November - December 2006
The Golden Hour
Air Medicine & Machinery
Catching Crooks & Saving Lives
The Golden Hour
Life from Above
By Kenneth Solosky
The biggest drawback of medevac assignments expressed by airborne law enforcement flight crews is that due to their nature, they can draw officers away from police work and assisting the street cop.
However, there are airborne units that are able to strike a balance between edevac and standard police work. There are perhaps thousands of cases in which the use of a police medevac helicopter was the difference between life and death, and in the case of the Maryland State Police (MSP) and Nassau County Police Department (NCPD) air sections, those lives have been saved without sacrificing an inordinate number of police assets. Two agencies doing it well and doing it right.
Including response, scene time and return to service, most medevac assignments take about one hour. If the aircraft is busy transporting a victim from an auto accident, for example, the searches or other law enforcement missions might have to wait. However, flight crews are quick to point out the benefits of these missions. Besides the obvious benefit of helping during serious emergencies, the public almost always views the missions as "positive." They are positive in the sense that they show the beneficial side of law enforcement and the passion and caring of most law enforcement personnel.
"I guess the hard part is that we respond to the worst accidents, the worst traumas, yet we are able to assist in a very positive way and help these critically injured persons get the care they desperately need," Nassau County’s Police Officer/Pilot Ralph Spinola said.
The Birth of Airborne Life Saving
The medevac mission for helicopters was born in World War II when 70 wounded soldiers were transported from Luzon in the Philippines to rear-area hospitals. However, it was the Korean War conflict that thrust the helicopter into a large-scale medevac mission. Finally, the Vietnam conflict stamped the helicopter in history as a critical tool in saving the lives of U.S. soldiers.
In emergency medicine, trauma personnel refer to the first hour of the injury as the "golden hour." Numerous medical research studies have shown that a trauma patient that reaches definitive care within an hour of their injury has a significantly better chance of survival than those in which treatment is delayed.
Dr. R. Adams Cowley was one of the leading forces in promoting the "golden hour;" he helped start the renowned University of Maryland Shock Trauma Center in Baltimore, MD. Dr. Cawley strongly believed that rapid transportation of trauma patients to appropriate medical facilities would save lives. On March 19, 1970, in what is believed to be the first non-military medevac in history, the Maryland State Police transported a critically injured trauma patient via helicopter.
THE "GOLD STANDARD": THE MARYLAND STATE POLICE (MSP)
The MSP began air medical transports in 1970 using Bell Jet Rangers. They quickly established themselves as the "gold standard" for these types of missions and are the yardstick against which many agencies measure their own programs.
Currently, the MSP uses 12 AE365 Dauphins for their missions. In addition to the helicopters, the MSP maintains three fixed-wing aircraft that are primarily used in pure law enforcement missions. Most aircraft maintenance is performed in-house by over 20 mechanics at their Martin State Airport in Baltimore County.
The current Commander, Major Jim Hock, a 22 year veteran of the MSP, is proud of his unit’s accomplishments. "I feel that we have the most experience in these types of missions and are among the best police/medevac operations in the world," he said. "As commercial medevac operators increase their presence, government/public use operators must take a long, hard look at their own operations."
To survive that government scrutiny, Major Hock is currently examining several initiatives to make the MSP Aviation Command a Part 135 operator and to have the operation accredited by the Commission on Accreditation of Medical Transport Systems (CAMTS).
"It’s about being progressive and always looking for safer and better ways of doing things," Hock said.
Major Hock is also looking at a helicopter to replace the current Dauphin. Certainly not a small undertaking, the entire project is expected to cost $150 million dollars. "We have a good safety record that is a combination of hard work, dedication and a commitment to safety by all personnel. We need the best equipment to perform these demanding missions."
The entire unit, including pilots, paramedics, mechanics and administrative personnel, numbers around 150. Always staffed by a pilot and paramedic, the unit responds to over 5,300 medical calls a year, which represents about 60 percent of their missions.
The MSP is proud to boast that they have performed over 100,000 medevac missions. Trooper 2, located at Andrews Air Force Base in Camp Springs, MD, does more than 1,000 medevac missions alone.
The MSP also conducts law enforcement, homeland security and search and rescue assignments. The fleet is located at eight bases throughout state, ranging from the Appalachian Mountains in the western part of the state to the Atlantic Ocean on the east coast. Trooper 5, located in the western reaches of the state, is unique in one respect; they are permanently based outside the State of Maryland at the Cumberland Regional Airport in Wiley Ford, WV.
In addition to state-of-the-art medical interior, the aircraft are equipped with FLIR, GPS and Nightsun. All flight operations are managed by a Syscom (communications center) command center located in Baltimore. Syscom serves as the central dispatching center for all medevac flights in the State of Maryland.
"When a ground resource requests a helicopter, there is no doubt or confusion as to the response," Hock said. "One call and one facility handles it all."
Throughout their history, the MSP has experienced three fatal accidents. Two of the three accidents involved flights into deteriorating weather. The crashes took the lives of six MSP troopers. After these accidents, the MSP took a hard look at their operations and made significant changes. A standard operating procedure contains weather minimums that crews must abide by; currently these minimums are: daytime, ceiling 600 feet, flight visibility two miles, and nighttime, ceiling 800 feet, flight visibility three miles.
In addition to instituting weather minimums, the command maintains a full-time risk management section, consisting of a pilot, maintenance inspector and flight paramedic. The risk management section manages the command’s accident prevention program.
The MSP staff their aircraft with a pilot, who is either a sworn trooper or a civilian, and a trooper-medic. According to Hock, the sworn vs. civilian pilot issue has never been a problem.
"Generally, our so-called civilian pilots are retired trooper-pilots or retired military," he said. "Their sense of duty, honor and commitment are every bit as ingrained as a sworn trooper." In fact, Hock wishes he could offer the civilian pilot a better career track. "Unfortunately," Hock laments, "we do not currently have a program in place that allows our civilian pilots to progress to supervisor." On the flip side, Major Hock points out that they get a very experienced pilot. "Our mission is very demanding, and scene work can be very dangerous," he noted. "I have the greatest confidence in the world in my pilots, and if there is a problem at 200 feet on departure, my pilots have the skills and experience to handle it."
All trooper/flight paramedics must have, as a pre-requisite for hire, certification as a Nationally Registered EMT-P and three years of advanced life support (ALS) field experience. The potential candidate must then meet the same requirements necessary to become a Maryland State Trooper and attend the 24-week academy. Upon graduation, the trooper is assigned to a field barracks for usually one to three years before transfer to Aviation Command. According to Corporal Douglas Baralo, a flight paramedic based at Trooper 2, and an eight-year MSP veteran, the support of the paramedics is outstanding.
"Our current medical director, Dr. Douglas Floccare, knows all his trooper/paramedics personally," he said. "If there is an issue or problem, we can all go to him for guidance. Our medical protocols are cutting edge." Corporal Baralo also notes that all paramedics attend yearly training at "shock trauma." "You simply cannot get that kind of learning and experience anywhere," he said.
For potential pilot candidates, the requirements are 2,000 rotary-wing hours as pilot-in-command and commercial/instrument rating in helicopters. Civilian pilots do not attend the State Police Academy and they do not become State Troopers.
Both Major Hock and Corporal Baralo point out that the MSP program is such a success because of the outstanding support from all segments of the community. Corporal Baralo states that the community has a strong "ownership" feeling for the program. "I can’t tell you how many times I have been approached while in uniform and been told of friend or relative saved by our unit," he said.
THE NASSAU COUNTY POLICE DEPARTMENT (NCPD)
The County of Nassau is a large, densely populated suburb located just east of New York City. The Nassau County Police Department is made up of approximately 1,600 officers and provides patrol services for most of the county, as well as airborne law enforcement/medevac services for the entire county.
The Nassau County Police Department currently operates a fleet of three helicopters – one Bell 407 and two Bell 206L4 Long Rangers. The unit is based at a hangar in Bethpage, NY, once the home of the famous Grumman Aerospace "Ironworks." In an area formerly graced by legendary fighters such as the Wildcat, Hellcat and the F-14 Tomcat, the NCPD’s three helicopters serve as the last permanently assigned aircraft in a region called the "Cradle of Aviation."
The Nassau County Police Air Bureau took delivery of another Bell 407 in September, replacing one of the Long Rangers. The commanding officer of the bureau, Sgt. Thomas Milton anticipates taking delivery of a third Bell 407 next year.
"It will be nice for both the pilots and paramedics to have a standardized fleet," Sgt. Milton said. "All bells, whistles and switches will be in the same place, and of course that helps for a safer operation."
The helicopters are operated by a sworn police officer/pilot and sworn paramedics. In addition to being a paramedic, the police officer/paramedic also performs the role of tactical flight officer on law enforcement missions.
The bulk of their medevac work is on-scene rescue work. This can present a particular challenge. Ralph Spinola, the Nassau County unit’s current chief pilot, explains: "We train our pilots in-house to become police pilots. Yes, they arrive with a commercial rotary-wing license, but the demands of police flying and in particular on-scene medevac work is enormous. The pilot is alone and without a co-pilot to assist."
The County of Nassau is bordered on two sides by the Long Island Sound and the Atlantic Ocean. Major ocean beaches are served by only two parkways and summer beach traffic can be a nightmare. "Due to its geography, the ocean beaches lend themselves to long ground transports. Oftentimes, the helicopter just makes medical sense for the patient," Spinola said. The Nassau County Police Air Bureau performs approximately 400 medevac missions a year.
In addition, the closing of the United States Coats Guard Air Station, Brooklyn, in 1998 has resulted in more air-sea rescues. All agencies in the area, including the NYPD, Suffolk County and Nassau County, have been handling more water assignments because of the lack of USCG aviation resources.
The NCPD is very pleased with the Bell 407. Spinola notes that the aircraft is perfect for their mission. "We need a fast, powerful, cost effective aircraft to perform our law enforcement/ medevac role," he said. "The 407 is that aircraft."
THE SOFTER SIDE OF AIRBORNE LAW ENFORCEMENT
Many of us are familiar with the infamous slogan, "death from above." This slogan has been used for years by our brave, heroic and courageous military aviators while performing their dangerous flying missions around the world defending our freedoms.
In airborne law enforcement, units perform a variety of missions and assignments. It would be hard to think of more rewarding missions than medevac. Perhaps "life from above" is an appropriate slogan for these missions.
Air Medicine & Machinery
Establishing the Medevac Mission
By Lisa A. Wright
Air Beat Magazine Editorial Director
In the US, there are an estimated 17,784 law enforcement agencies spread out across the federal, state and local levels of government. Of those, there are an estimated 350 units performing airborne law enforcement missions. Of those APSA member agencies, 34 aviation units perform some type of helicopter or fixed-wing emergency medical service. That means less than 10 percent of all police aviation agencies reported that they perform medevac or emergency transport missions.
The term "medevac" is usually applied to an airplane or helicopter used as an ambulance. This permits the rapid transport of seriously injured persons from the scene of an accident to a hospital. The technique has its roots in the establishment of the Australian Royal Flying Doctor Service, which was founded in 1928 to bring doctors to patients and patients to hospitals from the remote outback. In 1926, the US Army Air Corps used a converted airplane to transport patients from Nicaragua to an Army hospital in Panama that was 150 miles away.
Inevitably, the immense military potential of this practice was realized with the development of the helicopter. The US Army pioneered this lifesaving medevac technique during the Korean War. They established semi-permanent field hospitals immediately behind the front lines, which allowed wounded soldiers to receive complete medical treatment after only a short helicopter flight. This military tactic was later popularized in the 1970s TV series M*A*S*H.
In 1966, the landmark National Academy of Science white paper "Accidental Death and Disability: The Neglected Disease of Modern Society" underscored the profound impact of death and disability caused by injury, particularly in car crashes. This study contributed substantially to the development of the modern EMS system and its trauma care subsystem in the US. Its impact was compounded by the influence of returning military units and military medical helicopter pilots discharged to law enforcement and other public safety flying roles.
This soon led to the adaptation of military and public safety helicopters to be used for the evacuation of injured civilians. The Maryland State Police Aviation Command, which began in March 1970, became the first non-military agency to transport a critically injured trauma patient by helicopter, a service they continue to offer today. The first civilian hospital-based medical helicopter service was established in 1972 at St. Anthony’s Hospital in Denver, CO.
By 1980, some 32 helicopter emergency medical services (HEMS) programs with 39 helicopters were flying more than 17,000 patients a year. By 1990, this grew to 174 services with 231 helicopters flying nearly 160,000 patients. Ten years later, 231 helicopter services with 400 aircraft were flying over 203,000 patients each year. By 2005, 272 services operating 753 helicopters and 150 dedicated fixed-wing aircraft were in operation. There are now approximately 500,000 helicopter and fixed-wing emergency medical transports each year, according to the Association of Air Medical Services.
While helicopters and fixed-wing aircraft play a vital role in emergency transports, as mentioned, most law enforcement aviation units are not dedicated EMS providers. But as first responders, law enforcement crews may utilize equipment (long-line, hoist, litters, etc.) to rescue injured persons and deliver them to a safe area or bring flight medics to the accident scene.
Chief Pilot Phil Tilford of the Phoenix (AZ) Police Department Air Support Unit explains that they have become one of the busiest mountain rescue units in the country. In 1981, in cooperation with the Phoenix Fire Department, the Air Support Unit began training to be able to rescue hikers from the surrounding steep and mountainous terrain. Fire personnel provide the medical services and are the rescue hoist operators. The Air Support Unit, which purchased an Agusta A109E twin-engine helicopter in 2005, extracts patients and flies to a safe area for reloading the patient into ground transportation. "Only in extreme and immediate life threatening situations will we transport the patient to an approved medical facility by use of helicopter," remarked Tilford.
Tilford further explains that the Air Support Unit chose not to equip the new aircraft with installed and dedicated EMS gear, as that would decrease the available payload for law enforcement missions. The aircraft does have portable advanced life support (ALS) equipment that is transported to rescue sites, and fire department personnel regularly train with the unit’s pilots and TFOs to ensure safety, communication and proper technique.
The primary focus of the California Highway Patrol’s (CHP) Office of Air Operations is law enforcement missions, but their secondary mission is to provide assistance to allied agency operations with SAR and medical care and transportation, when available and appropriate.
In 2005, the CHP performed 6,873 searches, 140 rescues, 522 EMS missions and 499 patient transports, reports Captain K. R. Dittimus, CHP Commander of Air Operations. The CHP has eight air operations units located throughout the state. The placement of these units allows for maximum efficiency and immediate response to incidents requiring CHP airborne assistance. Currently, the department’s patrol fleet consists of 15 airplanes and 14 helicopters.
The CHP’s 11 Astar helicopters perform the full spectrum of law enforcement duties in both urban and rural environments. Each helicopter is equipped with a FLIR infrared/color CCD camera sensor system, AeroComputer moving map, Spectrolab SX-16 Nightsun, satellite telephone, 450-pound capacity external hoist and 1000-pound cargo hook limit. In addition to conducting search and rescue and external hoist missions, Astar crews are capable and equipped to provide ALS patient care and medical evacuation transport when called upon.
High Risks of Transport Medicine
Transport medicine is among the most complex arenas of medicine and is characterized by the need to provide immediate access to time-sensitive care for critically injured patients at the same time that operations are conducted in hostile environmental conditions with limited planning time. From 1972 through September 2002, when HEMS safety research by Dr. Ira Blumen of the University of Chicago Aeromedical Network (UCAN) was completed, HEMS had flown approximately 3,000,000 hours and transported some 275 million patients. In that time, there were 166 crashes involving HEMS with 183 fatalities.
The UCAN study found that while the number of crashes each year had fluctuated, the number per 100,000 patients flown had dropped from 17.36 in 1980 to 5.5 in 2001. The risk to patients, estimated over the years of the study, is reported as a fatality rate of 0.76 per 100,000 patients. Recognizing that risk cannot be completely eliminated, it is essential both for the public served and the pilots, nurses, paramedics, physicians and other providers who deliver care that the environment be as safe as possible.
To that end, the Association of Air Medical Services has already initiated Vision Zero (www.visionzero.aams.org) and joined the International Helicopter Safety Team (IHST, www.ihst.org), led by the American Helicopter Society (AHS), the Helicopter Association International (HAI), the Federal Aviation Administration (FAA), Transport Canada and the APSA to reduce helicopter accidents by 80 percent in the next 10 years. These initiatives seek more effective methods to avoiding errors in complex systems and accelerate the implementation of best practice standards.
Author note: A special thanks for information for this article provided by the Association of Air Medical Services, the Phoenix Police Department Air Support Unit, the California Highway Patrol and Jay Fuller, APSA Safety Staff.
