Lifesaving chopper faces state budget cut

News reports following actress Natasha Richardson’s death from a head injury have focused on the lack of emergency helicopter service in Quebec. She spent two and a half hours in an ambulance traveling from a smaller hospital in the resort town of Mt. Tremblant to a larger one in Montreal.

Quebec is one of the only provinces in Canada without an emergency helicopter service.

The Tri-state area has, in contrast, an embarrassment of riches. There are two services that provide emergency care, LIFE STAR, which operates out of two hospital bases in Connecticut, and Life Net, which flies out of Albany and Westchester, N.Y.

Sharon to Hartford in 20 minutes

According to LIFE STAR, about 30 percent of its transports are trauma calls from the scene and 70 percent are inter-facility transports (taking a patient from one hospital to another). Dr. Eugene Chin, head of the Emergency Department at Sharon Hospital, said, “LIFE STAR is equally important for both kinds of calls; both are very important for our area. Helicopter transport in general is an integral part of delivering medical care to the Northwest Corner.�

Sharon Hospital, a small general community hospital, is not set up to address multi-symptom trauma or neural issues.

It is the only hospital in the state of Connecticut with a “rural� designation, which means in essence that it is isolated from a trauma center. Level 1 Trauma centers (which are the highest level) are in Hartford, Albany or Westchester. The closest is one hour and 15 minutes away by ground transport.

LIFE STAR, which can travel at speeds of up to 155 mph, can make the trip from Sharon to Hartford in approximately 20 minutes.

Not only do the helicopters speed the patient to an appropriate trauma center, but the medical crews on board are trained to do high-level interventions. Lisa Graziano, chief flight nurse at LIFE STAR, likened the chopper to a “flying emergency room, an ICU.� The medics on board can start IV’s, give medicine, start central lines, and do critical-care monitoring. In fact, every crew consists of a pilot, a flight nurse and a respiratory therapist; both the nurse and therapist are also licensed paramedics.

With cases involving auto or motorcycle accidents, farming accidents, burns or cardiac incidents accounting for a large number of emergency service calls, seconds count. The onboard care and medical expertise of the crew are crucial factors in helping to stabilize, or even save the life of, the patient.

The Northwest Corner’s 911-emergency system, Litchfield County Dispatch (LCD), has been in operation since 1989 —and has been dispatching Life Star since its inception. Kevin Webb, communications manager at LCD, said Hartford’s LIFE STAR and Albany’s Life Net work closely together.

If they do not have a helicopter available they will coordinate services in an effort to find one. In fact, LIFE STAR and Life Net are both part of a New England-based group of emergency medical service companies. Graziano points out, “There is minimal overlap of the service areas, and they back each other up and work closely together to provide appropriate service.�

When a call comes in for LIFE STAR from the Northwest Corner, tactical decisions must be made. Is it fastest and safest for the helicopter to go to the scene or to meet the ambulance at the  helipad at Sharon Hospital? The helicopter can set down in a field; but an appropriate landing pad must be established (with the advice of the local fire department).

If the weather is questionable, which is not uncommon, since accidents are frequently weather-related, it might be in the patient’s best interest to be transported to the local hospital’s emergency room for stabilization and interventional medical care until the helicopter can safely land.

One of safest in country

Safety is a huge concern across the board. LIFE STAR has an impressive safety record, according to Graziano. There hasn’t been an accident or incident  since a crash in 1992. Following that incident the LIFE STAR system was completely overhauled and is now considered one of the safest programs in the country.

“LIFE STAR is ahead of the curve as far as safety initiatives,� Graziano said. “Our weather minimums [the standards by which they fly] are more stringent than the federal government requires. Many of the things the Federal Aviation Administration recommends now, we have had in place for years.�

Regardless of ability to pay

The mechanisms that put LIFE STAR in the air begin at the scene of an accident or in the emergency department of the hospital. Certified police, fire or ambulance personnel may request LIFE STAR upon evaluation of the patient  at the scene.

If the patient is transported by ambulance to the emergency room, then the doctor there may decide transport to a trauma center is needed.

In a critical-care situation, the patient probably is not consulted. There is no time to discuss insurance. LIFE STAR provides service to everyone regardless of their ability to pay.

However, the rates are set by the government and cannot be raised. If the state budget cuts include LIFE STAR, the service will not be able to offset its losses by increasing its fees.

LIFE STAR is a private service attached to Hartford Hospital, but it is a money loser for the hospital and does receive state funding.

According to state Rep. Roberta Willis (D-64), the governor’s proposed budget cuts for the coming fiscal year include a reduction of $69,410 for LIFE STAR (out of a total appropriation of $1,388,190).

Even more dire, the governor’s budget proposal for 2010-11 eliminates the entire subsidy.

Willis believes that the state Legislature would not, ultimately, do anything that would jeopardize the service — but there are no guarantees.

The Appropriations Committee, of which she is a member, hasn’t finalized the budget, and Willis noted that it is a priority of the subcommittee to restore that funding.