Twisted metal, shards of glass, random car parts and a mangled motorcycle litter the two-lane road and adjacent field. What seem like a million red lights pierce the night sky. A local volunteer paramedic tries desperately to stabilize a patient who is critically injured and in need of immediate surgery. The nearest hospital with surgical capabilities is 90 minutes away -- a ground ambulance won't get the patient there in time.
But, in all the commotion and confusion, a muffled staccato beat becomes clearer by the second, and before long, the patient's only hope, a lone helicopter, comes into view. The craft lands, a paramedic and a nurse leap from it and run to the scene with medical equipment and a stretcher in tow. Within minutes, they have stabilized the patient, loaded him into the helicopter, and are back in the air, headed towards the hospital, only 20 minutes away by air. With precious minutes saved, this patient's chances of survival have improved dramatically.
For people who live in metropolitan areas, this may seem foreign. If they have a medical emergency, an ambulance can reach them quickly. But, most rural citizens don't have that luxury. In Illinois, 84 of 102 counties are designated rural, and of those 84 counties, 78 are designated in whole or part by the U.S. Department of Health and Human Services as health professional shortage areas. Nearly 1 million residents currently live in these underserved areas.
Paramedic Larry Thies, Flight Nurse Cindy Spencer and Pilot Brett Sullivan from the Air Evac Effingham base enjoy a break while speaking to Coles Moultrie Electric Cooperative members about the program at the co-op's annual meeting this year.
Keeping healthcare professionals in rural Illinois is the single most critical issue for rural communities. Increasing healthcare costs, the fear of malpractice suits, serving many low income and uninsured residents and fighting difficulties with Medicaid reimbursement makes practicing in rural areas less appealing to doctors. This, coupled with a severe shortage of nursing professionals, has resulted in a reduction of services at rural hospitals, and even closings. This has led to wide geographic gaps in rural healthcare.
Long distances to travel to facilities that offer trauma, burn, emergency, surgical and many other specialized services can mean the difference between life and death. One way to fill the gap is through air ambulance services such as the Air Evac Lifeteam (AEL), which is headquartered in West Plains, Mo.
With 74 mutually supporting air-medical bases manned by more than 1,600 employees in 12 states, AEL is one of the largest and oldest independently owned air medical services in the United States.
Air Evac began serving rural areas in 1985, and its mission is simple: To save lives and positively impact outcomes during life- or limb-threatening medical emergencies by providing rapid access to definitive emergency health care for people in rural America. According to Dustin Bramer, Base Paramedic Supervisor at AEL's Pawnee base, "Putting the company in a rural area like we are means that 99 percent of our bases are just as rural. It gets us closer. Our company has said from day one that we are a rural company." And AEL's values are also simple:
- · Safety for patients and our people
- · Quality patient care
- · Professional environment of honesty, integrity and respect
- · Hard work and unwavering dedication to the mission
AEL offers a variety of memberships starting at $50 per year for a single membership. Two-person and family memberships are slightly more per year, and multiple-year memberships are also available.
Because a helicopter can quickly and easily maneuver to rural locations that can be difficult to find, AEL can react much faster than other rescue vehicles. According to Kurt Kennard, Base Pilot Supervisor, Pawnee, "It (AEL) provides the local emergency medical services (EMS) personnel the opportunity to have our service come right to a location. Then we fly straight to the hospital. What may take them an hour and a half driving is 40 minutes flying.
Air Evac teams in Illinois fly any time of the day or night to save lives. Air Evac is a membership supported service that is a critical part of the rural Illinois health care system.
While many organizations claim to be customer-driven, AEL is serious about it. According to Bramer, "Something interesting that our company offers is early activation. We love having a call-fast mentality. If you get a 911 call and you think it's bad, call us, get us in the air, get us close to you, and if you decide later that this guy's not hurt or sick, we'll go back home, and nobody gets a bill. We'd rather get cancelled five times in a row than have it be the one time that you wish you'd called us."
Kim Justice, Base Nurse Supervisor, Pawnee, says that every call they get deals with an extremely dire situation. She says, "These are the worst of the worse. There's a reason they call a helicopter. They're critical. It's a life or death situation. For cardiac patients, each minute equals lost heart muscle. In trauma, you have what's called the 'golden hour.' We've been trained as medical professionals that the survival rate dramatically increases if an intervention occurs within the golden hour. That golden hour can be sucked up quite dramatically if you've got a ground ambulance trying to find where it's supposed to be on this county road."
