An on-scene Life Flight Paramedic holds a transfusion bag.Continuously innovating to serve a growing demand

For the past 45 years, the Life Flight critical care air medical transport service has been instrumental in saving the lives of thousands of Houston residents and surrounding communities. Every year, Life Flight crews perform more than 3,000 missions and last year was the busiest, yet. How has Life Flight evolved to meet a growing demand?

“Life Flight pilots and medical crews train constantly to be the best in the country. It is primarily because of their hard work and dedication that we are able to meet the increase in demand for safe, highly-specialized air ambulance services,” says David Meyer, MD, assistant professor of acute care surgery in the Department of Surgery at McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth) and Life Flight Assistant Medical Director.

Memorial Hermann Trauma Service Line Vice President Tom Flanagan, who has been involved with the Life Flight program for 34 years, credits Memorial Hermann’s EMS partners for helping Life Flight realize Dr. Red Duke’s vision 45 years ago. “Life Flight gets a lot of attention,” he says, “but if it weren’t for our EMS partners’ ability to make the split-second decisions to call for air transport to a Level 1 trauma center, we certainly wouldn’t have had the outcomes we’ve had. And the evolution of EMS over the past 45 years has been phenomenal.”

Flanagan says saving lives takes everyone doing their part— pre-hospital, dispatch, maintenance, aviation and medical. Here are some of the enhancements Life Flight has implemented since celebrating its 40th anniversary five years ago.


Life Flight Command Center

In 2020, Memorial Hermann opened the Susan and Fayez Sarofim Pavilion, home of the Red Duke Trauma Institute at Memorial Hermann-Texas Medical Center. Among the 17-story facility’s features are a trauma hybrid OR, the Life Flight John S. Dunn Helipad, which can accommodate larger, heavier aircraft—including Black Hawk helicopters — and the Life Flight command center.

The command center is home to Life Flight’s new dispatch center, led by Life Flight Dispatch Manager Anthony Garcia. Flanagan describes Life Flight’s dispatchers as “the initial voice of Life Flight to EMS.” Garcia says, “Our Dispatch team is on duty taking flight requests 24/7, 365.

We know our customers are managing emergent situations, and our team strives to have an aircraft dispatched to their location within one minute of the initial call.”

Protocols and Procedures

Direct-to-OR Process

For critically injured patients, shortening time to definitive care is crucial. For this reason, in 2018, Life Flight implemented a new process which allows certain patients who are transported to Memorial Hermann-TMC via Life Flight to bypass the ER and go straight to the OR. “The average time from arrival to surgery start is 21 minutes, which represents a 66% reduction in time to definitive treatment,” says Life Flight Paramedic Josh Cools, who was instrumental in the development and implementation of the program.

COVID-19 Air Transport Protocol

Life Flight was the first air ambulance service in the region to provide details for the development of clinical and operational guidelines for flight crew members in order to establish a protocol for transporting highly infectious patients with SARS CoV2. Other out-of-hospital clinicians can utilize the Life Flight framework for their own COVID-19 response and for the care of other high-consequence infectious disease patients.

Crew Equipment

Life Flight Director of Aviation Damon Sanger and Life Flight Chief Flight Nurse Rudy Cabrera, RN, provide a flyover of some of the innovative technologies Life Flight crews use to provider safer, faster and better care to critically ill patients.

