Estimated reading time 12 minutes, 38 seconds.
As someone who loves helicopters and the great places they often fly over, I can certainly think of worse assignments than spending three days in the scenic Sierra Nevada Mountains with a helicopter emergency medical services (HEMS) crew. So, last year, when Vertical 911 asked me to profile one of the crews at Care Flight 3 in Truckee, Calif., just a few miles northwest of Lake Tahoe, I didnt hesitate to accept.
Care Flight 3 is part of Care Flights three-base air-medical program, which covers large parts of western and northwestern Nevada, as well as central and northeastern California. A service of the Regional Emergency Medical Services Authority based in Reno, Nev., with aviation services currently provided by Air Methods Corp., Care Flight has been providing HEMS to these regions since 1981, proudly celebrating its 30th anniversary in 2011.
Located at the Truckee-Tahoe Airport, and sitting at an elevation of 5,900 feet, Care Flight 3 responds to the full spectrum of Care Flights EMS calls: from outdoor recreation accidents associated with hiking, skiing and water sports, to motor vehicle accidents and inter-facility transfers.
Uniquely, Care Flight 3 also has what is still a relative rarity in the air medical world, an all-female flight crew. Appropriately, during Vertical 911s visit, we sat down with pilot Kristi Grant, flight nurse Natasha Lukasiewich and flight paramedic Molly Turner, to not only get a better understanding of the uniqueness and challenges of their bases mission, but to discuss how each one got into their respective professions and arrived at the well-regarded doors of Care Flight 3.
Pilot Kristi Grant
Truckee base pilot Kristi Grant has been flying with Care Flight for about three years now. Like many who enter the aviation world, Grants desire to fly began when she was a child; she remembers telling her parents that she was fascinated with helicopters and was going to be a pilot someday.
Appropriately, in 1999 Grant started training at Helicopter Adventures Inc., which is now Bristow Academy, in Concord, Calif. Flying the Schweizer 300CB and Robinson R22 piston trainers, she progressed through her private, commercial and flight instructor certifications, and instrument and flight instructor instrument ratings.
From there, teaching became her priority. Said Grant: Early in 2001, I went to Guidance Helicopters [now Guidance Aviation] in Prescott, Ariz., to start their instrument program, and helped with the helicopter degree program partnership with Embry-Riddle [Aeronautical University]. I eventually became the chief flight instructor at Guidance, flying Robinson R22 and R44s in hot-and-high conditions around Prescott. This gave me many hours of invaluable mountain experience. During her time there, Grant also got her airline transport pilot certificate, became a U.S. Federal Aviation Administration designated pilot examiner (DPE), and earned a bachelor of science in aeronautics with a minor in aviation business from Embry-Riddle.
Grant continued, After I had been with Guidance for about five years, I knew I needed to build turbine time, so [I managed to get a position] flying tours in Bell 206L-3 LongRangers for Papillon Grand Canyon Helicopters. Meanwhile, I continued as chief flight instructor for Guidance and a DPE for the Scottsdale FSDO [FAA flight standards district office].
After a season of flying in the Grand Canyon, Grant learned of a HEMS job with PHI Air Medical in Prescott. She got the job, and then spent two years flying Eurocopter AS350 B3s with Air Evac Arizona, while continuing to instruct and give checkrides at Guidance.
After nearly eight years in Arizona, Grant, who is originally from northern California, decided to return home. She moved back to fly an MBB/Eurocopter Bo.105LS for CALSTAR (although Arizona called her back for one more season with Papillon Grand Canyon Helicopters, flying the Eurocopter EC130).
In early 2009, Grant joined Air Methods, hoping to eventually fly for Care Flight, and its Truckee base in particular. I was slated for Winslow, Ariz., but at the last minute and with great luck, an opening at the Care Flight Truckee base opened up and I immediately took it, she said, noting that she spent a lot of time in the Sierra Nevadas when she was younger. Now that Im home again, I enjoy family and friends, the four seasons, all the recreation Tahoe has to offer, and the flying is some of the most beautiful on Earth.
Of course, scenic beauty often translates to flying challenges. Said Grant: I mentioned having the four seasons, and with this we experience heat, snow, high altitude, rugged terrain and winds, which routinely test the skills and judgment of an EMS pilot and flight crew. We also have a variety of terrain and distances in our operational area. Long flights are common. We can expect anything from Battle Mountain in the [north-central] Nevada desert to San Francisco, Calif. We fly far into the desert Sierra Mountains, to remote accident scenes or to outlying medical clinics for pick-ups or transfers. For night flights, we appreciate having the latest models of night vision goggles [NVGs] for crew and patient safety. Having NVGs here is essential with the dark conditions we experience. All three crew wear NVGs and interact during landings and takeoffs to maintain situational awareness.
