By Erin Young and Robert A. Poarch
This September 29 marks another year closer to three decades for Mission Health’s helicopter emergency transportation program we affectionately refer to as MAMA. This July, the Mountain Area Medical Airlift team transported their 25,000th patient. And, the team is looking forward to the arrival of a new, modern helicopter to improve service to the residents of western North Carolina. MAMA team members Johnny Grindstaff, Supervisor of the Air Medical Unit, and Marilee Arnold, Director of Regional EMS, answer some questions about the MAMA program.
Q: Is it true that MAMA’s had an unexpected start date?
[Johnny] The true anniversary day was supposed to have been October 1, but the team had been here training, doing marketing, out flying in the region, showing the helicopter off to the hospitals, EMS providers and fire services. And, Transylvania called and said we’ve got a patient who needs to come to Mission Emergency urgently, is that helicopter available? September 29, MAMA did her first flight. And, it’s been on from that point.
Q: Johnny, have you’ve been here since the beginning of MAMA?
Just about. I wasn’t one of the original crew. I started at Mission Health August 1986. I came from Buncombe EMS as a 911 paramedic. I came to Mission as a flight paramedic on the helicopter. I’ve worked as a flight paramedic from that point until 1990. I went back to nursing school and did time in intensive care units, still flying part time as a paramedic. I came back and started flying as a flight nurse until 2006, when I transitioned to the supervisor roll.
Q: Marilee, how did you get involved with MAMA?
My story’s a lot shorter than Johnny’s. I also started my career on the 911 side. I was an EMT and then a paramedic, working for a few years in Florida. I interacted with flight crews, handing off patients. I never flew as a paramedic. I came to Mission in 2016.
Q: How has your transition to Mission been?
[Marilee] Johnny and the whole team have been great, and they’ve really embraced me and educated me. And, I do my absolute best to provide them with the support and advocacy they need, because I understand how important their role is. And, I value their expertise and their clinical judgement. They’re outstanding at what they do.
Q: When is the new helicopter coming?
[Marilee] Early November. We’re very excited. This new aircraft that we’re getting is replacing one of our existing Asheville aircraft. We’re not adding to the size of our fleet, but we’re replacing an aircraft.
Q: How is the new helicopter different?
[Marilee] This one will look pretty much the same to the untrained eye. However, the cabin space is significantly bigger than either of our current aircraft. This gives us more working space and more payload capacity, so we accommodate more weight on the flight. So, if we have a complex patient, we can add an additional crew member. For example, if you need a specialist, like a perfusionist, you can add them to our crew. It’s a brand new aircraft, so the technology is more up to date and provides greater safety.
Q: What are we looking forward to with the new helicopter?
[Johnny] People don’t realize how small the helicopter is. The new helicopter has 31 percent larger patient care area. That’s a huge improvement for us, having more physical space to take care of the patient. Our leadership listened to us when we said we needed this larger aircraft. It’s going to be a safer environment for giving care.
Q: How fast are the helicopters?
[Johnny] If you drive from Angel Medical Center in Franklin to Asheville, it’s 68 miles by ground. That’s an hour and twenty minutes on a good day. If you fly, it’s twenty-two minutes. The helicopter flies about 150 miles per hour. And, it’s a really smooth ride for the most part.
Q: Tell us about the MAMA crew?
[Johnny] The experience of the MAMA team — pilots, nurses and paramedics — has a total of 1,071 years of experience. The median for the medical team is 24.7 years. And, for the pilots it’s 24.9 years of aviation experience. Compared to other air transports teams, we have a fairly experienced crew. And, the more experienced your crew is, the more times they’ve dealt with a sick mommy trying to have a baby, a toddler who got bit by a dog, a teenager who’s wrecked his car, heart attacks and strokes.
Q: Teamwork must be important in an emergency situation?
[Johnny] Having the diversity — it’s being an ER nurse, being an ICU nurse, being a 911 paramedic, being a respiratory therapist whose expertise is in caring for premature babies. It’s taking all those aspects and rolling them into a team with a professional aviator. When our helicopter lands, we’re bringing the full force of Mission Health to the emergency. We are Mission Stroke, Trauma, Cardiology, PICU, OB, Sepsis. All of those disciplines have helped train us.
Q: What is the typical crew for a flight?
[Johnny] If it’s a patient who’s coming back to the NICU, usually that’s someone who’s just born and maybe can’t breathe or has respiratory distress, a baby that’s less than 5 kilograms. There’s a registered nurse and a respiratory therapist who work in the NICU and are specially trained to do air and ground transport. They get on the helicopter with a special isolate, and they go pick up the neonate. If the baby weighs more than 5 kilograms all the way up to the 102 year olds, then the flight team is the pilot, an adult pediatric nurse and a critical care paramedic.
Q: What is your most frequent type of case?
[Johnny] It’s a pretty good mix across the whole lifespan. There’s no one thing that’s more than 50 percent. This year, trauma is about 38 percent. STEMI, stroke and sepsis come in there. About 2 percent of our total volume is neonates. On an average year, 8 percent of our total patients are under 18 years old.
Q: How often do you take patients to other hospitals?
[Johnny] About 99 percent of the time the patients come to Mission in Asheville. On occasion, we’ll take someone straight to a burn center, or we might take someone to another trauma center if it’s in that patient’s best interest or if the center is closer.
Q: Are you limited to one patient per flight?
[Johnny] Right now, our helicopters are physically capable of flying two patients. There’s probably thirty or forty times we’ve flow two patients in the helicopter. With the addition of the second MAMA helicopter in 2004 and with the increase in the number of helicopters around us, we saw a decline in the need for us to fly two patients in one helicopter. And, the patients are getting larger, and they’re getting sicker. If they’re sick enough to be in the helicopter, they need our full attention.
Q: I’ll bet your patients are very thankful?
Q: What kind of person does it take to be part of the MAMA crew?
[Johnny] A big part of it is that we have the opportunity to be pretty selective of who we hire. For some people, they look at it as the pinnacle of their career. For others, they get to work and live in western North Carolina. If you combine being a paramedic or a nurse or a pilot and getting to do this amazing job, it’s a win-win. Every one of them will tell you that they couldn’t imagine doing anything else.
[Marilee] I recognized their expertise and commitment to care. If you talk to people in the EMS industry, being a flight paramedic is a career goal. It’s kind of like the high point that you aim for and hope to achieve at some point. For some people, that’s the pinnacle of their career. They love it.
Q: What’s your team’s role with Mission Health’s Emergency Medical Services department?
[Johnny] We’re just a small part of the patient care continuum. It still takes public awareness to call 911. It takes the 911 operators to do their job. The fire department and EMS agencies have their job to call us. We transport the patient here, and then hand them off to the next level of care. We are part of the chain of survival. We’re the nosiest link, but we’re just a link in that chain.
Q: What role does dedication play in this job?
[Johnny] Here’s an example of the MAMA team’s dedication. For 34 years our helicopters have been in service 24 hours a day, 365 days a year. We have never taken our aircrafts out of service because we didn’t have staff to work. Sick, Christmas, holidays, birthdays — we have never closed because of staffing. It’s the expectation that we’re here to provide this service of Mission Health to our region.
Johnny Grindstaff is the Supervisor of the Air Medical Unit for Mission Health.
Marilee Arnold is the Director of Regional EMS for Mission Health.