Tips To Ensure Safe EMS Operations
Most medevac aircraft are modified aircraft with lifesaving equipment on board, as well as trained medical personnel as part of the aircrew. There are efforts law enforcement aviation units can make to ensure that their medevac missions save lives rather than lose them:
Maintain Standards – Well defined, inclusive operating standards, established by command/supervisory personnel and adhered to religiously by crews, can go a long way to reducing mission-related pilot decision error.
Train Hard – Single pilot medevac ops conducted with sophisticated modern aircraft and flown in busy ATC environments present one of the most complex, fast-paced operating environments possible. Train, train, train. Know your equipment and your crew members intimately.
Define Responsibilities – Pilots make the flight decisions; medical personnel make the patient decisions. Period. Ideally, pilots should not even know the medical status of their passenger.
Be Conservative – Pilots must keep in mind that their mission, ultimately, is to provide safe, sure transportation. All decisions should be conservative. Pilots can cause greater injury. Further time delays caused by flight deviations or diversions can make the helicopter less suitable than a ground ambulance.
Equip and Prepare – If you are going to be operating in known high-hazard environments (i.e.. night scene extractions), equip yourself and take precautions. Use night vision goggles and have specified, prescreened landing sites. Arm yourselves against known hazards.
Despite the inherent dangers, air medical flight operations remain a viable mission for many law enforcement aviation units having rural jurisdiction. But these operations must be conducted with all due restraint.
Catching Crooks & Saving Lives
By Deputy Carlos Quezada
San Bernardino County Sheriff’s Department Aviation Unit
The San Bernardino County Sheriff’s Department’s Emergency Operations Division Aviation Unit was assisting a local law enforcement agency with a vehicle pursuit of a carjacking suspect, when the pursuit went from the valley area up through winding roads that led to the local mountains. The suspect eventually turned around and began to drive back down the same road. Still, police vehicles pursued him quickly from behind.
The carjacker traveled at a high rate of speed and subsequently drove off a 300-foot cliff. The suspect was ejected and found on the ground unconscious. Suddenly, the Aviation Unit went from pursuing a suspect to sending its medical helicopter to conduct a technical rescue mission for this individual. There was a physician on duty that day that made every attempt to save his life, despite the fact that officers on duty had been trying only moments before to take his freedom.
It has been an evolutionary process for San Bernardino to become both law enforcement and medevac-capable. The birth of the Aviation Unit goes back to 1972 when Terry Jagerson, previously a sergeant with the Los Angeles County Sheriff’s Department, came in as a lateral and assumed the position of lieutenant. He began his quest of forming an airborne law enforcement division within the department with two Bell 47 helicopters purchased through federal grant money.
During this era, the West End portion of the county had a service search and rescue team run by a private organization and comprised of EMT and paramedic volunteers. In the late 1970s, they began looking for a new home. Jagerson acquired surplus B-model Hueys and brought the search and rescue teams online. This was the inception of the county’s Air Rescue Team.
As time progressed, so did advancements in medical equipment and procedures. Long-line extractions of victims from rugged terrain were a common practice, but some issues arose during the early periods. One example was the susceptibility of the medic and/or victim to spin due to the rotor wash. In an incident seen on national television, a medic spun at a rapid speed causing him to partially lose consciousness during a short-haul.
The Aviation Unit subsequently purchased a Lucas Western hoist with a working capacity of 600 pounds. Its advent presented increased functionality and improved safety and control. A tag line was added to attach to the hoist hook to decrease the chances of spinning during some hoist operations/missions.
The advanced life support (ALS) medical equipment in use by the medical crew includes a stokes litter with a backboard and straps, blood pressure monitor, heart monitor with defibrillator, suction machine, Sager splint for femur fractures, airway bag kits, IV bags and medications, such as paralytics, sedatives, various advanced cardiac life support (ACLS) meds and asthmatics. The helicopters can be configured to carry two patients.
Throughout the years, the Air Rescue program has undergone changes of its own. Currently, Dr. Jeff Grange is the medical director of the team. He is an emergency room physician for Loma Linda University Medical Center in Loma Linda, CA, and has earned the title of Emergency Medical Services Director there, as well. Grange is also a reserve deputy sheriff for the department. He has written the San Bernardino County Sheriff’s Air Rescue Team Medical Treatment guidelines, which are protocols utilized in the operation.
The team is also governed by protocols from the base hospital, the local EMS authority Inland Counties Emergency Medical Agency (ICEMA), which covers San Bernardino County, Mono County, and Inyo County, and the California Emergency Medical Services Authority (EMSA). The Air Rescue helicopters and private air ambulances are dispatched through the San Bernardino County Fire Communications Center.
