By Nanci L. Valcke
The Contra Costa Times
CONTRA COSTA COUNTY, Calif. — When there’s a medical emergency, the scramble is on to get the sick and injured to the hospital before the “golden hour” runs out.
That’s when first responders call CALSTAR California Shock Trauma Air Rescue because they trust the team of expert pilots and two flight nurses will arrive at the scene quickly.
“We are there when we say we’re going to be there,” said Ross Fay, regional director of CALSTAR 1 in Concord, the first operational site. Eleven locations now serve the state, including the North and East Bay areas.
Celebrating 25 years of service, the nonprofit has raced the clock flying gravely injured victims from isolated or distant areas to trauma centers within an hour.
“The golden hour is a benchmark created for getting a trauma patient to medical care,” said Kacey Hansen, R.N., director of trauma and transfer services at John Muir Trauma Center. “We’ve discovered by getting (a patient here) within that golden hour his chances improve.”
John Muir is the only designated trauma center for Contra Costa County, and Hansen said it also treats 70 to 80 percent of Solano County’s patients, along with others from outside counties where hospitals aren’t equipped with helipads.
Trauma centers differ from emergency rooms in that there is an operating room on standby as well as a team of specialized surgeons on 24-hour call. Trauma centers deal with people who have multiple, catastrophic injuries, said Hansen.
“I’ve been doing this a long time,” she said. “Just when I think I’ve seen it all, I see something new.”
Art Lathrop, director of Emergency Medial Service for Contra Costa County, said, “CALSTAR has been "... absolutely vital in making sure seriously injured patients are transported from their locations to the trauma center.”
The county’s marshes, mountains, waterside cliffs and other varied terrain, combined with the often-congested freeways and narrow winding roads, can mean drive times too long for saving lives.
“That’s the whole principal behind using helicopters,” said Fay.
During its first year of operation, CALSTAR transported around 250 patients, said Fay. “Today, we transport about 300 a month.”
“It started (in 1984) as a trial,” said flight nurse Michelle Starbuck, a veteran of more than 14 years.
Today the nonprofit employs around 30 pilots, 75 flight nurses and a staff of 200 in its various locations.
Starbuck was a nurse in a hospital emergency room before taking to the sky.
“You are working in a very confined and often dark space,” the registered nurse said.
They rely on patient information from the first responder (police, paramedics and firefighters) but don’t always know what they’ll see until they get there. The moment the pilot lands the helicopter, Starbuck and her partner are out and racing to the victim.
“I will land as close to the scene as possible,” said CALSTAR 1 lead pilot Mark Ramos. “We land in places that are tight holes. It’s almost always going to be a night flight in an area we’ve not been to before. Those require the most attention.”
The Concord resident recalled landing in a parking lot and those on scene had him flying over power lines.
“Fortunately, I had my vision goggles,” said Ramos. “Our night vision is the latest technology available.”
“It definitely feels good to have a provider with a fantastic safety record,” said Dr. Joseph Barger, Emergency Medical System director, at the recognition of CALSTAR’s 25 years of service.
“We have an enviable safety record,” said Fay. “No one has ever been injured in a CALSTAR transport. We have had a training accident, but no one was injured.”
Fay attributes the safety record to pilot skill, continued training and investment in equipment. CALSTAR’s nonprofit status, he said, allows decisions about repairing, replacing or purchasing equipment to be made without the cost being the overriding factor. The nonprofit receives many grants in support of its operations.
“They’re pioneers in the field for safety,” said flight nurse Alana Gibson. She remembers getting the night vision equipment and wondering how she had done the job without it.
“CALSTAR puts my safety first,” she said.
Safety is also a concern with the pilots. Ramos, who prides himself in getting a patient from Brentwood to John Muir in 15 minutes or under, said he puts safety above all else.
Safety and teamwork are the touchstones that make CALSTAR a success. Starbuck and Hansen said saving Marin County firefighter Ruben Martin was a heartwarming example of the team working in perfect harmony.
Martin’s leg was crushed between two fire trucks at one of the isolated stations. As a paramedic, he knew his life was in jeopardy, and wanted to go to a nearby hospital so he could see and say goodbye to his wife.
But Starbuck, the flight nurse on that mission, insisted on taking Martin to John Muir. There, Hansen met the flight and took Martin to the operating room not knowing if he would ever walk again. The quick, synchronized actions of CALSTAR and the John Muir Trauma Center saved Martin’s life and his ability to walk.
CALSTAR continues to fly ill and injured patients regardless of their ability to pay.
“The presence in the community of that air medical service makes all the difference in situations where time to the trauma center is most critical,” said Lathrop.
Copyright 2009 Contra Costra Newspapers