STAT MedEvac: A Glimpse Inside Air Medical Transport in Our Region

| November 11, 2019

CLARION CO., Pa. (EYT) – Many people may be surprised to discover the helicopters we regularly see overhead in our region are closer to flying ICUs than flying ambulances.

(Pictured, left to right: Tim Lowrey, Flight Paramedic; Michael Merwin, Flight Nurse; and Jim Shuckers, Pilot)

UPMC’s STAT MedEvac has been active in our region for decades. Their Clarion base, which has operated out of Clarion County Airport for the last two years, was previously housed at Clarion Hospital beginning in 1995. They’re officially owned and operated, as a non-profit, by UPMC’s Center for Emergency Medicine. However, while they’re officially a part of the UPMC system, that doesn’t limit where they transport patients.

“We take people anywhere they need to go,” Heather Sauer, Regional Medical Manager and Flight Paramedic for STAT MedEvac, told exploreClarion.com.

Sauer, who started her career as a ground crew paramedic in the Erie region 16 years ago, has been with STAT for almost ten years, and moved up into a managerial position about six years ago.

“We’re not limited to the UMPC system. That’s definitely a misconception some people have,” Sauer said.

Tim Lowrey, a Flight Paramedic for STAT added that he has been to West Virginia, Ohio, Pennsylvania, and New York, all out of the Clarion base.

“You just never know,” he said.

Lowrey, a self-described “dairy farm boy” originally from Washington County, Pa., has 28 years experience as a paramedic and has been with STAT for five years.

“I like to think of STAT MedEvac as a critical component in the healthcare system to get patients from a place to another place for the advancement of their healthcare. That can be anybody, from anywhere, for anything.”

The mistaken belief that they’re limited in which facilities they fly to is just one of the misconceptions the STAT crew runs into on occasion. Another is a misunderstanding of what they actually do.

According to Lowrey, while they are technically an air ambulance, there are distinct differences in what they can do versus what can be done by a regular ground ambulance crew.

“We are trained and held to a higher level of care than a ground ambulance, specifically in the Commonwealth of Pennsylvania. We carry certain medications that ground ambulances don’t. We do certain treatments that ground ambulances don’t. We carry blood while ground ambulances don’t,” Lowrey noted.

“We do specialized treatment and transport. It’s critical care medicine. So, it is truly on a different level. That’s in no way meant in any offense to ground crews, it is just two different things.

“We’re really more of a flying ICU.”

Sauer noted that she thinks of the STAT crews as a mobile part of the actual hospital facilities.

“We’re bringing that level of care to the bedside, to the back back of the ambulance, and to local facilities. We work very closely with our medical command positions, and we’re initiating treatments that would have started in Pittsburgh early, before we even leave. We can resuscitate and stabilize a patient and start medications and treatments before we even take off so that when we get there, there’s not any delay in life saving measures.”

Lowrey added, “We really are an extension of that tertiary care center.”

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Each STAT flight crew consists of a pilot, responsible for aviation and navigation, and a medical crew of one flight nurse and one flight paramedic. While a flight nurse can sometimes play role of paramedic, a paramedic can’t play role of flight nurse. Each medical crew member works two 24-hour shifts per week, while the crew pilots work shorter, 12-hour shifts, all eating, sleeping, and working from the base for those shift hours.

“We’re kind of like a family,” Sauer noted.

The schedules are also randomized, and they do not keep permanent partners.

“We don’t want to build complacency by having a permanent partner because what studies have shown is that once you get comfortable enough with somebody, then there’s less talking and less communication, because you can anticipate their next move. That has led to complacency and medical errors in the industry, so we have a random schedule where they’re working two 24’s and they’re not assigned any particular partner,” Sauer said.

While constantly working with different partners may sound difficult, STAT’s system standardization makes it far easier than it would otherwise be.

“Every aircraft and all of the bags in every aircraft are set up the same way,” Michael Merwin, a Flight Nurse with STAT MedEvac, noted.

Merwin, a Clarion County native, graduated from the nursing program at Clarion University’s Venango Campus and spent several years working in an ICU in Williamsport before returning to the area to work for STAT.

“If I go to another base to help out, to pick up a shift, everything in the aircraft will be the same, and all the bags will be set up the same, so I’ll always know where everything is. It makes it very easy to switch between bases.”

Sauer explained that although the standardization of the system is difficult to maintain, it is worth it.

“We’re very proud of our system standardization. During our Spring Education, we bring in every crew member for education and training, and we partner people from opposite sides of system intentionally because we all follow the same protocols and everything standardized, and we want to see them function never having met before. It always works out very well.”

Lowrey noted that the training is huge.

“You meet a person for the first time that day, and the next thing you know, you’re clicking and spinning together. In minutes, you feel like you’ve known them and worked with them for years.”

The crew’s regular shifts begin at 8:00 a.m., at which time they start their day by checking all of their preparations – from going over the drug bag medications and checking their blood supplies to checking their aircraft and equipment.

