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December 19, 2019

Inside Mayo Clinic's hospital 5,000 feet in the sky

Daily Briefing

    At Mayo Clinic's St. Marys Hospital in Minnesota, a helicopter crew stands ready to respond at a moment's notice to severe traumas, providing life-saving care and transport to patients in critical condition at 5,000 feet in the air, Steve Lange reports for the Rochester Post Bulletin.

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    About Mayo's helicopter and airplane unit

    Mayo's helicopter unit, called Mayo One, was created in 1984 when Mayo purchased its first helicopter. That year, Mayo One completed 57 medical flights and was described as "the first hospital-based air medical transport service in the state and the largest aeromedical craft made," Lange reports.


    Today, the Mayo Clinic Medical Transport fleet consists of four helicopter units and one airplane, which is based out of Rochester International Airport. The Mayo One helicopter units complete 2,000 patient transports, and travel about 250,000 miles every year.

    Mayo One travels at speeds up to 130 miles per hour and can transport patients up to 150 miles away from the scene of an incident. The helicopters, which are retrofitted Airbus EC145, are each equipped with blood products, a handheld blood analysis lab, IV fluids, a ventilator, 70 medications, and in some cases, an isolette for infants born premature.

    Mayo Clinic's Medical Transport fleet is on call 24/7 and is staffed by a team of 30 nurses, 30 paramedics, 10 mechanics, and 24 pilots.

    On a standard flight, the crew will include a pilot, flight nurse, and paramedic, who work 12-hour shifts about three days a week, Lange reports.

    Flight dispatch

    When the crew is dispatched, they generally only know the location, enabling the pilot to make an unbiased call about weather conditions and flight safety, Lange reports.

    The crew begins every dispatch by going through their pre-flight checklist. The list includes loading the blood cooler onto the flight, checking the helicopter for abnormalities, and assessing weather conditions and fuel levels. In all, the process takes less than 10 minutes, Lange reports.

    In the Rochester area, about 20% of Mayo One's 1,000 annual flights are automatically triggered by 911 calls in southeastern Minnesota, northeastern Iowa, and western Wisconsin, according to Lange. To auto-launch Mayo One, the emergency calls must meet a specific criteria. For example, the 911 call must involve a passenger ejection, a vehicle accident at highway speeds, falls from significant heights, near drownings, and burns over more than 20% of a patient's body. About 75% of auto-launches are canceled if other first responders arrive at the scene before Mayo One.

    A majority—about 80%—of Mayo One flights go to an area hospital to transfer a patient recently admitted to the emergency department, pick up an organ donation, or transfer a long-term patient in need of specialized care. 

    What a typical emergency is like

    When it comes to a "typical" Mayo One call, Meghan Lamp, a Mayo One flight nurse, said, "Cardiac arrest, stroke, motor vehicle accidents, ATV accidents, and plenty of falls" are all reasons a flight may be dispatched.

    Others cases included a five-year-old hit by a car, a teen's suicide attempt, a pregnant woman with a fetus in distress, and a girl who burned herself in attempt to rescue her brother from a house fire.

    The crew also makes flights for organ donation transfers. For example, Lamp, who served as part of the team delivering organs, once delivered a heart for her mother-in-law's sister's heart transplant. Lamp said, "I'll never forget the flight when we delivered her heart to her. It's humbling to bring back a gift for others."

    What makes Mayo One unique

    Mayo One is likely the first and one of only a few medical helicopters equipped with whole blood and units of packed red blood cells, plasma, and platelets, Lange reports.

    Kathleen Berns, the Clinical Nurse Specialist, said, "We have a wonderful blood bank, and that separates us from a lot of other groups. The majority of our blood products come from our own employees."

    Mayo Clinic's employees donate about 40,000 units of blood—or about 5,000 gallons—annually.

    The blood supply has proven essential. For example, Mayo One in 2012 landed in a farm field to transport Nels Gunderson, a farmer who was sucked into a commercial rototiller and had his leg severed four inches above his knee. During the flight, the crew administered seven pints of blood to keep Gunderson stable. Gunderson survived the incident and was back home five days after his surgery.

    "I'm living proof of how important [Mayo One] is," Gunderson told the Associated Press. "Because, without it, I may or may not have been here" (Lange, Rochester Post Bulletin, 12/14).

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