Before joining the San Bernardino County Sheriff’s Department Air Rescue Team, there are minimum requirements that the volunteers must meet. Physicians must have a minimum of two years experience working in a critical care or emergency department within the previous three years. Nurses must have two years of the same experience within the previous five years. Paramedics must have a minimum of two years experience working for an advanced life support (ALS) provider. Finally, EMTs must have five years experience working full time for an ALS provider.
San Bernardino is comprised of different terrains, and the aviation unit is equipped with the tools necessary for those challenges. San Bernardino County is the largest county in the continental United States. The county covers approximately 22,000 square miles of valley, rugged desert and mountainous areas reaching as high as 11,500 feet. To patrol such a varied expanse, the Aviation Unit has a fleet of aircraft designed for various types of missions, including both law enforcement patrol (narcotics surveillance, transporting officials, prisoner extraditions) and medical patrol (fires, technical rescues, medical trauma transports).
The agency’s fleet of aircraft consists of one Sikorsky H-3, one Bell 212, two UH-1H Super Huey IIs, six Eurocopter Astar B3s, one McDonald Douglas 500E, one Aero Commander Grand Renaissance, one Cessna 182 and one Cessna 207.
The Aviation Unit has 17 pilots, including a captain, one lieutenant, two sergeants, eight mechanics, one corporal and one civilian employee. There are seven tactical flight officers, four of which are EMTs/crewchiefs/hoist operators. The volunteer Air Rescue team is comprised of seven medical doctors, 15 registered nurses, 26 paramedics and seven EMTs for a total of 55 volunteers – 20 of these members are reserve deputy sheriffs.
Some of the missions performed are search and rescue, body recoveries, downed planes, fall victims, vehicles driven over the sides of mountains, traffic collisions on the roads and inter-facility hospital transfers. The medics are equipped for Alpine conditions and carry packs in case atmospheric conditions worsen and recovery of the victim and rescuer becomes difficult in the mountainous areas, one of which is San Gorgonio Mountain that has an altitude of approximately 11,500 feet.
When the unit responds to a rescue mission within the county and the victim is a San Bernardino resident, there is no cost to him or her. The taxes they have paid take care of the cost. There are times when the unit is called upon to assist other counties that don’t have the luxury of equipment or manpower. In these cases, the California Governor’s Office of Emergency Services is contacted and the San Bernardino Aviation Unit is given an OES number. The unit then performs the mission in the other county and reimbursement is worked out between the agencies.
When conducting technical rescues or normal trauma transports, the unit makes every attempt to limit on-scene time on the ground to 10 minutes or less. The "golden hour" makes a difference between life and death. But certain situations require more time for extrication and/or extraction of victims.
The total team hours volunteers provided San Bernardino County Sheriff’s Department in 2005 amounted to more than 13,200 hours. The Air Rescue Team conducted a total of 338 missions, medically evaluated 289 persons and transported 286 injured subjects to local area hospitals/trauma centers. They also assisted in 39 hoist rescues and five SWAT missions.
With all of these volunteers giving up their free time to provide service to the people of the community, one can’t ask for a better medical team to help in desperate situations that require the experience they possess in emergency medicine and pre-hospital care.
Law Enforcement And Air Medical Operations
By Dr. Tania Glenn
Readiness Group International, LLC
Airborne law enforcement operators that also respond to emergency medical calls encounter unique challenges. Namely, they must balance the equally difficult tasks of flight operations and patient care.
The mission of law enforcement officers functioning as flight medics fluctuates rapidly between taking down bad guys and taking care of the ill. Not only must these rescuers change their mentality and focus during the course of such a mission, they also must change their equipment, their skills, their habits and their practices. This requires flexibility and fast thinking.
Airborne law enforcement officers who are required to begin patient care may be able to maintain some focus on the law enforcement mission at hand. During this type of mission, however, patient care should be considered the priority. This can be very difficult for police officers to do, as law enforcement is typically their primary role, and being required to refrain from police activities can feel foreign and very uncomfortable.
At the same time, the transformation of flight officer to flight medic during the course of a mission takes a significant personnel resource out of the operation. The result of this is the potential loss of a set of eyes and ears that are able to focus on aviation, thereby requiring other crew members to increase their attention and focus. All crew members must be aware of this change in dynamics and able to adjust to the difference.
