The Life Flight Experience

Dr. Corinn Cross (Host): Advancing health. Personalizing care. At Memorial Hermann, this is our mission. This podcast shares the science and stories behind those efforts. Welcome. I'm Dr. Corinn Cross. Today, we'll be exploring Life Flight®, a critical care air medical transport service, serving the Greater Houston area. Founded in 1976, the service operates around the clock with crews performing more than 3,500 missions each year. Today, we'll dive deeper into Life Flight's area of expertise and what sets them apart from other air medical providers. We are thrilled to be joined by John Talley, a flight paramedic for Life Flight Operations, who will discuss with us Life Flight's capabilities and tell us about some of the unique equipment found on their aircrafts. John, thank you for joining us.

John Talley: Hey, thanks for having me.

Host: So, John, tell us about your background and why you chose to work for Life Flight.

John Talley: Absolutely. You know, growing up in EMS in the last 10 years in the Houston area, Life Flight was a big part of a lot of our scene calls and everyone knew Life Flight, and getting to see how professional they were, how quick and efficient on scenes and transporting these patients to a level one trauma center really made a big difference and impact to me, and it was a source for role models.

So, when I was initially going through EMT basic, actually one of my instructors worked for Life Flight and he still does to this day and getting to interact with him and learn about the program, it all just left a big impact on me to be the best that I could. So, that's where that goal came from.

Host: That's amazing. It's amazing when you have something that you feel so connected to, and it fulfills you to do it. So that's wonderful. I'm interested in your daily routine. What's a day at Life Flight like? Give me a rough breakdown of the number and the types of calls you get.

John Talley: So, we have four satellite bases in the surrounding Houston area. They're 24 hours a day, seven days a week. And we have a fifth helicopter that's actually located at Memorial Hermann in the Texas Medical Center that operates 12 hours a day. So that helicopter, its specialty, it handles balloon pumps, neonatal transfers, pediatric transfers, Impellas, ECMO. So that's kind of our layout for the bases.

A normal day after we get our aircraft checked off, we verify our blood products. We get a briefing with our pilot. Then after that, we're on for the city and the surrounding areas. So it really depends on who calls and what the day brings. It could be anything different.

Host: So if there's a wreck on the highway, how do they decide if an ambulance should come versus a helicopter? What triggers your response?

John Talley: So there's two types of calls. There's scene calls and hospital transfers. And we're going off of a scene call. So that's EMTs and paramedics on the ambulance or firemen on the fire truck that get on scene. So an ambulance will get dispatched every time. Once the crew makes contact with the patient, they determine basically if the patient needs transport to a Level One trauma center. That's usually the determining factor for ambulance versus air. Another thing is if the patient needs blood products quickly, that they'll call us since we do carry blood.

Host: So, a scene call then is when someone is on the scene and they realize that this is necessary, that the patient needs to get there faster than you could do by ambulance. Is that what I'm understanding?

John Talley: Yes. And not just for a Level One trauma center and blood, but distance. A lot of these services are pretty far out from facilities, specifically a Level One trauma center, so we can get there much quicker.

Host: Got it. And you mentioned that you have blood on board, which I'm assuming is part of the reason that you would choose to use Life Flight versus a different mode of transport because you're able to provide care en route. Is that correct?

John Talley: That's correct. At Life Flight, it's unique in the fact that we carry more blood on board than most other air medical providers in Texas, including whole blood. We have packed red blood cells and plasma on every flight. So you know, this means we're able to transfuse at the time of patient contact and during the flight. And once the components are utilized for the patient, we just restock at the hospital, and then we're ready to go on another one.

Host: Yeah. What a lot of people don't realize is that minutes really do matter when you're in a crisis. And those minutes can be eaten up by transportation. So, when you can start to provide care at the moment of contact, that really can change outcomes. So you're able to give transfusions in route. Do you have vasopressors as well?