Kennard relates a story about a patient named Tim Welch, who he flew from Jacksonville. Welch, who is from Bluffs, had been released from Passavant Area Hospital in Jacksonville on Nov. 16, 2004, following surgery to put a steel plate in his arm. Tim arrived home at around 7:30 p.m. that night, and went to bed at around 10 p.m. Tim says, "At about 1:30 or 1:45 a.m., I woke up and my arm was throbbing. I actually could feel my heart beating in my arm. My back and my neck were killing me, and my chest was tight."
His wife, Tammie, thought the pain was from the surgery, and was going to get him more pain medication, but Tim knew that wasn't the problem. "When I got up, I tried to ease the pain any way I could, and I couldn't. It felt like a dagger in my left shoulder and my back. I said, 'Something's not right.' And then I started getting sick to my stomach, and I pretty much knew what was going on," he says.
Tammie drove Tim to the Passavant Area Hospital in record time. As soon as they reached the hospital and personnel there realized he was suffering from a massive heart attack, they called for AEL to transport Welch to St. John's Hospital in Springfield. Kennard recalls, "We were talking with him in the hospital, and as soon as we got him on the aircraft, it just went bad. He basically had died. His heart had stopped. We had to take him back out of the aircraft at Jacksonville." Justice was the nurse on board, and after considerable effort, was able to stabilize Welch. Kennard says, "We put him back on the aircraft and flew as fast as we could to Springfield."
Welch called the next day to thank the crew for saving his life. He says, "If they hadn't been there, I'd never have made it. They kept me alive and got me there so fast. I guess the heart attack I had is one that very few people survive."
Justice says, "That is a story that is the true definition of saving someone's life." And it shows the value of immediate medical assistance.
AEL personnel have a lighter side to their profession too. As directed by AEL's marketing plan, each base's personnel are required to provide outreach support to communities within their base's coverage area. They have each adopted hospitals in rural communities, and are seen at all types of activities in their areas.
They want people there to know that the air ambulance service is available to them, and also they want to be a part of the communities they serve. "Our company is also huge with benefits. Anytime in our 70-mile radius there is somebody trying to raise money for someone who is sick, all they need to do is ask and the company is giving us free helicopter ride certificates so they can auction them off. It's all part of being in a rural community," says Bramer.
AEL personnel often interact at electric cooperative annual meetings. Russ Riggins, Regional Membership Manager, says that AEL has forged a good partnership with the electric cooperatives in getting the word out about the service. And through the cooperatives, AEL offers what is called the utility plan. According to Riggins, "It's strictly an option -- a value-added benefit if the co-op members want to take advantage of it. It's a convenience for the people who want to be members of both."
Tom Ling, AEL's Membership Coordinator at the Pawnee base, says that Rural Electric Convenience Cooperative (RECC) in Auburn was the first Illinois cooperative to join AEL's utility plan. Ling says with pride, "RECC is not only located right here by our base, but it serves us with electricity."
For David Stuva, President and CEO of RECC, signing up for AEL's utility plan was a " no-brainer." He says, "We've had a relationship with AEL since 2005, and we feel the company provides a vital service to rural residents. By participating in the utility plan, and splitting our members' yearly membership fee into 12 equal payments that are wrapped into their electric bills, we're doing what we can to make it easier for them to take advantage of the program."
Stuva also feels it's vital for the co-op's linemen to participate in the service. "Knowing we have the security of a helicopter that can travel to the most remote areas of our service area in case of a serious accident gives us great peace of mind," he says.
Kurt Kennard, Dustin Bramer, Kim Justice and Tom Ling, all of the Air Evac Pawnee base, can be the difference between life or death for their members, who need fast transportation during medical emergencies.
Ling states that the very low cost of the program is great insurance for when the unexpected happens. He says, "It's a financial issue of flying with us being a member compared to not being a member. If they have to fly with us because of a life or limb emergency, the only cost to them is going to be the cost of membership. The average cost to fly a non-member is about $12,000. Members also get to know that they're helping to keep an aircraft in rural America."
AEL crews attend all the events they can to promote AEL. According to Ling, "We have nearly 1/2 million members in all the states we're in. Because of membership, we're able to do public relations events and be involved in communities. We provide free training to fire agencies and EMS agencies. Without memberships, we wouldn't be able to do it.
AEL management understands that the company wouldn't have nearly the presence it has in rural communities or its tremendous reputation if it weren't for its dedicated personnel. It's about their passion -- passion for a grueling profession where they know they hold peoples' lives in their hands every day. They eat, breathe and live their commitment to their patients and their communities.
Welch says, "They're not people who just do a job and move on to the next one. I really think you get a place in their heart. And they make a place in ours. If there's any angels who walk and talk that you could see every day, it would be those people right there."
For more information about Air Evac Lifeteam membership or questions about the service, please call 417-256-0010 or log on at www.air-evac.com.