Sent from above

Inside REACH Air Medical Services

By Michael Somerby EBS DIGITAL EDITOR

BIG SKY – A two-tone siren sounds through the crisp winter air, trailed by a location and a patient’s weight in kilos. The team clad in black jumpsuits with thin red stripes down the sides and black leather boots shuffles briskly from the tarmac and into the REACH Air Medical Services office at Bozeman Yellowstone International Airport.

Inside the understated office, a conspicuous map covered in shorthand, figures, charted courses and concentric circles denotes distance from REACH’s hangar in nautical miles.

Two data points—location and the physical weight of a respective patient—are weighed against current and projected weather conditions. Using those three immediate pieces of information, the flight nurse, flight paramedic and pilot that comprise the on-duty REACH crew come to a crossroads: Does the team launch its medically equipped helicopter and personnel services to potentially save a life?

“We make sure everyone going on the flight is comfortable with the known conditions. If they aren’t, we don’t go. It’s that simple,” says Greg Kellogg, who has been flying helicopters commercially since 2006, flying Emergency Medical Services for REACH since 2018. “That’s why the information we get initially is so limited … we want to take all the personal emotion out of the equation.”

“It’s no good if we show up dead,” adds Jared Sibbitt, a flight nurse who’s been with REACH for a year and half on a part-time basis, but whose career as a nurse spans nine years. “Everything we do prioritizes the safety of everyone involved.”

When a REACH team decides to accept a dispatch, another pilot at a remote Operational Control Center, who also reviews the available information, sets a series of events into motion.

Typically, while the pilot undergoes the flight-planning process with his dispatch center, the rest of the team makes their way into an adjoining hangar concealed by a nondescript door. There, they wheel a candy-red Airbus AS350B3E single-engine helicopter, known by those in the industry as the A-Star, from beyond the enormous hangar doors and onto the tarmac, stocking it with additional supplies.

Just before liftoff, the crew circles the A-Star ensuring every hatch is sealed and bolt is in place. Once confirmed, they climb into the cabin and don their mic’d helmets while the pilot notifies Bozeman airport’s flight tower of impending liftoff.

In warmer months, the process can take as little as six minutes; the team shoots for 10 minutes or less in inclement conditions.

Once airborne, the pilot works in harmony with the French-made aircraft, known for its performance capabilities and proven record in high altitudes and extreme conditions, charting the safest and fastest course to the patient.

“The norm is that the group is so well trained and rehearsed, the entire process from liftoff to securing the patient goes perfectly,” said Clayton Scotson, a former REACH pilot now serving as program director for REACH’s Montana division.

The privately owned air medical service, with locations in California, Colorado, Nevada, Oregon and Montana, operates on a single mission: “In every situation, do what is right for the patient.”

The rewarding and adrenaline-pumping nature of REACH’s work attracts only the most experienced and highly-qualified personnel, requiring pilots to have a minimum 2,500 hours of professional helicopter flight experience, and requiring medical personnel to have a minimum of 3-5 years of experience in their respective medical field, preferably at a higher level hospital or busy EMS system, along with myriad certifications of training.

“It’s a super competitive position at the pinnacle of the EMS world,” said Ryan Merrit, the Bozeman operation’s rookie flight paramedic with more than 10 years experience as a medic under his belt. “The challenge of it, the nonstop training and learning, the cutting-edge medical work [is] incredibly attractive for people in our field.”

These rigid qualifications are what make REACH particularly valuable. When REACH responds to a dispatch, it brings this high level of expertise, experience and medical equipment that immediately upgrades a patient’s level of care from that provided by many first responders and smaller hospital’s services.

Operating 24-7, REACH pilots work a 12-hours-on, 12-hours-off shift schedule, and REACH medical professionals on grueling 24-hour stints, keeping medics and pilots available around the clock for the local service area, a radius of 140 kilometers and roughly an hour flight time in ideal conditions. A team may operate beyond this service area, however, taking on dispatches anywhere in the state and Yellowstone National Park at the discretion of the team and within the limits of the A-Star’s fuel capacity.

With an ability to reach Big Sky in less than 20 minutes, REACH’s Bozeman location routinely flies to Big Sky Medical Center four times a week in what’s called a “day basing operation.”

While not exclusive or contracted this intimate cooperation has led to a sense of camaraderie and team cohesion.

In July 2018, Scotson coordinated an ongoing “bi-directional educational effort” with Big Sky Medical Center Nurse Manager Jason Buchovecky, through which REACH team members enhance the knowledge of hospital staff, drawing upon their medical expertise. In return, Big Sky Medical Center nurses share insights into the mindset necessary for lower-intensity care needs.

“An ER gets exposed to a wider variety of medical needs,” said Travis Weiss, who’s worked as a flight nurse for REACH for the past three years, and over 16 in EMS service. “We appreciate the opportunity to actually to be with the hospital’s care providers and gain exposure as to how the providers sort through the differential diagnoses, which is much more difficult in the environment that we work in.”

Dealing in low frequency, high demand needs means many days can go by without a dispatch, so idle moments are spent religiously training for future emergencies. Yet it’s those emergency-free repositioning days between Bozeman and Big Sky that afford REACH teams a beautiful vantage most will never experience.

“I used to be a raft guide in Idaho, and one day while on the river I saw this very model [A-Star] in a fire relief effort,” Kellogg said, “and I knew right then that’s what I wanted to do: fly those.”