15-Dec-2022 Source: GundersenAIR
What started 30 years ago as a modest program born out of the hospital’s need for trauma patients has evolved into a dual-machine operation that’s called on multiple times a day when minutes matter the most.
GundersenAIR – called Medlink Air at its inception – began in 1992, and for nearly the entire time, Jeff Hillesland, MD, has been its medical director – a role he was interested in following his work with a helicopter program that was created during his medical residency at Spectrum Butterworth in Grand Rapids, Mich. Gundersen’s program, he says, began out of necessity, as at that time, many trauma cases in the area were being flown to other facilities. Because of that, Gundersen’s medical residents were losing out on the opportunity to care for trauma patients, which was potentially putting the residency program at risk.
“That was one of the big impetuses to put it in, and also to get some of the critical patients we were losing,” Dr. Hillesland says. “Madison had a helicopter, Mayo had a helicopter, so they were pulling our patients.”
At the onset, the program started small, and so did the aircraft itself. In that maiden machine, the patient was tucked up near the pilot, so it wasn’t possible to perform some procedures or use sophisticated equipment.
However, once a larger helicopter was secured, flight crews were able to begin patient transfers between facilities, as well as respond to active scenes involving cardiac arrest, strokes and other conditions where time is of the essence, including auto accidents. Not only was the size of the helicopter and its capabilities growing, but so was the program.
As requirements to keep its accreditation became more stringent, GundersenAIR began adding staff, including a nurse educator and quality improvement specialist, who work primarily on compliance with those regulations. They’re in addition to 11 flight nurses, 10 flight paramedics, the chief flight nurse, Hillesland as medical director and Stephanie Hill, GundersenAIR’s director of eight years. They also work with eight pilots and five mechanics through its contractor, Metro Aviation.
“When I think about everything we’ve added just since I’ve been here, it’s been pretty rapid,” Hill says of the program’s growth. “In talking about the 22 years previous, they could probably name a lot of things they added, changed and did differently, and it’s probably going to stay that way for the foreseeable future.”
She added, “You never get comfortable. There’s always the newest, latest and greatest in what we’re doing for our patients and what they need from us.”
As GundersenAIR’s ability to reach more people increased, so did the size of its service area. In its infancy, with just one helicopter based in La Crosse, trips to the outer reaches, such as Gundersen Moundview Hospital and Clinics, required considerable flights – delaying response times. And only one machine left no backup if mechanical issues arose, or a second call came in. Therefore, it made sense to add another helicopter to the fleet and base them in regional locations, which happened in 2019.
“Having the helicopters out in the Region, we put them close to our customers,” says Dr. Hillesland, adding that Sparta and Decorah were ultimately chosen as home bases. “That was a real win for us.”
As the geographic area that GundersenAIR covers expanded, so did the number of flights it could take each year. According to data, in 1992, the program’s inaugural year, crews completed 166 flights, a number that’s continued to increase steadily, through last year’s highwater mark of 874 flights.
But GundersenAIR doesn’t exist simply to respond to emergency calls. Working in the department also involves a fair amount of community outreach. The helicopters make dozens of appearances at events such as National Night Out, high school mock crashes, or mass casualty events, and crew members will also provide medical training to any area first responders, fire departments, and regional critical access hospitals that requests the service, free of charge.
“We’ll go out in the evening and do a lesson on anaphylaxis or trauma management, or whatever they request,” Dr. Hillesland says. “We’ll provide that education for them out in the Region.”
“That’s a huge part of our job,” Hill added. “It could be clinical, or it could be a touch-a-truck. We just do everything.”
That level of community participation, as well as the number of crew members who are involved in their local EMS, is a source of pride for Hill. But what she’s most proud of is the critical role her department plays in saving lives – 30 years ago and today.
“We’re the 9-1-1 for 9-1-1,” Hill says. “If 9-1-1 is called out to the scene and they need more help, they call us. If there’s something so severe or specialized at our hospital that needs to go to a bigger hospital, they call us. There’s definitely a certain amount of pride with that.”