John Talley: We do carry multiple vasoactive drugs for our patients, for those that have hypotension, depending on any type of illness or injury, like our septic patients, cardiac failure, our renal failure patients, neuro injuries. But if the patient is hemorrhaging, if they need blood, then that's going to be our first line.

Host: Of course. And then, what other type of diagnostic equipment do you have on board?

John Talley: So, on the aircraft, our crew consists of a flight nurse, which is also a paramedic and then a flight paramedic. And we're both trained in the use of ultrasound. Currently onboard all our aircrafts, we carry handheld ultrasound devices, which we can use for detecting a collapsed lung, a pneumothorax, free fluid within the abdominal cavity, free fluid around the heart. We can monitor fetal heart tones as well. We have the capability to conduct lab tests on board. We also have our cardiac monitor, which we do 12 leads with, our ventilators and IV pumps. All these are pretty much standard here on every aircraft at Life Flight.

Host: What is Life Flight doing to benefit preventable or potentially preventable death rates in trauma patients?

John Talley: Our Texas Medical Center campus, we're affiliated with McGovern Medical School at UTHealth Houston. So, we're fortunate enough to work for a program that's at one of the nation's largest and busiest Level One trauma centers, first of all. And because of that, there's a lot of research that goes on and a lot of education, given how much trauma that we actually do deal with at Life Flight. We're included in these studies and they impact new technology, medical advancements.

We have two medical directors. One is in emergency medicine, board certified. The other is board certified in trauma surgery. And because of that, we have a unique process for our trauma patients, which is called Scene to OR. This is where we have a trauma patient with a life-threatening injury. And from the helipad, we're able to bypass the ER and go straight to our hybrid OR for surgical intervention. And the hybrid OR combines the benefits of the operating room with advanced imaging techniques, such as CT scan and angiography. So, our crew can have the patient in the operating room within two minutes of landing. So, I think that's definitely one of the most impactful things that we're doing for our trauma patients.

Host: I would say that's amazing. I'm a pediatrician. And I know, having worked in the trauma center, how important it is to get patients who need surgery to that OR right away. And what you guys are able to do by doing the diagnostic tests on board, by being able to start to treat onboard and then being able to get the patients directly from the helipad to that hybrid OR definitely is shaving minutes off of their time. And a lot of times those minutes are what changes the outcome in those patients. So, it sounds like you've got a really well-oiled machine there. And then, I'm sure the people in Houston are benefiting greatly from that. As a crew member, what does it mean to you to be a patient advocate?

John Talley: It's a big responsibility to be able to, one, find out what their problem is, what pathology's going on. And two, treat that accordingly and take care of that promptly. And three, relay that to the providers that are in the ED or the OR, so that nothing's missed, there's no lapse in care. It's a big responsibility to have that continuum of care from initial contact all the way into when we deliver them to the ED or OR. And most of these patients, it's going to be the worst day of their life to get flown in a helicopter to the med center. So being able to have the equipment, the resources to take care of them and be an advocate for whatever's going on with them that day, to me, that's a big responsibility and I'm really proud to undertake that here at Life Flight.

Host: And you should be. Thank you so much for your service. Is there anything else you'd like to add?

John Talley: In addition to saying thanks for having me today, I have to say working for Memorial Hermann Life Flight and being a part of the legacy that our founder, Dr. Red Duke has set forth and all the history that we have here, it's an absolute honor. It's a privilege to have the resources, the education, the training, anything that we need to be 100% patient care-centered and focused. I just have to say I'm more than proud to work for the program. And again, thank you for having me.

Host: You can tell how proud you are and what a real difference you're making in that community. John, thank you so much for joining us today and sharing your expertise on this topic. We really appreciate it.

Now is the time to learn more about Memorial Hermann Life Flight and incorporate Life Flight into the community to improve patient care. Visit us at Memorial Hermann Life Flight. Or contact us at (713) 704-4000 to discuss how Life Flight can better partner with you as clinicians.

That concludes this episode of Advance, the podcast series from Memorial Hermann.

Please remember to subscribe and review this podcast in all other podcasts in our library. I'm Dr. Corinn Cross.