Flight nurse and emergency medical specialist Michael Baulch is the program manager of Stanford Life Flight, which this year marks its 30th year of operation. (Photo: Norbert von der Groben)
In May 1984, a 70-year-old woman critically injured in a car accident in Santa Cruz County became Stanford Life Flight’s inaugural mission. With that incident, Life Flight was established as the first helicopter emergency services program in the Bay Area, and Stanford Hospital & Clinics became the first medical center in the region to have its own helicopter and air medical transport team.
Thirty years and many thousands of flights later, Life Flight has a proud history to celebrate. Its flight crew has years of experience, and its helicopter carries some of the most advanced airborne health-care technology available.
“Stanford has always been regarded as one of the premier programs in the state, if not the country,” said MICHAEL BAULCH, RN, JD Life Flight’s program manager.
Life Flight may launch its helicopter and crew up to three times a day and averages about 700 flights annually, ranging as far south as Santa Barbara and as far north as the Oregon border. Between 30 and 40 percent of those flights carry children to the neonatal intensive care unit of Lucile Packard Children’s Hospital Stanford. Adult patients are most often transported to Stanford for stroke, cardiac or trauma care.
A number of the flight nurses have been on board for years, even decades. To be considered for the crew requires years of experience, as well as extensive clinical qualifications and exceptional interpersonal skills. “People say, ‘I bet your staff is a bunch of Type A personalities,’” Baulch said. “I want the Type D personality whose heart rate never goes up. When you land on a highway where there are badly injured people, you want someone to step in and infuse a sense of calm into the situation.”
Most Life Flight nurses have advanced certifications in flight nursing and critical care specialties, and several have graduate degrees. The nurses maintain their expertise through ongoing training, continuing education courses and hours of practice with simulation mannequins for procedures they may not perform frequently but must manage well in a crisis.
Flight nurses also assist with trauma alerts in the Emergency Department and help in the intensive care units with advanced procedures. “Our job has evolved greatly over the years,” said GERALYN MARTINEZ, RN, a Life Flight nurse since 1990. “When I started, a doctor was giving the orders. Now we have protocols and expanded responsibilities. It’s a very collaborative, team-centered approach.”
Evolving technology has made the Life Flight helicopter faster and larger and filled with medical equipment that is compact, lightweight and rugged to withstand an environment that is not as controlled as a hospital’s clean and accommodating spaces. “We have benefitted from war-zone medical care techniques developed by the military overseas,” Baulch said.
A nurse now can insert a breathing tube guided by video that interfaces with a computer tablet. Stanford’s Life Flight program is one of just a few programs with professionals qualified to insert a catheter into an artery to monitor blood pressure in critically ill patients, Baulch said. “And we have nurses who are world experts in dialing in the optimal setting for a patient breathing on a ventilator,” he added.
Stanford Life Flight also is the only flight program in Northern California able to transport critically ill cardiac patients who need advanced equipment such as an intra-aortic balloon pump. Its helicopter is equipped with instrument-aided flight capability to make it safer to transport patients in inclement weather. Crew members wear night vision goggles on all nighttime flights to improve safety. “Stanford has kept its focus on safety,” Baulch said, “and on the best use of this very expensive asset.”
Life Flight’s nurses and pilots are perhaps the most visible part of the program, but its success also depends on other types of professional expertise: a team of mechanics to maintain the aircraft and a group of communication technicians who track flights and coordinate arrangements so that appropriate medical personnel are ready for patients when they arrive.
Beneath all the technology and specialized training, however, remains the power of a calming voice. “A patient wrote me a very nice letter to say thanks,” recalled DAVID BEVIN, RN, a 20-year veteran with Life Flight, “because I leaned over her and said, ‘You’re going to be OK. You’re going to make it to Stanford.’”
— SARA WYKES, Stanford Hospital & Clinics