LifeFlight of Maine has been providing critical care transport to patients across its state since 1998, taking requests for its services directly from hospitals, physicians and first responders at a scene of an accident. The nonprofit service is jointly owned by Eastern Maine Healthcare Systems and Central Maine Healthcare Corporation, with a steering committee from both companies providing oversight; SevenBar Aviation – one of the nation’s premier air medical transportation operators based in Dallas, Texas – manages, operates and maintains aviation services.
LifeFlight’s vision is for the state to be a place in which every person, in every community, has access to critical care and medical transport when they need it. Maine, the second most rural state in the United States based on population density, has a need for LifeFlight’s services at small, rural hospitals throughout the state. Since the service began, more than 19,000 patients have been successfully transported. Eighty-five percent of LifeFlight’s missions are transporting from rural, community hospitals to one of Maine’s three trauma centers, or to specialty centers in Boston. The remaining flights are to transport patients directly from accident scenes.
A Greater Requirement
With bases in Bangor and Lewiston, LifeFlight carried out their services via helicopter and ground ambulances until 2015. With a growing number of transport requests unfulfilled because of high demand or weather grounding the helicopters, LifeFlight decided to add a fixed-wing airplane to its fleet with the following mission-critical requirements:
- Easily reconfigurable cabin for medical evacuation operations
- Improved short runway take-off and landing (STOL) performance
- Better weather capability and efficient endurance to perform the missions LifeFlight’s existing rotary-wing fleet was missing
- Dependability – a reputation of little to no unscheduled maintenance incidents
- Reliable parts base and support program in place throughout the United States
After months of researching, scouring through aircraft listings and crunching numbers, a pre-owned Beechcraft King Air B200 was found in the U.K. that fit the criteria perfectly. An added bonus was this particular King Air had relatively low time and JSSI engine coverage.
LifeFlight worked with SevenBar to determine what modifications and upgrades would create the safest, most reliable, best-equipped platform. One critical addition was the Raisbeck Engineering EPIC Platinum Performance package, which would provide the necessary takeoff, climb, cruise and landing performance needed at Maine’s predominantly rural airports. “The faraway rural areas tend to have the shortest runways and, due to their location, are also the areas in the greatest need of LifeFlight, so the Raisbeck package was the first thing we identified as a must-have for our B200,” said LifeFlight of Maine’s Fixed Wing Manager, Joshua Dickson.
LifeFlight was also counting on the EPIC system improving the overall efficiency of the aircraft, enabling the completion of critical missions in less time while saving on fuel. This capability would be extremely beneficial for critically ill and injured patients relying on specialized care outside the local area, sometimes as far away as Cleveland; Washington, D.C.; and Toronto.
Due to dense tree coverage, varying terrain and ever-changing weather, accurate and reliable navigation is directly tied to LifeFlight’s ability to respond during periods of inclement weather. Because of this, they decided to replace the aircraft’s current EFIS 84 CRT tube system and right-sided mechanical gauges with dual Garmin G600 flat screen displays and dual Garmin GPS400W navigation systems. Being WAAS-equipped allows LifeFlight to use LPV approaches, which a number of Maine’s airports already support, for increased safety and reduced pilot workload.
In LifeFlight’s lifesaving work, clear and instant communication is vital, so a custom internal communications system, consisting of a Technisonic TDFM-9100 communication radio and a SkyTrac ISAT-200 phone system was installed. These devices allow reliable communication between the flight crew and the medical transport team onboard the aircraft, as well as with on-ground emergency and medical personnel and LifeFlight’s communication center in Bangor, Maine.
A Team Effort
With funding from a combination of private donations and a tax-exempt, low interest loan obtained through a local municipal bond program, LifeFlight of Maine Executive Director Thomas Judge’s goals were to keep the project on budget and to spend the money within the state of Maine, or farthermost the New England area.
Finding partners within budget proved challenging, but LifeFlight and SevenBar found C & L Aviation of Bangor, Maine, and Pro Star Aviation of Londonderry, New Hampshire, who could make the numbers work. For these two aviation companies, the opportunity to work on such a project brought its own rewards – providing needed expertise in the aeromedical industry and having the opportunity to prove the unique benefits inherent in working with local businesses. C & L acted as the primary contractor and oversaw the entire project, while Pro Star acted as a sub-contractor providing avionics and structures expertise.
