Mon, 03/20/2017 - 13:11

Eva Murray

(Photo courtesy Kimberly Peabody)

On Monday afternoon, March 13, members of the small wintertime community on Matinicus Island took a break from trap work and firewood duty to discuss helicopter landing zone operations and to enjoy a chance to look over one of the LifeFlight of Maine helicopters.

In remote parts of the State of Maine, road access by ambulance to definitive medical care for patients with severe injuries and illnesses can mean an awfully long drive. Way up in the woods, where remote logging operations and outdoor recreation bring people far from any town, it can be quite a haul to even Greenville or Caribou, not to mention large hospitals and trauma centers. On Maine's offshore islands, where there isn't even a chance of a road trip by ambulance, the process gets even more complicated.

A call to LifeFlight of Maine brings more than just a hop over the woods, waters, or summertime traffic to medical care. Each LifeFlight helicopter is essentially a miniature critical care unit, where sophisticated medical interventions can be started. It is not just a ride to the doctor's; it is a flying ICU, with whole blood transfusion, ultrasound, labs, and other hospital-type care available.

LifeFlight's mission is basically to respond to "life, limb, and eyesight-threatening" injury and illness, but sometimes, when the patient is many hours away from the specific type of care needed, the realities of geography (accessing the patient) and time are part of the decision to deploy the helicopter. For example, in the case of a stroke victim, getting the patient to definitive care—which may not be the closest small-town hospital—quickly can make the difference between long-term disability and an easier outcome. In the case of a site such as Monhegan Island, which does not have an airstrip, non-critical injury patients might still be transported by helicopter when the only alternative involves very rough seas. In more remote wooded parts of the state, designated "rendezvous points," maintained by local groups such as snowmobile clubs, provide helicopter landing areas for patients a long way from any established helipad or airport.

LifeFlight has never transported a patient to a hospital directly from Matinicus Island (knock knock!) They have been to Matinicus Rock; I know about that call, because the Marine Patrol stopped at the island to pick me up that day, with my oxygen and AED, in case we could help. But the helicopter was the better option, because carrying a patient into a boat from the slippery ledges of Matinicus Rock—where there is no easy access much of the time—would have been risky. There have also been cases where Matinicus patients were transported first to the mainland, then by local ambulance to Pen Bay Medical Center, and from there "LifeFlighted" to larger hospitals for more specialized care.

The LifeFlight pilot is equipped with military night vision equipment. There is still some weather in which the helicopter cannot respond; for example, when conditions indicate a real risk of ice forming on the aircraft, it is unsafe to fly. The pilot does have to see the island in order to land here; the Matinicus airstrip is not equipped for instrument landings. However, LifeFlight may be able to respond at times when conditions do not allow our usual travel options, those being small airplane, or local lobster boats, the seasonal water taxi, and Marine Patrol or USCG vessels. Matinicus is not served by a daily vehicle ferry, and as no drive-aboard patient transport option is normally available, this municipality does not maintain an ambulance.

The LifeFlight of Maine fleet of aircraft is about to grow to three helicopters. The organization also operates one fixed-wing, twin-engine airplane—not for backcountry response, to be sure, but useful for delivering patients with particular needs to hospitals in other cities while providing advanced care en route.

On Matinicus Island, the wintertime community is sometimes extremely small. 11 community members came out to review landing zone set-up and helicopter safety last Monday; that was easily half the people physically on the island at the time!

We were taught that when a pre-designated helicopter landing zone is not available and a field, parking lot, road, or trail intersection will be used, LifeFlight asks for a site at least 100x100 feet square, as level and flat as possible (less than a 5% grade,) with minimal loose debris such as gravel (the helicopter will create a small hurricane for a moment as it lands and takes off). Obviously, keep people, animals, and vehicles out of the way! Too many people running–or driving--around "trying to help" can make for an unsafe landing zone.

At night, they recommend setting out four lights, at the corners of the landing area, and a fifth light on the side of the square from which direction the wind is blowing (it is safest for all aircraft to land into the wind). If possible, illuminate or somehow mark power lines which may be near the area, but avoid too much lighting; it doesn't help the pilot to have 27 emergency vehicles with all sorts of lights flashing everywhere.

The helicopter (N901CM) landed in Tony's field, across from the island post office, in front of an excited little crowd. Our thanks go out to pilot David Burr and to medical crew Kathy Beller, Frank McClellan, and trainee Brent Melvin for making the trip to Matinicus. We're so glad they were able to come and show us their equipment without it being any sort of emergency!

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