“We have to be ‘mission ready,’ that’s our phrase, at all times,” Lowrey said.

They also have a morning briefing with their pilot on weather conditions. Most of the remainder of their day is taken up with base duties, keeping their base clean and organized, and education and training.

“The crew members have regular requirements they have to meet to maintain competency. We take education very seriously. We hold our medical crew to a very high standard to be able to provide exceptional care,” Sauer noted.

However, once they are paged, everything else is set aside, and they snap to action.

“We try to be in the air within ten minutes, but it’s usually more around five,” Merwin said.

They pack up their blood supplies, their medication bags, which have to remain in their possession at all times, get their helmets and head for their aircraft.

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While the medical crew members are preparing their medical supplies, the pilot is also preparing for the flight, which often includes a check on weather conditions.

“Our pilot will either be green, which means the weather forecast for the rest of the day looks good, and we don’t even need to check because we know it’s good. But, around this time of year, they’re going to be yellow and pending weather a lot,” Sauer said.

“The pilot is one the phone with our Communications Center. There’s a Flight Follower in our Communications Center that speaks over the phone with the pilot, and they look at weather together, and both of them have to agree that everything is good to go before we accept the mission. We’re not given any information regarding the patient before we accept the mission because we don’t want anything to influence whether we’re going to push weather to do it or not. Everything is based off of safety first.”

Even when both the pilot and the Flight Follower both agree the weather appears to be safe, the flight can still be called off.

“We have a ‘three to go, one to say no’ policy. If anyone on the team says this is not okay, we don’t go. Also, if the weather changes mid-run, if we get halfway there and conditions deteriorate and we know it’s not safe, we’ll find another means,” Sauer added, noting that often, another STAT base can avoid weather by coming in from another direction.

Once a mission is accepted, and the crew heads for the aircraft, they also all do a walk around it before they take off.

“We check and make sure nothing is attached, all the latches closed, and all the doors are secured. Then, we go through a checklist with pilot,” Merwin said.

Lowrey echoed that safety is paramount.

“Safety is job one here from top guy to the last guy hired. Mission number one is always safety. It comes first before anything and everything else. We don’t drift from safety. We have a good safety track record here, and it’s very important to us.”

Once they’re at their destination, which can be a hospital or a scene, they finally learn the situation.

“When you get that information and you’re handed that at the appropriate time, things speed up and take on a whole different dynamic,” Lowrey noted.

“You have to be ready for everything all the time. You just never know what you’re going to get. We’re not influenced on front end on what we’re going to get. It’s a mission. We just go.”

Sauer explained that everything is unpredictable.

“I think what’s interesting about the role we play is that we can walk into an Emergency Room or the back of an ambulance or even into an ICU, and we have ten seconds to start initiating aggressive resuscitation because they’re dying in front of you. You need to move now, you need to start critically thinking now”

While they do often get critical patients that require immediate intervention, that isn’t the only thing they see.

“There’s other patients we take that it’s a smooth and uneventful flight. They just need service that’s unavailable there (at a local hospital),” Sauer noted.

According to Sauer, another misconception about air medical transport is that they serve mostly trauma scenes.

“I couldn’t give you a definite ratio of scenes to inter-facility transports, but if I had to guess, I’d say it’s probably about 60 percent inter-facility to 40 percent scenes.

“I don’t think people realize that a lot of times we’re seeing neurological and cardiac emergencies. We’re often flying patients to cath labs and interventional radiology centers,” Sauer said.

Merwin explained, “Those services are just not available close enough for an ambulance to drive them. It would take them maybe hour, where it only takes us ten to fifteen minutes.”

While working as medical crew members for air medical transport is certainly not for everyone, for the crew members at STAT, it is more than just a job.

“This was the career goal from day one,” Lowrey said.

“I got involved in my local small town, rural USA fire department, and I immediately had more affection for the emergency medical services side of things as opposed to fire or anything else. My goal was always to fly.”

Although he noted that “life happened” and it took him longer than he hoped to reach that goal, he couldn’t be happier about where he’s finally found himself.

“It is the most challenging, difficult job I’ve ever had in my life, but it is also the most rewarding job I’ve ever had at the same time. I love it, and there’s nothing I’d rather do.”

Merwin, a Clarion-Limestone and Clarion University graduate, didn’t initially plan to go into the field of medicine until a sudden accident changed everything.

“In 2011, I was in a really bad motocross accident. I was flown by STAT MedEvac out of Clarion Hospital to Presby. I spent four days in the hospital down there, and that’s when I decided I wanted to be a nurse. I had no intentions of doing anything medical until then.

“I started about a year and a half later and did nursing school, then went to Williamsport and did ICU nursing there. When I finally met requirements, I applied for a job with STAT MedEvac and was hired. It just seemed to work out really well, because I set a five-year goal, and I made it in five years. That was pretty much my dream when I started nursing school.”

Merwin said that he enjoys every minute of it.

“Your day can go from zero to 100 and you have no idea what is going to happen later. It’s definitely a ride, and I wouldn’t trade it for anything.”


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