If you look up in the sky over Prince George and see a large helicopter with a red and white cockpit and long blue tail, chances are it is the latest addition to the B.C. Emergency Health Services northern B.C. air ambulance fleet.
The dedicated medevac helicopter now serving north central B.C. is staffed with paramedics who bring the hospital to the patient in half the time it takes for a ground ambulance to arrive.
Based at the Summit Helicopters/Northern Thunderbird hangar at Prince George Airport, BCEHS launched its rotary air ambulance service Dec. 1, 2020. Since then, that Bell 412 EP helicopter has logged more than 680 hours and flown 247 patients.
“The bulk of the helicopter’s trips have been interfacility transfers or even health centres for the remote communities, but they have had a few scene calls (to pick up accident victims),” said Deb Trumbley, BCEHS director of clinical operations for northern B.C.
“It’s a huge positive addition. It has helped immensely, just (to reduce) the fatigue factor on the crews having those long trips. It keeps them in their communities and they’re not spending the whole day doing one trip. It’s such a benefit to the patient, not having to spend four hours in the back of an ambulance to get to the next level of care. It’s much more comfortable, much faster.”
Capable of flying at 220 kilometres per hour, the Prince George helicopter has a range of about 800 km, which can be extended to nearly 1,000 km with use of its auxiliary fuel tank.
Each flight includes a pilot, co-pilot, and two paramedics, who sit directly behind the stretcher that carries each patient. It’s a bit of tight squeeze for BCEHS critical care paramedic (CCP) Brian McNamara but there’s enough room for him and another paramedic to work on the patient during the flight.
The helicopter serves communities such as Quesnel, McBride, Valemount, Mackenzie, Tumbler Ridge. It will reach as far west as Hazelton (two hours) and as far north as Kwadacha (2 ½ hours), but a trip that far requires a fuel top-up in either Smithers or Mackenzie.
“To get a patient out of Hazelton we used to have land an airplane in Smithers, drive an hour there and an hour back, where now we can take the helicopter directly to Hazelton, where they don’t have an airport,” said McNamara. “Even though the machine is a bit slower (than a plane) it saves all that driving time and it’s actually faster.”
From Prince George, they can make it to Tumbler Ridge in 40 minutes and can land in McBride an hour after launch.
Prior to the region getting a dedicated medevac helicopter service, ground patient transport of sick or injured patients from outlying communities required an ambulance team from Prince George to either make the lengthy two-way trip themselves or meet a second ambulance halfway on the highway to transfer the patient.
“I started my career in Fort St. James (15 years ago) and we did a lot of those road transfers and often had to bring a nurse or a physician with us, which obviously depletes that hospital,” McNamara said. “When the helicopter rolled out, that was right at the start of the COVID outbreak in Fort St. James and the Nak’azdli reserve and we were just a shuttle for about two weeks, landing at the hospital there back and forth to here.
“So instead of an hour-and-a-half drive each way, that’s a (30-minute) flight now,” he said. “We’re able to bring critical care paramedics there, which means not pulling doctors and nurses out of that community, and we can move so many more people that day. It’s about the speed of moving patients, but also getting us there to deliver those interventions.”
His critical care training allows McNamara to remotely intubate a patient, if needed, which means delivering an anesthetic powerful enough to induce paralysis and insert a breathing tube. That was required to save the life of one of his patients who had suffered catastrophic injuries in a highway accident. The cabin provides connections for a ventilator and intravenous pump and as they flew McNamara ran diagnostic blood tests, performed an ultrasound scan to check for internal bleeding and also gave the patient medication to prevent brain swelling.
“Upon arrival to UHNBC here, because of what we were able to do during flight, it expedited their care and they were able to go right to the CT scanner, get the injuries (diagnosed) and roll to surgery right away,” said McNamara.
BCEHS paramedics trained for flights are not assigned to any specific aircraft. Some ground paramedics are also trained for flight operations and can be called upon to fill air ambulance shifts as needed. Three crews are assigned daily for flight operations and are at the airport on standby ready to respond to calls immediately.
Unlike most major cities in B.C., Prince George does not have a hospital helipad, which means patients are transferred to ground ambulances upon arrival at the airport for the 20-minute ride to UHNBC.
Technology allows night-time flights
The Prince George helicopter lacks a de-icing capability and does not fly in all-weather conditions but will fly at night. The service provider, Summit Helicopters, has its pilots trained in the use of night-vision goggles, which allow pilots to see the ground below them while they’re flying.
“Before, we were flying unaided at night and having the goggles adds a huge level of safety, just being able to see where you’re flying and not going off instruments so much,” said Evan Buckley, Prince George base lead pilot for Summit Helicopters.
“We can accept calls that take us later into the night in worse weather than we could previously, so it’s a big gamechanger, especially in the winter where it’s dark at 4 ‘o’clock. That allows to extend to 7 for a regular day and up to 9 o’clock for something that’s more critical. It allows us to go to lit and unlit air strips at night, which is something airplanes right now can’t do, so it give the service a huge amount of flexibility.”
The helicopter can land on highways, logging roads, forest cutblocks or school fields and relies on other first responders trained to assist in landings. It does not retrieve patients using longlines or other hover entry-exit techniques more commonly used by search and rescue services. Four pilots fill the BCEHS helicopter shifts.
BCEHS addressing Prince George critical care paramedic shortage
For each flight, BCEHS dispatch determines the level of paramedic care needed to retrieve a patient, whether that’s primary care, advanced care or critical care. If critical care is required, two CCP paramedics will be sent.
McNamara is one of only four CCP practitioners in Prince George, with more on the way. Two years ago, BCEHS started a critical care training program in the city – the first ever conducted outside of Greater Vancouver - and five local paramedics are nearing completion of their CCP training.
“It’s a gamechanger to have the (CCP) program taught locally, so that paramedics don’t have to leave their families for that stretch of time,” said Trumbley. “Having it up here just opened it up to our advanced care paramedics.”
BCEHS is dealing with a province-wide shortage of paramedics at all levels of training, which limits plans to expand its air and ground services. McNamara said having the helicopter based in Prince George, combined with the support paramedics get from ICU staff at the hospital will help BCEHS recruit and attract higher-level paramedics to the city.
“There’s a lot of northern pride and the nurses and doctors here really bought into helping with the program, giving us access and teaching,” said the 35-year-old McNamara.
‘You come out of the critical care program so well-prepared, you’re at an all-time high for confidence that you can deal with any situation you’ll be in. We do a really good job as a team, the whole health care service, in moving these people around.”