Inside HELP Flight: Cool equipment, important jobs

I’ll be honest: one of the main reasons I wanted to write this article was so I could get paid to ride in a helicopter. I mean, what childhood dreams would be satisfied on such a ride? What anxieties quelled? This would be a transcendent experience, a dream come true.

Riding on a helicopter would be a closer approximation to the ideal: flying wingless through the air, a body darting through the sky, effortless. A helicopter is to a plane as a motorcycle is to a car: less machinery, more fun.

As part of this project, this ride-along, I would spend 12 hours at St. Vincent Healthcare, observing the processes of the HELP Flight crew and maybe flying with them to a person in need. This way I would get to see the inner workings of the HELP Flight operation, writing the article from an informative angle and through the lens of my sunny sojourn through the big Montana sky.

There was a hitch. They call it the Ride-Along Curse. Whenever someone like me tags along, so they told me, business seems to slow down at HELP Flight HQ, offering fewer flights for the overeager visitor. I prayed that I might one of the lucky ones, that I might be fortunate enough to ride on the golden blades of the mighty helicopter. It came down to this: if I had been lucky enough to get a ride, someone else would have been unlucky enough to need it.

So I spent the day in the labyrinthine halls of the hospital pestering the HELP Flight crew with questions as they tried to do their job, which boils down to a lot of preparation and a few small moments of exact execution. Because they are an emergency response unit, they must always be ready to go full-throttle at a moment’s notice. These rapid-response operations must always be prepared, whether or not their preparations meet any immediate need.

I saw a similar practice during a summer I worked for the Forest Service, with a firefighting crew. “It’s feast or famine out here,” they told me. They would spend days sharpening and resharpening their axes and then weeks with scarcely a minute to spare, being flown all over the country, to places with long fire seasons like Arizona and California. There is a good deal of randomness with this sort of business—it is precisely their job to deal with the randomness and provide dependable services despite it.

The same could be said of air ambulance transport. Though, much to my chagrin, there were no flights during the 12-hour shift I was with them, the day before they had had five flights between the chopper and the fixed-wing—a busy day flying between Billings and Salt Lake City and Denver.

I was surprised to learn that about 80 percent of HELP flights are “inter-facility transports,” taking a patient to or from St. Vincent from or to another hospital in a nearby city. The other 20 percent or so are “scene calls,” the majority of which are trauma cases. Most scene calls are the result of car accidents, motorcycle accidents and horse/ATV accidents, in about that descending order. These emergency response situations are the ones I imagined would be the bread and butter for HELP Flight: side of a highway, flashing lights, rain on big shiny helmets, steady hands, saved lives.

And boy, do they have cool helmets, complete with the best night-vision goggles money can buy. I got to wear one and pose for picture in the cockpit of the helicopter—this was as close as I’d get to flying that day. The helmet had dropdown sunglasses and a walkie-talkie headset and made me feet like I was in “Black Hawk Down.”

And it really is awe-inspiring, their operation, like something out of a movie. The flying machines are impressive, costly pieces of equipment—the helicopter $6 million new, the airplane $1 million. Each of them is owned by national entities, the helicopter by Metro Aviation Inc. and the plane by Edwards Jet Center. The chopper has a maximum speed of 130 knots, or about 145 mph. It has a 190-gallon gas tank and burns about a gallon a minute. I’m told the helicopter has a 150-mile radius in which it can fly without refueling—a 300 mile round-trip. The fixed wing, on the other hand, has a top speed of almost 300 mph and can fly all over the country.

Below ground is the the communication center, a desk with six computer monitors displaying GPS maps, weather conditions and various other data. The so-called comm center receives the calls for the flight teams, helping to coordinate who needs what where, and connecting with the Billings airport and the larger ATC (Air Traffic Control) to facilitate landings and takings-off in all parts of the country. Of course, the comm center comes complete with a headset and oodles of coffee.