Another significant challenge for flight officers who serve as medics lies in the fact that the vast majority of the patients they care for are critically ill or injured. If ground units triage well, aviation resources are not called for stable patients with good survivability. Traumatically ill or injured patients may be very challenging, as they present numerous medical complications and may require difficult or invasive procedures to save their lives. As the seconds tick away in the golden hour of a critically injured patient’s life, a great deal of pressure is placed on the law enforcement flight medic to implement difficult yet vital interventions.
Further complications lie in the types of patients cared for by law enforcement officers functioning as flight medics. Sometimes the patient is a child, a known victim or another law enforcement officer. Frequently, in the emergency room, "cops and kids get worked on the hardest." While all patients get the best care possible, it is no secret that police officers and children who are critically injured increase the desire of staff members to give their all. This is due to the emotional situation that this type of patient brings. No one likes to give up on a cop or a kid – plain and simple.
For a flight officer who is a medic, the task of treating a fellow serviceman is one of the honorable acts of service. While most airborne officers serving as medics would not want it any other way, this responsibility is significant, and the impact can be difficult to manage. Overcoming the lasting impressions, memories and feelings associated with caring for a critically injured officer can require assistance.
40 Years of Aerial Law Enforcement
By Lisa A. Wright
Air Beat Editorial Director
Located 23 miles southeast of Los Angeles, the City of Lakewood, CA initiated the first day and night law enforcement helicopter patrol program in the nation in 1966. Helicopters and aircraft had specialized law enforcement uses before that time, but Sky Knight was the first to use helicopters as "patrol cars in the sky."
In its 40 years, Sky Knight has pursued criminals, rescued victims and responded to disasters. When terrain or buildings have isolated ground units, Sky Knight has always been on top of the situation, coordinating the movement of men and equipment. Sky Knight spawned dozens of aerial patrol programs worldwide and employed the first female law enforcement pilot (Monica McIntyre) in the nation, a distinction honored by the Smithsonian Institution.
In September of this year, local city and law enforcement officials celebrated the program that began as an 18-month experiment four decades ago with a reception at the Los Angeles County Sheriff's hangar. The Airborne Public Safety Association honored the program for its safety and commitment to airborne operations with the presentation of a Board Proclamation by APSA President Dan Schwarzbach and Western Region Director Gregg Weitzman. APSA Board member Barbara Tweedt also was on hand to represent Schweizer Aircraft. "The Sky Knight Program is a pioneer in the field of airborne law enforcement, and we owe them a debt of gratitude for making it possible for us to do the job we love," said Schwarzbach.
Sponsored by the City of Lakewood and the Los Angeles County Sheriff’s Department, the test program was originally funded by a grant from the Law Enforcement Assistance Administration. Neighboring cities soon saw Sky Knight’s successes and offered to pay for this resource to help offset costs, a partnership that remains today. Currently, the cities of Artesia, Bellflower, Cerritos, Lakewood and Paramount share in the $860,000 expense of operating and maintaining Sky Knight’s three Schweizer 300C helicopters, which are based at Long Beach Airport.
With 107,000 hours of flight time since 1966 (about 1,800 patrol hours a year), the Sky Knight program is completely integrated in the Lakewood Sheriff Station’s tactical operations. Sky Knight pilots are Lakewood employees, and the Los Angles Sheriff’s Department provides deputy observers through Lakewood’s law enforcement contract. Lakewood is the lead agency overseeing operation of the program on behalf of the participating cities.
"Our primary mission is ground unit support and officer safety," explains Sky Knight Chief Pilot Wes Pearson, who has been with the program since 1976. "We will respond when possible to any call we can assist – backup to a traffic stop, silent burglar alarm, barricaded suspects, or crimes in progress. We will check the perimeter of buildings and roofs or watch for a possible suspect attempting to flee on foot or in a vehicle.
"A secondary mission is patrol of inaccessible areas such as riverbeds, flood control channels, power line and railroad rights of way for illegal activities. Our major benefit is that we can provide a rapid response for our service area; ground units can depend on us for quick backup," Pearson said.
Sky Knight expanded its initial 9.5-square-mile patrol area in 1967 to include the entire region served by the Lakewood Sheriff’s Station. Since then, Sky Knight has flown virtually every day.