Adam Coulter at MedCom
Though not as visible as ambulance or Mountain Area Medical Airlift (MAMA) helicopter crew members, Mission Health’s MedCom communication specialists play just as important a part in saving lives. Working 12-hour shifts, 24/7 every day of the year, MedCom team members are central to all out-of-hospital patient transport to and requests for trauma services at Mission Hospital. And, it takes someone with a lot of patience and medical knowledge to be on the MedCom team.
“Nothing that happens in the dispatch center is difficult by itself, but a lot of things can happen at the same time, which adds pressure to the job at hand. You have to be able to handle each piece of it,” said Adam Coulter, a communications specialist on the MedCom team for 11 years. “You may go from organizing a transport from a nursing facility to answering a code STEMI call from a different hospital within a minute. So, you have to be able to focus on different things at one time and be able to move from one to the next without skipping a beat.”
Experience Matters
The MedCom staff is comprised of 17 employees with professional experience both in and out of the medical field. As you might expect, many of them have 911 dispatch or EMS (emergency medical services) experience. Several have experience in other areas of Mission Hospital, including the cath (“catheterization”) lab and security. Some also have military and fire department experience.
Before coming to Mission, Coulter worked at the 911 center in Haywood County. He was also a volunteer firefighter and an EMT (emergency medical technician). “I had previous experience as a 911 dispatcher, and I liked it better than being on the truck,” said Coulter. “I feel more at ease in the office, organizing the resources and getting people the help that they need. That appeals to me more than the other side of it.”
MedCom receives upward of 300 phone calls every 24 hours. Many of these calls are for ground transports — patients being transported from a hospital to another or to a nursing facility — by Regional Transport Services (RTS), Mission’s fleet of ambulances staffed with critical care paramedics and EMTs.
It takes a log of technology to keep track of all the MedCom activity. The MedCom “office” looks like something from a sci-fi or spy espionage movie. “There are three of us on duty at a time. And, we each have 7 computer screens,” said Coulter. “That includes the telephone and the radio that we talk to the helicopter with and the ambulances, as well as the computer that keeps up with the scheduled transports that we get during the day. Then we have the mapping computer that we use for our mapping programs.”
The mapping programs have really come along since Coulter joined MedCom. “We’re able to check the helicopters and vehicles better than we ever have been able to do in the past,” he said. “That makes them easier to keep up with as to the safety of everyone — patients and the crew.”
Following the Flights
Dispatching and tracking the MAMA helicopters takes a lot of effort. Calls for MAMA are received from every county 911 center or hospital in western North Carolina from Burke County to Cherokee County.
“My favorite part is the helicopter work, because every call is an emergency,” said Coulter. “And you really feel that you’re getting the patient where they need to be to get the care that they need.”
After a MAMA call is received, the pilot is asked to perform a weather check. If flight conditions are acceptable, MedCom dispatchers gather patient information, including the nature of the call, age and weight of the patient, latitude/longitude coordinates and any hazards the flight crew may encounter, such as power lines or drones around the landing zone.
Once a flight is initiated, MedCom staff notifies Metro Aviation, the flight agency that oversees operational control of the MAMA helicopters, the county or hospital requesting MAMA and the charge nurse of the Mission emergency department. A 75-inch computerized mapping program called Outerlink is used to track MAMA during their flights across the region, highlighting weather, landmarks, airports and preestablished landing zones.
“We maintain contact with the helicopter at all times. We follow them on the tracking map. If they need anything before they land at Mission Hospital, they tell us, and we make sure to get them what they need,” said Coulter. “And, if they’re bringing a patient to the ED, we’ll connect them over the radio so they can give a report.”
It is not unheard of to have four helicopters landing close to the same time. The addition of the rooftop helipad in 2019 allows one helicopter to land on the roof of the North Tower building and two helicopters are able to land on the ground helipad. MedCom also communicates with other flight agencies to ensure all pilots and flight crews know what to expect when arriving at Mission Hospital. Many times helicopters from other flight agencies, such as Med Center Air in Charlotte and LifeForce in Chattanooga, transport patients to Mission Hospital.
More Patient Care
In addition to the flight program, MedCom works closely with the cath lab, alerting them any time of day of all Code STEMI patients received by Mission Hospital. Patients can arrive by ground ambulance transport or by helicopter. MedCom is responsible for alerting on-call cardiologists, the cath team, the ER and others needed to take care of Code STEMI patients.
Also dispatched and coordinated through MedCom, Behavioral Health Transport (BHT) is a subdepartment of RTS. These crews transport behavioral health patients to various mental health facilities across the state. Both BHT vehicles and RTS ambulances can be tracked through computer software so their location is known at all times. “This improves the safety of crews and patients during long-distance transports,” said Coulter.
