Air ambulances see their roles change during pandemic

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    Lincoln, NE (Matt Olberding) — Before the coronavirus pandemic, the StarCare helicopter based in Crete did most of its transports for trauma victims and those having heart attacks and strokes. Interfacility transfers — moving a patient from one hospital to another — were relatively rare.

Oh, how things have changed.

The crew of the medical helicopter can now find itself transporting two, three or sometimes even four COVID-19 patients a day, causing its interfacility transport numbers to rise anywhere from 50-100% over the past couple of months.

“I’ve never seen anything like this in the 20-plus years I’ve been a paramedic,” said Dan Duncan, a StarCare flight paramedic.

StarCare and other Air Methods-owned medical helicopters and airplanes based in Nebraska have been playing a big role in helping rural hospitals keep from getting overwhelmed.

Duncan said StarCare and other aircraft in the Air Methods network have provided assistance to small rural hospitals in places such as Lexington and Crete that don’t really have the capability to care for very sick patients, as well as to larger hospitals in Grand Island and Hastings that needed to free up space in their nearly full intensive care units.

Those hospitals “have kind of gotten overwhelmed at times,” said Kevin Hallam, an account executive with Air Methods.

In mid-April, CHI Health St. Francis hospital in Grand Island was transferring patients to hospitals in Lincoln and Omaha several times a week, and StarCare, as well as LifeNet, another Air Methods-owned helicopter based in North Platte, were called on to move some of those patients.

A week or so later, there was a surge of COVID-19 patients in Lexington, and those helicopters were again called on to transport patients to hospitals with higher-level facilities.

Last month during an an Infectious Diseases Society of America press briefing, Angela Hewlett, associate medical director of infection control and epidemiology at the University of Nebraska Medical Center, said air transport has been vital in Nebraska to keep smaller hospitals from becoming overwhelmed.

“When those beds are full … they are needing to ship those sick patients out to other hospitals. And so finding ways to do that has been difficult,” she said, according to Bloomberg News.

Duncan said COVID-19 patients who get transferred are “probably some of the sickest patients I’ve ever seen.”

They are on ventilators, hooked up to various infusing devices and on multiple medications.

That alone presents a challenge that the flight paramedics don’t usually have to deal with, but treatment is complicated by the personal protective equipment the flight crew has to wear.

There are three people on each flight — a paramedic, a flight nurse and the pilot. Normally, the paramedic and nurse will wear gloves and maybe a mask if necessary.

But now, when transferring COVID-19 patients, they have to wear full gear that includes a Tyvek biohazard suit and N95 respirator masks.

“That gets pretty hot,” Duncan said. “It’s not very easy to work in.”

In addition, the crew has to clean and sanitize the helicopter and themselves after every COVID-19 patient they transport.

That means taking all equipment that can be moved out of the helicopter’s passenger bay and fully cleaning and sanitizing all surfaces. The crew also takes a shower after each trip and puts on new gear.

Those steps can add an hour or two to each trip.

But so far those extra steps seem to have been worth it, as Hallam said no crew member has tested positive for the disease, and they are constantly checking, taking their temperatures twice a day while on duty and watching out for any symptoms.

Like most health care companies, Air Methods is taking a financial hit from COVID-19. Hallam said reimbursements for interfacility transfers are not nearly as high as they are for transporting trauma patients, even though there is more work involved with coronavirus patients.

Still, he said the company has vowed not to bill patients for any costs, even if insurance reimbursements don’t cover them.

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