Seven minutes or less – that’s the target, from the moment an emergency call comes in to all-clear for the Life Flight helicopter to lift off the roof of Stanford Hospital.

Onboard and strapped in are the pilot and two flight nurses, wearing red jumpsuits and flight helmets, ready for any situation.

The destination might be the site of a car accident or a community hospital; it could be in the Bay Area or hundreds of miles north at the California-Oregon border. The mission is to bring a critically ill or injured patient to life-saving medical care as soon as possible.

In the world of helicopter emergency medical transport, time is of the essence. And Stanford Medicine’s Life Flight program, already known for its rapid response, is about to get an upgrade. The program’s new helicopter, an Airbus H145 D3, is one of the most advanced medical helicopters available and the only one of its model in the state.

Life Flight’s new Airbus H145 D3 is one of the most advanced medical helicopters available and the only one of its model in the state. | Nigel Walker

Every detail of the new helicopter is designed to provide the fastest and safest transport for patients in the region in need of critical care.

The interior is about the size of a minivan – spacious for a medical transport helicopter – with enough room for a handful of crew and one or two patients on gurneys.

On the interior walls, a hospital-grade vital signs monitor, ventilator and up to 12 IV pumps are attached to interchangeable mounts, allowing equipment to be quickly reconfigured to address any medical situation. The new aircraft’s larger cabin space means that, in addition to standard equipment like a defibrillator and an ultrasound, it can accommodate specialized medical technology such as ECMO (extracorporeal membrane oxygenation machine), IABP (intra-aortic balloon pump), and Impella (percutaneous heart pump). There’s even a neonatal incubator to transport the smallest of patients.

40 years of service

As the Bay Area’s first helicopter emergency medical service, Stanford Medicine Life Flight has been in operation for more than 40 years – running 24 hours a day, seven days a week. Its first call, on May 1, 1984, led to the transport of a 70-year-old woman who had been seriously injured in a car accident in Santa Cruz County.

Life Flight serves all communities within a roughly 300-mile radius of Stanford – extending north to the Oregon-California border, south to Santa Barbara, and east to Reno, Nevada. Many calls come from hospitals needing to transfer a critically ill patient to a higher level of care. Strokes and aortic dissections (a tear to the inner layer of the body’s main artery) are some of the most common conditions seen by the Life Flight crew.

Approximately 20% of flights are in response to 911 calls from the nine counties that make up the greater Bay Area. They may involve evacuating trauma patients from car accidents, bicycle accidents, falls, assaults, and near-drownings, as well as medical emergencies such as strokes, heart attacks, respiratory failures, and seizures.

Life Flight also collaborates with the Critical Care Transport team at Lucile Packard Children’s Hospital on about 50 flights per year, bringing newborns, children, and expectant mothers to the highly skilled care they need.

A head start

With state-of-the-art equipment and experienced crew onboard, Life Flight does more than transport – it gives a head start to the medical team waiting on the ground. Stanford Medicine flight nurses have an expanded scope of practice that allows them to insert breathing tubes that open airways and arterial lines that monitor blood pressure. They can start the patient on blood transfusions and intravenous medications in flight.

“Initiating these treatments saves crucial time in the OR because we’ve accomplished it already,” said Sheryl Blankers, RN, the most senior member of the Life Flight team.

Blankers had more than a decade of nursing experience in high-pressure environments like emergency departments and intensive care units before she took those skills to the skies. She’s now been a flight nurse for 27 years – 24 of those with Stanford Medicine Life Flight. She remembers the helicopter that was in service when she joined the team, a custom-configured BK117, a newer model at the time. There was an upgrade in 2007 to the larger and more powerful Airbus EC145 C2, which served the program until this year. The Airbus H145 D3 is another step up.

“It’s the improving technology that makes everything safer and that lets us dedicate more attention to patient care,” Blankers said.

Even small upgrades, like the ability to fit standard-sized gurneys that can go straight from helicopter to hospital without moving the patient, make a difference in outcomes. In stroke cases, for example, the saying is “Time is brain.”

A ride in the new helicopter is noticeably smoother and quieter thanks to a bearing-less, five-blade rotor system that minimizes vibrations. The added stability provides more comfort for patients in distress and easier working conditions for the crew, especially during invasive procedures.

Caring for patients in a small space when the stakes are high and every second counts is like a game of chess, said Rebecca Rogers, RN, who joined the Life Flight team last year. “You have to think three steps ahead.”

Flight nurses have a minimum of five years’ experience working in critical care, and they undergo at least six months of on-the-job training to gain experience on a diversity of calls. The job requires both breadth and depth of experience, Rogers said.

“I have the coolest job in the world.”

Always on call

The new aircraft can handle more challenging conditions, maintaining lift and stability at higher altitudes and hotter temperatures. It can land on a variety of terrain, from highways to rooftop helipads to mountain clearings. With a smaller rotor diameter and improved hover ability, it can land safely in constrained spaces. And with two built-in spotlights and military-grade night vision goggles for the crew, Life Flight can do it all in the dark.

Life Flight pilot Douglas Evans checks out his helicopter before a recent flight. | Nigel Walker

The service currently transports about 450 to 500 patients a year. The new helicopter will allow the Life Flight team to be dispatched to rural or urban settings, day or night, to reach more people in the community.

The Life Flight team includes 13 flight nurses and four pilots, who rotate in 12-hour shifts. Two flight nurses and a pilot are on duty at Stanford Hospital around the clock, ready to head out at a moment’s notice.

In fact, it’s not uncommon for a call to be canceled when the team is already in the air. But they’d rather turn back than lose those precious minutes.