture of himself as an 11-year-old, posed at the controls of Pegasus.

"Public relations is a big part of our job," Singel said.

Still, Pegasus is much more than an orange-and-blue "flying billboard" for the U.Va. Medical Center, Himes Fields said. Besides providing first-rate emergency care, the program is expected to pay for itself; patients are billed for transport, she said.

For the crew, the rewards are less tangible.

Elliott recalled a recent mission, when the helicopter was called in to transport a 6-week-old infant. The tiny child, who had been born prematurely, was thrown from his car seat in an auto accident and badly injured. It was a very upsetting call, even for a seasoned pro like Elliott.

A few days later, he went to the pediatric intensive care unit to check on the baby, fearing what he might learn.

Entering the ward, Elliott found the infant -- well on his way to recovery, and nestled in his grandfather's arms.

"That's what makes this job kind of cool," Elliott said.

 


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