That may be why the team holds its morning brief there. Well, that and the computers. At the brief, one of the day’s pilots gives the low-down on expectations for weather—the helicopter cannot fly in low-visibility or windy conditions—and other topics, such as updates on procedure and equipment, personnel, etc. They discuss the busy previous day, working out kinks they ran into. Apparently the fixed wing’s windshield spiderwebbed halfway through a flight, and they had to turn around. Everyone seemed impressed at this news. Bad news for me though: the plane would be out for repairs today, thus lessening my chances of flying. Now the helicopter was my only hope.

Today I’d hang out with Brent Certain, an RN on the flight team, and Stephanie Rickbiel, a paramedic. With no early morning flights, the two began checking up on supplies, doing inventory-type stuff. They showed me the rooftop supply room where they keep in-flight medical materials—anything from gauze to drugs, special sedatives and painkillers. Some of the medicines they had to keep in a refrigerator, which I found immensely interesting for some reason. They also kept them locked up.

This was one among many locks: the elevator to the roof required a code; as did the door from the elevator to the roof; as did the door from the roof to the storage hall; as did the door from the storage hall to the storage room; and as did, of course, the drug cabinet in the storage room. HELP Flight teams are serious about their locks.

Everything is cataloged because everything is expensive. The aforementioned refrigerated medicine, the helicopter, the plane, the fuel, the highly trained nurses and paramedics and pilots, the insurance on the helicopter and the plane, the maintenance of the communications systems on the radio and GPS. All very expensive and state-of-the-art. Those night-vision goggles I mentioned? Eleven thousand bucks a pair, and only available to EMT services and to the military.

In fact, there seems to be a lot of overlap between the military and medical worlds, in terms of gear and personnel. Sam Ausen, my connection to HELP Flight and (full disclosure) future father-in-law, works as a flight nurse on the HELP Flight team. He has experience with the Coast Guard. Three of the four helicopter pilots at St. Vincent have military experience. No doubt the technologies used by air ambulance operations owe their existence to military development, from blades and engines to communications and tracking systems. And behind it all is the Internet, itself a product of military innovation.

But the HELP Flight wasn’t always as high-tech and tight a system as it is now. A decade after its inception in 1979 the team got a nighttime scene call; a rancher needed to be picked up. This was before many of the refinements to the flight program, before stricter regulations on things like how many hours pilots needed to fly before they were allowed to fly night missions.

The helicopter team took the call, picked up the rancher. Next thing you know, a family arrived at the hospital looking for a patient who came in on a flight. People at the hospital soon realized that the helicopter flight team had left without telling anybody (not uncommon at the time), and had met an unfortunate end in a crash. Four people died, the patient and three crewmembers. No one in the hospital had even known they left.

Such an occurrence is nearly impossible to imagine now. Over the years the methods of the industry have been refined to a near-science, thereby minimizing risk to crew and patients, not to mention all the expensive equipment. Now there’s almost no way to go missing, no way to get off the grid or off the books.

This aspect of high regulation helps make HELP Flight and operations like it probably some of the best in the world. They engage in a distinctly American activity: the obsessive pursuit of an insane goal—in this case, medical help, anytime, anywhere—with the even crazier achievement of that goal. Of course such a feat requires lots of physical resources and layer upon layer of some very sophisticated systems. With high-power machines and communications technologies and fine-tuned protocol these operations effectively bend space and time.

They are basically a freak of nature, a denial of natural laws. In other words, their services amount to nothing less than a miracle. This helps explain the spendy gear and the locks, just as the spendy gear and the locks explain the miracle.

In the end, I never got to ride the helicopter, but I didn’t really need to.

(Special thanks to St. Vincent Hospital and the HELP Flight team, particularly Stephanie and Brent and Sam, because I harassed them the most.)

Phillip Griffin recently received degrees in English and philosophy from the University of Montana and recently moved back to Billings with his fiancée and his cat, Mitch. He has a passion for vegetables and environmental issues, and he likes to talk about systems. He also plays music.

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