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LifeFlight

Purpose of LifeFlight

UMass Memorial LifeFlight is an emergency medical helicopter service providing transport for the critically ill or injured LightFlight operates out of UMass Memorial Medical Center, Worcester, MA, 24 hours a day, seven days a week, and operates with in a 130-miles radius of Worcester.

The Flight Crew

The flight crew consists of

1. An emergency medicine physician
2. A critical care nurse who is also an EMT in Massachusetts, and
3. An experience EMS pilot

The Aircraft

• America Eurocopter BK-117
• Cruising speed of 130 mph
• Range of 130 miles

LifeFlight Use Guidelines

There are three major considerations when deciding to request response from LifeFlight:

1. Would the amount of time needed to transport the patient by grounding to an appropriate facility pose a threat to the patient's survival and recovery?
2. Would weather and road conditions or other factors effecting ground transport seriously delay the patients access to advanced life support?
3. Does the availibility ambulance unit have the clinical skills and equipment needed to care for the patient during transport?

Trauma Triage Guidelines

Consider requesting ground advanced life support (ALS) and air medical support when operational conditions listed below exist and the following patient conditions are present.

1. Operation Conditions
   1. When a patient meets criteria defined below and scene arrival time to estimated arrival time at the nearest appropriate hospital, including extrication time, exceeds 20 minutes.
   2. Patient location, weather and road conditions preclude the use of standard ground ambulance.
   3. Multiple casualties/patients are present that will exceed the capabilities of local hospitals and agencies.
2. Patient Conditions
   • Physiologic criteria
     1. Unstable vital signs
     2. Blood pressure less than 90
     3. Respiratory rate greater than 30 or less than 10
   • Anatomic injury
     1. Evidence of spinal cord injury, including paralysis or paresthesia
     2. Severe blunt trauma
        • Head injury (Glascow Come Scale of 12 or less)
        • Severe chest of abdominal injury
        • Severe pelvic injury excluding simple hip fractures
     3. Burns
        • Greater than 20 percent body surface area (BSA) second or third degree burns
        • Evidence of airway or facial burns
        • Circumferential extremity burns
        • Burns associated with trauma
        • Penetrating injuries of head, neck, chest, abdomen or groin
        • Amputations of extremities, exclusing digits
3. Special Conditions
   The following should be considered in deciding whether to request air medical transport, but are not automatic or absolute criteria:
   
   • Mechanism of Injury
     • Motor vehicle crash
       • Patient ejected from vehicle
       • Death in same passenger compartment
     • Pedestrian struck by a vehicle and thrown more than 15 feet, or run over by a vehicle
   • Significant medical history
   • Are greater than 55 or less than 10
   • Significant coexistent illness
   • Pregnancy

LifeFlight Arrangements

LifeFlight may be requested by contacting the communications center at UMass Memorial - University Campus in Worcester, MA

• Worcester: 508-799-6333
• Toll-free: 800-322-4354
• Business: 508-856-3558

Information Required

• Agency name and phone number
• Nature of the accident/illness
• Accident location in relation to the center of town or major roadways
• Radio frequency and PL (channel guard) of the vehicle/personnel securing the landing zone

After initial dispatch of the helicopter, other information to relay to LifeFlight, if available, includes:

• Exact location of accident
• Number of patients and whether any are under the age of 17
• The presence of any hazardous materials, if applicable

Preparing for LifeFlight

Proper preparation is essential to the safe operation of a LifeFlight mission

Establish Command

The incident commander should designate a landing zone (LZ) officer to coordinate aircraft landing and landing zone security.

Landing Site Selection

• 100 feet x 100 feet is preferred
• 60 feet x 60 feet is minimum
• slope of the ground cannot be greater than 5 degrees
• ground cover (pavement, grass, loose dirt, rocks, snow, etc.)
• The landing site should be firm and level
• The surface should be free of all loose debris and objects.
  Suitable landing sites would include:
  • Four-way intersections free of poles, wires and trees
  • Parking lots
  • Park and athletic fields
  • Highways and other 60-foot-wide roadways

Hazards

• locating wires
• power lines
• light poles
• antennas
• trees
• chimneys, etc.
• any other obstructions

All inforamtion about these safety hazards must be communicated to the pilot prior to arrival

Landing Site Preparations

Mark the landing zone by:

1. Four weighted orange highway cones in the four corners of the landing zone with hand-held lights under the cones at night.
2. Shine the low headlight beams of two vehicles onto the landing zone in an X fashion.
   Never shine the light toward the aircraft
3. Be prepared to extinguish headlights upon request by pilot.
4. DO NOT USE FLARES

Communications - Ground-to-air

1. Communications between LZ officer and the pilot should be conducted over your community's police or fire radio frequency
2. The pilot will attempt to contact the LZ officer when the aircraft has an approximate ETA of five minutes from the landing zone.
3. At this time, the LZ officer should relay the following information
   • Brief description of the landing zone (i.e. field, parking lot, etc.)
   • Idenitify any hazards such as poles, wires or tall trees
   • Confirm that the landing zone is secure, i.e. free of people, vehicles and loose debris
4. As the helicopter approaches the landing zone it will circle the area making note of all obstructions and hazards
   • During the final approach all unnecessary radio communications should be avoided.
5. LZ officer should maintain visual contact with the aircraft.
   • Radio communications may be used to warn the pilot that the landing zone has become unsafe. Use of "LifeFlight - Stop!" will alert the pilot to abort the approach.

LifeFlight - After Arrival

• After the aircraft has landed, the medical crew will depart the aircraft.
• At the flight crew's discretion, this could occur while the aircraft is still running or they might wait until it is shutdown.
• No one should approach the aircraft until it is determined if a HOT or COLD landing will be made.
  • HOT load - the helicopter's rotors will remain running while the patient is loaded into the helicopter.
  • COLD load - the helicopter rotors will be shut down while the patient is loaded into the helicopter
  • The medical crew will evaluate the patient and prepare for transport.
  • The flight crew will direct the loading process.
  • All directions must be followed strictly.

Helicopter Safety and Security

• The most important function of the LZ officer is to maintain security and safety, safety, safety!
• Do not approach the aircraft
• All personnel should remain outside the diameter of the rotor blades at all times unless accompanied by a flight crew member
• Never approach a helicopter from the rear of the aircraft. Always approach and depart from the front of the aircraft, and only when signaled by the pilot to do so.
• Keep vehicles at least 100 feet away from the aircraft.
• No smoking within 100 feet of the aircraft.
• Remember, helicopter safety is nothing more than good common sense. All movements around the helicopter should remin unrushed.

For the critically injured patient, delay can mean death. Minutes matter. Through you, LifeFlight can provide a lifeline for the patient needing care at a trauma center.

The most important component of this program is the commitment of all people and organizations involved. Thank you for your dedication to emergency medical care.

Taken from: LifeFlight - EMS/First Responder Manual, Dept. of Emergency Medicine, UMassMemorial Hospital, Worcester, MA

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