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Through the window of the HealthNet helicopter, miles of stopped traffic could be seen on interstate 64-westbound. The pilot turned and it became clear why — one semi-truck had rear-ended another, crumpling the front end of the second truck like a discarded tin can.
The helicopter landed on the road.
On the ground, local emergency medical technicians and firefighters worked to extract the driver from the second truck. He was alive and talking, but bleeding from his head and torso. The air medical team hooked up an intravenous solution and loaded the injured man into the helicopter.
“It’s hot in here,” the man complained above the sound of propellers.
“It is,” agreed the paramedic, as he monitored vitals and blood loss. The helicopter landed on the roof of Charleston Area Medical Center 20 minutes later and a trauma team took over. The air medical team cleaned up and flew back to base to await the next call.
Thirty years ago, the largest hospital systems in West Virginia collaborated to found HealthNet Aeromedical Services – the first dedicated emergency air transport company in the state. HealthNet is also one of the only nonprofit air transport services in the country, according to CEO Clinton Burley. To date, HealthNet has flown more than 75,000 patients, including the truck driver above; it operates nine bases 24 hours a day, seven days a week.
Thomas Reed has been a flight paramedic with HealthNet since it began and has been on more than 5,000 patient flights – a number almost unheard of in medical flight services.
“We could start out at 8:00 literally in the morning and start flying and you’re going like, ‘This is going to be a bust day – really rocking and rolling – and then other times there’s this lull, and you’re waiting because you know it’s going to break,’ ” he said. “And then all of a sudden all of the birds are up in the air.”
HealthNet is owned equally by WVU Medicine, Charleston Area Medical Center, and Cabell-Huntington Hospital.
“When it comes to critical care transport, for 30 years these hospitals have worked together cooperatively to meet the needs of central Appalachia,” said Burley. He called HealthNet’s mission “altruistic” because it’s an example of three major medical centers – who all want critical patients – working together to provide the service to central Appalachia.
“We are literally connecting the emergency departments and the intensive care units of our member hospitals out to the far reaches of Appalachia,” Burley said.
His team has to be extremely well-trained, he said, to stabilize and manage patients for long periods until they can get to a hospital.
“In more urban areas, they have very short transport times. You may have a higher density of population, but your actual time in flight may be very short,” he said. “It’s not uncommon for us to have a patient in a helicopter for 45 minutes to an hour to reach the appropriate medical facility.”
But top-of-the-line training and services aren’t cheap.
“There’s no question – helicopter transport is expensive, and it’s not there for every patient,” Burley said. “It wouldn’t be out of the question that a patient may have a bill in the neighborhood of $25,000 to $30,000.”
By “not there for every patient” Burley means HealthNet exists to fly acutely ill or injured patients who require the speed of the helicopter and its expert medical crew. If someone can be properly and safely transported on the ground, then that’s the way they should be transported so that expensive healthcare assets aren’t being misused.
If a patient can’t pay for the flight, the hospitals absorb the cost as part of what Burley called “an aggressive charity care program.”
“At the core of the program, when the phone rings we don’t know if someone is a prince or a pauper, and we don’t know that [information] until way after the patient is delivered at the hospital – which is how it should be.”
Burley said the system works well because the aircrafts are not based at the academic medical centers, but out in the community where patients are to be able to get quicker access to them.
But working in emergency medical services can be taxing on employees.
Even for a paramedic like Thomas Reed, with 5,000 trips logged, “it is difficult to cope with the really hard things,” like the death of a child.
“You come to the realization if you have done all you know to do, that’s all that can be asked of you,” said Reed. “It’s realizing your limitations and what your expectations should be.”
Reed said the medical teams, which usually include a pilot, a nurse and a paramedic, make the decision to fly or not based on safety, not who is injured. As difficult as this may be, they may need to resist the urge to push through unsafe flying conditions to pick up a child in respiratory distress, he explained.
That policy of “safety first” seems to be working for them. Over three decades and 75,000 patient flights, HealthNet has had no accidents while transporting a patient.
HealthNet has continuously expanded its services during the past 30 years, adding their newest base in Lewisburg in 2015.
Editor’s Note: 9/14/2016 This story was updated to change WVU Medical Center to WVU Medicine.
Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation.