St. Cloud Times, Minn., Bright Ideas column

Oct. 11--The helicopter purrs in the distance as seen from the top of St. Cloud Hospital. Within moments, it has touched down on the helipad and delivered a patient in need of urgent care on a gurney, attended by a paramedic and flight nurse.

They move through a set of doors into an express elevator that puts them right in the emergency room of a Level 1 trauma center -- perhaps the best place for urgent medical care north of the Twin Cities.

These flights aren't new. They've been coming and going for decades.

But the helicopters you see today are. Life Link III, a nonprofit consortium of which St. Cloud Hospital and CentraCare Health is one of 10 members, recently bought six new AgustaWestland 119Kx Koala helicopters to the tune of $4.8 million each.

The new fleet can get to patients faster, transport them in less time and provide more room for the crew to perform critical care en route. They're also equipped with the latest avionics, including synthetic vision and satellite weather reporting.

"These helicopters and their crews are incredibly important to what we do," said Dr. Steve Jameson, medical director for the emergency room at St. Cloud Hospital. "Usually, the victims they're responding to are in remote areas and they can get to the scene faster than anything else -- and transport the patient to an emergency room in less time than they have before. But they can also bring a specialized trauma team to a rural location that, even if there are caregivers available, might not have people as comfortable treating people as these acute-care specialists."

Jameson, who has been with CentraCare for 21 years, served on medical helicopters for three years during his residency.

"These crews are the best and sometimes with critical cases, if we didn't have the helicopter, you'd be looking at a much worse outcome," Jameson said. "The patient could die or suffer some devastating consequences because the window of time when they need to receive help is short. If the helicopter can get the crew to them or get the patient to us within that window, sometimes we can take that person and treat them to where they have no long-term complications from what happened."

2nd system in country to feature Koala helicopters

The new helicopters operate at each of four bases in Minnesota (Alexandria, Anoka, Hibbing and Willmar) and one in Wisconsin (Rice Lake). One is a spare. Life Link III is the second system in the country to use the Koala airframe for emergency services.

From 2000 until 2010, a medical helicopter was stationed in St. Cloud, however, it was determined response times could be improved by having them based in more rural areas. The incidents requiring transport by helicopter are more likely to be remote from a metropolitan area like St. Cloud, in which ambulances can operate more effectively.

Each of the new Koala craft can carry a three-person care team in addition to the patient with full-body access.

That's a big difference, according to Twyla Bergenstal, a flight nurse on a crew based in Willmar.

"The Bell 407s we were flying before had just two seats (in addition to the pilot)," said Bergenstal, a former nurse at a Level 1 trauma center in West Virginia who has been flying for the past two years. "Our bags also had to ride along and get strapped in and the result was I only had access to a part of the patient's body. Now, our bags are custom-made to fit stowed out of the way. It's easier for us to move around and perform different skills -- not just those you could have done based on the location of your seat."

On this particular fall day, Bergenstal was teamed with Phil Nicolas, an 18-year paramedic who has spent the past 14 of those in the air, and pilot Dave Anderson.

"The patient loading system is different," Nicolas said. "We can load bigger patients with ease and we have a bigger payload. For us, when we're working on somebody, the openness of this cabin is the real advantage. It may not sound like much to have an extra 6, 12 or 18 inches here or there, but it's huge. The extra room is precious."

Bergenstal said she's seen the new helicopter make a potential difference in life and death. The victim in a motorcycle accident went into cardiac arrest in the air en route to the hospital.

"In the old helicopter, we had no LUCAS device available in flight," she said, referring to an automatic chest compression system. "We had one stored in the tail, but there was no room for it in the cabin. So in that situation we would've had to either land or try to do manual compressions -- which put us at risk because it's not very safe to do that when you're flying along at 150 miles an hour a couple of thousand feet up. That's just one instance I can think of, but the capabilities of the new helicopters likely will be responsible for saving more lives."

High-tech power doesn't come cheap

Anderson has been an EMS pilot for four years. He's also a big beneficiary of new technology.

"All the controls are on computer systems, so it's almost like having a glass cockpit," he said. "The avionics are so complex, they'll show you towers or other obstacles up to 500 feet tall that might be in your way. The flight paths are also made to look like a map or a runway. It's kind of like a video game."

The craft can fly faster than 175 mph and has a Garmin G1000H avionics package with synthetic vision, enhanced safety and situational awareness features.

Pilots can use night vision goggles and access satellite weather and tracking systems.

The cabin includes a ventilator, automatic compression device, multiple channel infusion pump, a video laryngoscope, 12-lead defibrillator/monitors, balloon pump and blood products.

Of course, all of the enhancements don't come cheap. The cost of transport in the medical helicopters is calculated by a base rate and mileage, similar to how ground ambulance rides are charged. Life Link III said its rates are proprietary, but a trip from Brainerd to St. Cloud within the past two years costs more than $13,000.

"The fact is people need helicopter transport," Jameson said. "We try not to overutilize it and there are times when you have to say it's not necessary. But, as a system, we've decided it's a necessary service and there are situations where time is of the essence. Helicopters aren't cheap and neither is it to train and have a crew on call. Our goal is to make it pay from a business standpoint and yet do our best to be fiscally responsible with the costs and number of transports."

St. Cloud Hospital averages more than 700 helicopter landings per year. The rest of the CentraCare system adds another 75.

The new helicopters can fly from Willmar to St. Cloud in about 17 minutes.

"It's an executive-type helicopter, so it's built for speed, but it's also specially designed for us," said Nate Lebeck, operations manager for the crew, who lives in Sartell. "It used to be, they'd get an aircraft and figure out how to outfit it after the fact. Now, they're looking at what's best for an air medical helicopter and these are also being used for search and rescue. It's quite an improvement."

For more about Life Link III, visit www.lifelinkiii.com. And, for more about CentraCare Health, visit www.centracare.com.

Follow Kevin Allenspach on Twitter @KevinAllenspach. Reach him by phone at 255-8745.

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