Other assets that help overcome the associated flying challenges of the operational area include the helicopters themselves and the equipment Air Methods and Care Flight provide. In particular, Grant praised the AS350 B3 model she flies, calling it a smooth and comfortable aircraft thats relatively fast and
has excellent hot-and-high performance. Its probably the best single-engine airframe for the conditions we operate [in]. Additionally, our pilots and crews appreciate how Care Flight and Air Methods are always willing to invest in top-of-the-line avionics and equipment to increase flight safety.
Flight Nurse Natasha Lukasiewich
Flight nurse Natasha Lukasiewich graduated from an Edmonton, Alta., nursing school in 2005 and currently holds certifications as a registered nurse; an adult, pediatric and neonatal critical care nurse; an emergency nurse; and a holistic health practitioner.
One of the first positions Lukasiewich had after moving to California a few years ago was in one of the Central Coasts busiest emergency rooms. She quickly realized, though, that she was never going to be a conventional nurse, because she is not a conventional girl: her highly active lifestyle involves martial arts, snowboarding, mountain biking, hiking, surfing and photography on her days off.
Fortunately, one day Lukasiewich got to do a ride-along with CALSTAR (California Shock Trauma Air Rescue) in a Bell 222. Instantly hooked, she decided then and there to become a flight nurse: I just loved the autonomy a flight nurse has, being able to make immediate lifesaving decisions.
After gaining more experience, she applied and got an interview with CALSTAR, hoping to work at CALSTAR 7, the programs Central Coast base in Santa Maria, Calif. Lukasiewich was indeed hired and ended up flying for almost two years with CALSTAR 7, which has an instrument-flight-rules-capable Bell 222, and whose crews fly some of the longest-range HEMS missions in California.
In 2010, Lukasiewich relocated to the northern Sierra Nevadas to become a flight nurse with Care Flight. I am very outdoorsy, she explained, and love the mountains and what they have to offer during all four seasons it reminds me of back home in Canada. Flying up here is spectacular and beautiful, and also very challenging, with the ever-changing, high-altitude terrain and weather considerations. Our flights take us from the Nevada deserts to all over the Sierra Mountains; the sunsets and sunrises are gorgeous, some of the best I have seen.
With plans to continue her flight-nursing career, Lukasiewich continues to pursue advanced training and certifications to be able to provide her patients with the utmost in specialized care. Being a flight nurse is not for everyone, she remarked, but if you like the mental and physical challenges, then flight nursing can be a great career.
Flight Paramedic Molly Turner
Critical care flight paramedic Molly Turner came to Care Flight in 2008, after working as a firefighter/paramedic for the Truckee Fire Protection District. She began her EMS career in 1999, and since then has seen great diversity in regards to both her acquired skill set and professional experience. She has even participated in setting up medical clinics at dozens of high-profile fires and natural disasters, including a deployment to New Orleans, La., after Hurricane Katrina in 2005.
Now, after more than three years as a Care Flight paramedic, Turner couldnt be more pleased with her career direction: Ive always wanted to fly and be involved in helicopter EMS. For me, Care Flight was an obvious choice, because its a highly regarded program in a beautiful part of the country. Care Flight puts tremendous emphasis on safety and quality patient care. Professionally, I can feel good about that; but on a more personal level, flying in the Sierra Nevadas is a spectacular experience. The sunrises and sunsets are beautiful around Lake Tahoe. And when Im not flying, the job has a great work schedule that allows me time to enjoy my days off and live an active life.
Turner said the challenges associated with Care Flight 3s operational area are more geographical than medical. We get flight requests that send us to the middle of the Nevada desert during the heat of summer, or to a remote region of the Sierra Nevadas during the dead of winter. Our crews are often the first or only responding asset to an incident. Once we arrive on scene, just gaining patient access can sometimes be difficult in the mountains. Other times, scene and helicopter safety management, or even getting patients packaged and loaded, can present unusual challenges. Sometimes, with only our three crewmembers, relocating a patient [on scene] requires a substantial effort due to weather or terrain. We get additional support from other emergency responders or bystanders, but sometimes we just have to do the best we can with what we have.
Asked about patient care, Turner said, One reason I became a flight paramedic is to have the autonomy to make thoughtful decisions about patient care and treatment. Every incident is a bit different, and this means we need to be consistently flexible and innovative. Again, circumstances are rarely perfect, but thats what I find attractive about it.
A Caring Focus
Grant, Lukasiewich and Turner are just a few of the highly trained and dedicated crewmembers that make Care Flight a standout program; their passion and drive for excellence are very representative of Care Flight crews as a whole. For Care Flight, now firmly in its 31st year of operation, its that kind of drive and dedication that helps ensure it can continue to provide high-quality air medical services to the residents of Nevada and California.