Judi Currie
Foster’s Daily Democrat
KITTERY, Maine — Before a helicopter can fly in to pick up a patient at the scene of a serious motor vehicle accident or other traumatic event, first responders on the ground must know how to play their part.
To that end several area departments took part in a DHART (Dartmouth-Hitchcock Advanced Response Team) ground safety course Tuesday evening.
Kyle Madigan, DHART program director, said the class is used to teach departments how to activate services and improve awareness so those on scene know how to pick out an appropriate landing zone, and then talk the pilot in.
“They learn how to communicate with staff at our dispatch center as well as our pilots who would be flying a medical crew to the scene of an accident,” Madigan said.
The training was held at the Kittery Fire Department’s Gorges Road station. Class was interrupted when a truck fire emptied the station of personnel and two American Ambulance crews were called out. The helicopter was even pressed into service and arrived later than planned.
Madigan said it is all about safety for the patients, the DHART crew and those on the ground at the scene.
“We rely on the fire departments and the EMS providers to be our eyes and ears on the ground looking for wires, trees, obstructions,” Madigan said. “So that we have a safe place for the helicopter to come into and then land; assuring safety for us but also for the personnel on the ground.”
Madigan said the helicopters can’t tolerate much of a slope and need a level field, ideally about 100 by 100 square foot area.
“The things that we look for are obstructions, such as power poles or power lines stretched between poles,” Madigan said. “Those are the things that can be difficult to see at altitudes from the helicopter, so we rely on the firefighters to give us a description.”
Madigan said the person on scene will be very descriptive, “…so I’m standing in the (landing zone) I am looking up and I’ve got power lines on the west side, trees on the east side, clear north and south.”
The pilot will still do what they call an orbit, flying around looking down at the area to make sure they are seeing all the features being described before they try to make the approach and come in to land.
“Is it a grassy field, has it just been mowed; is it snow covered — is it going to blow up and create whiteout conditions?” Madigan said. “Different environmental factors go into this because it is a 365-day a year operation.”
The DHART helicopter is smaller than a typical ambulance and they are afforded advanced protocols (the authority to perform certain procedures) to care for the patient.
Madigan said it is a ‘step up’ from an ambulance as they have a ventilator, pacemakers, fluid warmers, enough blood to do transfusions.
They have two helicopters, one based at Dartmouth Hitchcock Medical Center in Lebanon, N.H., and one at the airport in Manchester, N.H. They operate 24 hours a day, seven days a week; with a pilot, a nurse and a paramedic standing by.
“The teams are on a 12-hour schedule. They work 12 hours then rotate,” Madigan said. “Roughly four pilots, five nurses, and five paramedics at each base.”
According to Madigan DHART has been in operation for almost 21 years and has successfully transported more than 25,000 patients.
American Ambulance Operations Manager Scott Schuler brought two of his teams to the training.
Even with the level of care they can offer with their state-of-the-art ambulances, they do sometime have to make the call to DHART.
“We look at certain criteria that are defined within state protocols on both sides of the border and consistent with CDC guidelines,” Schuler said. “When we see that criteria, we are looking to put the patient in the best place for trauma care which typically is an academic level one trauma center.”
Schuler said studies show that patients who go to an academic level one trauma center, such as Maine Medical Center in Portland or Boston Hospital, who meet that specific criteria are back to work two weeks faster than going to other trauma centers.
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©2015 the Foster’s Daily Democrat (Dover, N.H.)