  • Powered air purifying respirators. “These lightweight, rechargeable masks keep our crews safe and are a superior alternative to N95s, which, during long, hot shifts can get really uncomfortable,” says Cabrera.
  • Electronic flight bags (EFBs). Gone are the days of paper maps and other reference materials. Each Life Flight pilot is equipped with an EFB, a digital tablet through which he or she can file flight plans and access essential information.
  • White phosphor NVGs. “These military grade night vision goggles provide a minimum of 20/25 visual acuity and at times 20/20, far superior to their green counterparts,” says Sanger. “Without them, we would be operating at 20/200 acuity at best at night. And they reduce eye strain and fatigue.”
  • Handheld blood analyzers. “These lightweight, handheld devices help us to reliably assess patients onboard the aircraft,” says Cabrera. “Results are communicated directly to the trauma team.”
  • Portable diagnostic ultrasound. “Using these handheld devices on scene to identify internal injuries has helped us cut a patient’s time to OR,” says Cabrera. “By the time we’re headed back to the helicopter, we’ve relayed results to the trauma surgeon, who has potentially given us the green light to bypass the ER and take the patient straight to the OR.”
  • Chest compression device. “Before we began using this device, one person would be performing CPR while the other was doing interventions,” says Cabrera. “The device performs compressions at an accurate rate, and frees up four crew hands to do something else.”
  • High-fidelity mannequins. In 2019, Life Flight began using life-like, interactive mannequins for annual training—including ultrasound training—that provide real-time feedback.
  • Blood cooler bags. Each month, Life Flight crews administer about 30 units of whole blood, which must be maintained between two and six degrees Celsius. In 2021, Life Flight crews began using lightweight blood cooler bags to carry one unit of whole blood to the scene, leaving heavy blood coolers in the aircraft.

Aviation and Operations

Aircraft Maintenance

Life Flight’s fleet of six EC-145 twin-engine helicopters are expertly maintained by a team of eight, who are led by Life Flight Director of Maintenance Mike Snowden. Snowden, who has been with Life Flight since 1992, says he’s seen everything from bird strikes in flight and short notice manufacturer safety bulletins, to COVID-19 decontamination procedures. In addition to performing scheduled, preventive maintenance, his 24/7, on call team responds, respond as needed to keep the helicopters airworthy and in service. Last year, the fleet’s operational availability was 99.3%.

“Their dedication to delivering the most advanced trauma and medical resuscitative measures to the Greater Houston population is unwavering.” LESLEY OSBORN, MD

Flight Training

“Life Flight’s aviation training program is robust, well above industry standard, says Sanger. Training starts during the job interview, when the interviewee plans and conducts an actual flight, and continues throughout their employment. In addition to required training, we train on specific tasks, for proficiency.”

Life Flight utilizes a Level D full-motion flight simulator in Shreveport, La., where pilots prepare for a host of emergencies, such as engine failure and weather conditions, including sea fog. “Most pilots do well in normal conditions,” says Sanger. “But when you stress it, you test it.”

Instrument Flight Rules (IFR)

In 2018, Life Flight began conducting flights under Instrument Flight Rules (IFR). IFR flights do not require visual cues, and are flown by reference to aircraft flight instruments using advanced navigation systems.

“Prior to using IFR, about 600 Life Flight flights per year were prohibited due to inclement weather,” says Sanger. “IFR allows Life Flight crews to fly when weather conditions might restrict flight under Visual Flight Rules (VFR), enabling us to respond to more requests and with fewer weather aborts.”

Expanded Aviation Capabilities in Southeast Texas

Sanger says since 2016, Life Flight has made numerous expansions to better serve the residents of Southeast Texas. Among them, Life Flight:

  • Added a fifth, central base, located at Memorial Hermann-Texas Medical Center;
  • Relocated the South aircraft to Texas Gulf Coast Regional Airport to better serve the communities of Brazoria, Matagorda and Wharton Counties;
  • Added a North Fuel facility and upgraded the helipad at the Fast
  • Fuel facility; and
  • Initiated operations out of Liberty Municipal Airport and helped fund the installation of weather reporting stations there.

Collaboration with Community Partners

Patients’ lives depend on the close collaboration between Life Flight and its community partners, including fire departments and EMS agencies, government agencies and law enforcement. Life Flight personnel are active in the community and provide partner agencies and the public with training and educational programs, which include safe landing zone classes.

Life Flight looks forward to celebrating its 50th anniversary in 2026 and continuing to find new and innovative ways to serve the residents of Southeast Texas. Lesley Osborn, MD, assistant professor of emergency medicine at McGovern Medical School at UTHealth Houston and Life Flight Medical Director says, “Life Flight crews’ dedication to delivering the most advanced trauma and medical resuscitative measures to the Greater Houston population is unwavering. I could not be more impressed with the clinicians that we have hand-picked to serve this organization, and I’m truly excited to see what we can achieve in the years to come.”

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Summer 2021 Edition
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