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.”
