An alarm rings through the Geisinger Life Flight 3 hangar at the Wilkes-Barre/ Scranton International Airport in Avoca. A dispatch call comes through the loudspeaker. Red Lines, Life Flight 3’s base manager, prepares for a flurry of activity.
“From the time that we get the dispatch till the time that we're off the ground on the way to the call is 15 minutes or less,” Lines said.
Pilot Brian Enderes ultimately turned down the dispatch request due to ice in the atmosphere.
“The most difficult part of the job is when I can't get these guys to where they need to go because of weather or something that deals with safety. It really does kind of eat away at you a little bit when you know somebody is on the other end that needs help, and you can't give them that help,” he said.
Life Flight pilots' most important job is to protect their crew.
“They're making very conservative determinations,” Lines said. “We hire very experienced pilots, and we tell them all the time, we don't pay them for their ability to fly or say yes, we hire them for their ability to say when it's not safe to go. The pilots are not given any information about the patient prior to accepting the flight. So they are only given information on the point of pickup to the destination, and that's what they make their decision on. So if it's someone's critical child, they're not turning a flight down knowing that.”
Lines moved his crew to hangar five at the airport last November. The hangar, built from the ground up using grants from the pandemic, offers a comfortable and what Lines calls a “home away from home” feeling to Life Flight 3 employees.
Geisinger Life Flight
Lines said that Geisinger’s Life Flight program averages 420 to 450 transports a month among all of its bases.
“Life Flight 1 is based at the Selinsgrove airport. Life Flight 2 is at University Park in State College. This is, of course, the Life Flight 3 base and critical care ground three. Life Flight 4 is at the Montoursville airport in Williamsport. Life Flight 5 in Minersville. Life Flight 6 is a cooperative effort between Geisinger and St Luke's University Health System to provide service out of Lehighton,” Lines said.
“We also have another critical care ground location that is at the Geisinger Medical Center in Danville. And then we also have an additional ambulance that is stationed at our Minersville location, so when they don't have flyable weather, it gives them resources to still provide transports,” he continued.
The crew gets calls daily from first responders at emergency situations. The helicopters sometimes land right on the highway or site of the crash or on a nearby landing zone, sometimes at a sports field, marked by first responders with flares.
The Life Flight team transports within the Geisinger health system network but also outside of it, depending on the needs of the patient.
“This helicopter that's based in the Wilkes-Barre/ Scranton area has completed patient transports as far away as Boston and Pittsburgh, Cincinnati, Cleveland, Delaware, and routinely goes to Philadelphia, Hershey Medical Center, Allentown,” Lines said.
Not all transports are emergencies.
“In many cases, patients move from one hospital to another because services are not available,” Lines said. “Or in recent years, services are overwhelmed with the amount of patients that are presenting at that hospital, and it's our job to move those critically ill or injured people from one facility to another, to not just move them from one hospital to another, but continue that critical care and hopefully improve on their condition and their situation before we get them to the destination and give them a very fast ride to the next level of care.”
The crew aims to get consent from patients. But that’s not always possible in emergencies.
“We try to get consent from every patient that we transport, but sometimes, you know, from accidents, from scenes of crashes or injury, there's no way to really get consent. We're always trying to act on the patient's best interests,” Lines said.
A Life Flight crew
Each dispatch crew typically includes the pilot or driver for the ambulance, a life flight trained critical care nurse and a life flight trained critical care paramedic. Paramedics can be substituted for an additional nurse if necessary.
Morgan Fuller started working as a Life Flight nurse two years ago. Before that, Fuller worked as a nurse in a surgical intensive care unit, or ICU, and trauma ICU.
“We need to either have worked in the emergency room or the ICU of a large volume hospital or a trauma center where they're getting a good experience to learn everything we need to bring here,” he said.
Nurses need to be certified through a state paramedic program. Many of the nurses at Life Flight 3 go through a program at Luzerne County Community College. After that’s complete, nurses have a mandatory three- to four-month orientation.
They then need to complete a national board certification within one year of hire.
“A lot of the ERs have to have accreditation standards of half of their people have to have it, where it has to be 100% here for us just because of our level of care,” said Kevin Rinehimer, a flight nurse at Life Flight 3.
The nurses and paramedics on the crew work together to ensure the best outcomes for patients.
“The nurses tend to be stronger in some of the hospital-based procedures working with things like balloon pumps and ventilators and the paramedics tend to be very strong at working in the field, in areas like joining up with an ambulance, extricating a patient from a scene, but we work very closely as a team, and we both take turns being in charge of the call, and always working as a team. It's very important that you work as a team and trust each other when you're working on an emergency situation,” said Brooke Lininger, a Life Flight paramedic.
There’s also room for parents if a child is being transported.
“Our job is to take care of the parent and the patient, but really our focus should be on their child. And if the parent is not calm to the point where they could follow direction, or they will be calm inside the helicopter and be a hazard to our safety and the safety of the transport, we make a decision that they cannot go,” Lines said.
Life Flight ambulances
Ambulances dispatch when the helicopter cannot take off because of weather or if its in use.
Lines said the ambulances average 5,000 to 6,000 miles a month. The ambulance currently in use has about 80,000 miles after only a year of service.
The crew determines whether or not to use the ambulance based on the needs of the patient.
“We deal with critically ill patients all the time, and sometimes those critically ill patients are expected to be critically ill for a long period of time,” Lines said. “It's not necessarily an emergency that they need the high risk, high cost of the helicopter, but they still need to be moved from one hospital to another, and the critical care ambulance and the team that we provide gives us the opportunity to provide that transport, but yet at a lower cost.”
The Life Flight ambulance has more equipment than typical ambulances.
“We're capable of transporting patients with balloon pumps or heart lung bypass ECMO, neonates that require transport in an incubator, and we actually have a dedicated incubator for the ground vehicle as well as the aircraft,” Lines said.
Struggles and triumphs of working on a Life Flight crew
The job is always stressful.
“Every call you go on is very high stakes, whether it's an emergency scene or whether it's an inter facility transport, it's a job that doesn't leave hardly any room for error,” Lininger said. “You have to be on your game all the time, and that can be very stressful, but it's also very rewarding to work at that level with patients, knowing that you have such a big influence on the outcomes and how they will eventually recover in their journey through the healthcare system.”
There’s also less resources for the life flight crew to handle emergency situations.
“In the hospital setting, you have various people to help you with all those chores and tasks,” Rinehimer said. “Where we're at, it's just the two of us, and we don't have all that extra help, so we have to do everything on our own, do what we would do in a hospital with various resources, in an aircraft with limited resources, or ambulance and limited resources.”
The helicopter cabins are cramped. But it allows for the safety of the crew and the patient.
“With the two crew members strapped into their seats, every piece of equipment, medication and supplies that are onboard this aircraft they can reach from their seat, and they can provide whatever care they need to that patient without getting out of their seat,” Lines said.
Despite the high stakes scenarios the crew faces daily, they find the job to be very rewarding.
“We're meeting a patient who's having the worst day of their life, and they're scared, and they don't know what's going to happen next. We come and within five minutes, we need to let them know we're going to take care of them, and they can trust us, and they can know that they're safe wherever we're taking them. And that's a lot to ask from someone,” Fuller said.