Crews at Pro Star Aviation installed the Raisbeck EPIC package, performed the avionics upgrades and modified the flight deck, and addressed various structural modifications that were required. Once completed, the aircraft was tested then flown back to C & L Aviation for the remainder of the modifications.
The C & L team started with the interior, outfitting the cabin with a Spectrum Aeromed medical module system and installing all mission-essential medical equipment. The finishing touches – made possible by the generosity of Sherwin-Williams Aerospace Coatings Division, who donated the paint – were made to the newly refurbished B200 by undergoing a complete exterior repaint, branding it with LifeFlight of Maine’s company colors and making it an official part of the LifeFlight fleet.
When the LifeFlight King Air was mission-ready, an official ribbon cutting was held to present the B200 to the people of Maine. During the event, people from all over New England stopped by to show their support, resembling an atmosphere akin to family gatherings – conversations were many, while hugs and handshakes were frequently given and received. Among the crowd, prior LifeFlight patients stopped by to share their stories and express their ongoing gratitude for services rendered. There is no doubt the positive impact LifeFlight is having on the state of Maine.
It wasn’t long before the King Air B200 was in the air, helping LifeFlight fulfill its vision. “This new aircraft means we’ll be able to answer hundreds more calls for help every year,” Judge said. “We’re especially lucky and grateful to have incredible partners like SevenBar, C & L Aviation, Pro Star Aviation, Raisbeck Engineering and Sherwin-Williams who helped make sure LifeFlight continues to be there for the people of Maine.”
(Photo courtesy of Pro Star Aviation)
One of the first patients saved by LifeFlight’s new airplane
Within a few short months of LifeFlight launching its new fixed wing program, the airplane had already proven itself as a great asset to the organization and Maine’s critically ill and injured patients, including 36-year-old Maine native Aaron Birt.
Born and raised in a small town in Maine, Aaron now lives and works in Massachusetts but returns home often to see his family. He was there one weekend visiting with his mother, sister and nephews when he began to feel dizzy and short of breath. He knew something wasn’t right and told his mother he needed to get to the hospital right away. The last thing he remembers is walking into the emergency department at the local hospital.
As it turns out Aaron was suffering from a massive pulmonary embolism. A blood clot was caught in his pulmonary artery, blocking the blood flow and not allowing his blood to become oxygenated. This condition can quickly become serious, often fatal.
The emergency medical staff knew that Aaron was going to require specialized treatment at a major medical center. The hospital made an initial request for LifeFlight to transport Aaron to a regional medical center within 100 miles. While a LifeFlight helicopter was en route, Aaron’s condition deteriorated and the emergency physician placed a breathing tube to secure his airway. When the flight crew arrived, they worked with hospital staff to sedate Aaron and hook him up to a special ventilator.
But then Aaron’s heart stopped. The flight crew and emergency staff performed CPR for more than five minutes before his heart started beating again. Over the next half hour, Aaron’s heart stopped three more times, requiring several more minutes of CPR and full resuscitative efforts.
What started out as a relatively routine critical care transport, best suited to the helicopter, quickly became much more complicated. The flight crew and emergency physicians realized a change of plan was necessary to make sure Aaron received the care he desperately needed. The team determined that a medical center in Portland, roughly 200 miles away, was the best facility to treat Aaron’s illness. The added distance, together with the very real possibility that he would need CPR again during the trip, also meant that LifeFlight’s new King Air was the best way to transport and care for Aaron. The plane was dispatched to meet the team at the local airport.
When Aaron’s heart finally began to respond to the treatments and medications intended to stabilize him, he was ready to be transported by ambulance to the airport. LifeFlight’s King Air was waiting to carry him to get the specialized care he needed. During the flight, the crew maintained his blood oxygen level and worked to improve his heart rate and blood pressure.
Aaron woke up three days later, groggy and confused and not yet realizing just how traumatic the past few days had been. He was moved to recovery where he worked hard to regain his strength, making great strides in just a few days. He was determined to prove he could walk out of the hospital on his own, which he did 11 days after arriving. Three weeks later, he returned to his job managing supply chains. He takes care to avoid situations that might cause internal bleeding but has returned to his life before his ordeal, with one major exception.
“I’ve grown much closer to my family, leaving less and less time between visits back home,” Aaron said. “This was a total life-changing event. A lot of people worked hard to make sure I wouldn’t miss the joys of watching my nephews grow up. I intend to make the most of every moment.”
– Story provided by LifeFlight of Maine
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