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Thursday, July 07, 2022

It sounds like a lawnmower on loudspeakers. Blades whir at full speed, creating a frantic windstorm that spreads the smell of jet fuel.

No one flinches.

The ShandsCair aeromedical team is used to the loud noise, the vibrations, the chaos.

Everything else fades into the background when calm collaboration can determine a patient's fate aboard a ShandsCair helicopter.

ShandsCair is a Shands at UF hospital program that incorporates helicopter, jet and ambulance transport for critically ill patients.

It provides services to a large chunk of the Southeast, from Atlanta to Miami.

Dr. David Meurer, ShandsCair medical director and emergency room physician, said the ShandsCair team has what is considered the pinnacle job in Emergency Medical Services, also known as EMS.

"The reason we're in it is not just for the joy of flying but taking care of some really sick folks," Meurer said.

ShandsCair is split into the adult-pediatric team and the neonatal-pediatric team, which serves premature babies to 5-year-old patients.

ShandsCair communications takes calls and relays them to the crew.

John Brown, a communications transport specialist, said they receive a lot of scene calls, or incidents involving people who are seriously ill or have been in accidents.

In addition to being a dispatcher, Brown also serves as an ambulance driver and makes trips to the emergency room.

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Brown said he enjoys dispatching more because it makes him feel like he's in the heart of operations.

A little after 8 a.m. Tuesday, ShandsCair teams held a morning briefing, discussing the weather, scheduled maintenance and problems the outgoing shift had.

Shortly before the briefing, Brown received a call from Shands Lake Shore Hospital in Lake City.

Crucial Cases

A woman who was about 30 weeks pregnant went into pre-term labor and possibly needed helicopter transport.

Ambulances couldn't arrive for another 2 to 4 hours.

The orange and blue Agusta A-109 Power helicopter, which can go about 170 miles per hour, was wheeled out of the hangar by a tractor and placed on the launch pad.

As soon as team members were ready to take off, another call acknowledged that the patient was stable enough for available ground transport.

The mission was aborted.

Jim Howard, flight program coordinator, said the helicopter is saved for the most critical cases.

"The last thing you want to do is fly routine patients who don't really need it," Howard said.

Down to the Second

Trauma calls take up about 65 percent of helicopter missions, which was the result of Shands at UF becoming a level-one trauma center two years ago, Howard said.

ShandsCair cannot predict when it will receive transport missions, he said.

"Today's typical," Howard said. "It's not much different from an EMS station or a fire station in that it can be boring or extremely exciting. You never know day by day."

Flight paramedic Bruce Young said the helicopter houses everything from IV equipment to blood pressure cuffs.

"It's like a flying ICU (Intensive Care Unit)," Young said.

Pilot Steve Pierce, 52, said he's been flying for 20 years.

"I just focus on my job up front and let them do their job," Pierce said.

Flight nurse Staccie Allen said trusting the pilot makes it easier to care for patients in the back.

"We don't have to worry about what's going on in the air," Allen said.

The ShandsCair helicopter lands on the hospital's launch pad at the 12th floor, and the crew wheels critical patients to the Emergency Room.

Physicians and nurses try to stabilize the patient during the golden hour, which is the first vital hour to improve the person's mortality rate.

Allen said they usually take patients that nobody else wants to transport, due to lack of equipment or experience.

Transporting Babies

Besides traumas, neonatal care is another one of ShandCair's specialties. In the helicopter, there are monitoring, oxygen and heating systems for ill babies.

Respiratory therapist Bill Chesser helps out at Shands' Neonatal Intensive Care Unit during the downtime at work.

ShandsCair tends to transport women who have higher-risk pregnancies.

They prefer that women give birth on the ground, Chesser said.

"The womb is a much better transport than we are," he said.

Allen said they will occasionally deliver the mother and then take the baby back by helicopter.

Howard said several counties around Gainesville rely on ShandsCair because they have no medical facility.

"Some of these rural counties really need that back-up support," he said.

'It's Intense At Times'

The jet ShandsCair uses for longer distances is kept at the Gainesville Regional Airport.

Despite long distances, the crew also faces long hours.

With a critical patient on their hands and fatigue building from a 24-hour shift, the job can become grueling.

"It's intense at times," Young said. "I think we all know that's what we're in it for."

Allen said an important factor of ShandsCair's success is trusting teammates.

"You're able to sense before it happens what your partner is going to do," she said. "There isn't one person I wouldn't work with."

Her teammate, Todd Brooks, is a paramedic who said they have to learn from each other.

"You have to know the strengths and weaknesses of everybody," Brooks said.

Meurer understands the rough decision-making that goes on in the air.

During a flight, there was bad weather and a patient was dying from an abdominal aneurism, Meurer said.

They had to decide whether the patient died or the aircraft crashed due to bad weather.

"It's one of the more tough things we've had to do," he said.

ShandsCair Family

Meurer, who was named National Air Medical Director of the Year by the Air Medical Physician Association, was nominated by his crew.

He has been at Shands at UF since 1993 and his leadership has impressed the ShandsCair crew.

"They make my job easy," Meurer said.

Last year was the 25th anniversary of ShandsCair, and Meurer said they got to look at past photos of team members.

"It was funny to recognize faces you see around the hospital now when they were 20 years younger," he said.

Last Christmas, they had a party at the hangar. Families attended and a communications specialist dressed up like Santa.

"We're all just big kids at heart sometimes," Meurer said.

The members of ShandsCair have spent so much time together that they have become a family, Meurer said.

"I trust them with my life," he said. "I trust them with the lives in our service area."

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