When Seconds Count
Air Evac Lifeteam takes
emergency services to rural people

by Jim McCarty

On a northeast Missouri farm a woman watches in horror as her husband’s tractor slowly tips over and pins him underneath. She grabs her phone and quickly dials a toll-free number. In short order the alien drumbeat of a helicopter splits the air.

Air Evac 13 based in St. Clair returns from a mission. The service has 36 bases in 10 states. Most of the bases are in small towns like St. Clair, population 4,000.

The chopper sets down close to the accident scene with a crew of three on board — a pilot, a registered nurse and a paramedic. They set to work digging the man out from under the tractor. They load him into the helicopter and make a beeline for the hospital at 130 mph.

Every day similar tragedies take place across rural America. Often the outcome is tragic because the level of care needed by the patient is not available or the distance to the hospital too vast.

In this case the patient survives, his life saved thanks to Air Evac Lifeteam, a helicopter ambulance service with 36 mostly rural bases in Missouri and nine other states.

Air Evac got its start in 1985 when a group of private citizens from West Plains founded the company to give rural people in this south-central Missouri area better access to emergency care. Roads in this part of Missouri are treacherous, so accidents are common. While West Plains has a hospital, the nearest trauma center is a 120-mile drive to Springfield.

Air Evac has overlapping bases in 10 states. Most are in small towns like Yellville, Ark., population 1,700.

“There’s a basic concept we’ve got to get across,” says Colin Collins, CEO of Air Evac. “Urgency and time are extremely important in some medical conditions. Every minute, every second counts.”

Collins says rapid response to an accident is an issue metro areas have solved but rural areas have not. He says urban ambulances are located so that, on average, no person is more than six minutes away. Rural areas average 17 minutes response time, then 54 minutes to arrive at a hospital capable of dealing with trauma.

He says when it comes to life-threatening injuries, 10 percent of urban patients will die. In rural areas nearly 40 percent won’t survive.

Emergency services in Missouri are funded at the local level. So rural areas, with low population densities, lag behind their urban counterparts.

“I’ve been with families when the surgeon comes out and says, ‘I’m sorry, but the injuries were just too severe to sustain life.’ What he should have said is we didn’t have what we needed here to save his life. Because probably if that injury had happened in Columbia, Greene County or Jackson County he would have lived,” says Collins, who was CEO of Ozarks Medical Center in West Plains when Air Evac was founded.

A state-of-the-art communications center in West Plains dispatches and tracks each helicopter.

Collins was involved in the medical field for many years and saw first hand the disparity between rural and urban services. He left the field for a time and when he returned nothing had changed.

“There’s nothing on the horizon that’s going to push the level of technology out to areas like this,” he says.

Instead of fighting a losing battle to bring rural hospitals up to big city standards, Air Evac’s founders turned instead to getting rural people to urban hospitals faster. Air ambulance services were nothing new. Following the Vietnam War helicopters started appearing in places like St. Louis, Kansas City and Columbia. When a rural person needed their services they had to wait for the helicopter to travel to them.

Air Evac tried a different approach. Its helicopters are based where they are needed. When the service started West Plains was the smallest city in the United States with a dedicated air ambulance service. Air Evac can still make that claim with a base in Yellville, Ark., population 1,700.

Air Evac personnel load a patient into a waiting helicopter during a simulated rescue. Photo courtesy of Air Evac Lifeteam

Besides the West Plains base, Air Evac helicopters fly out of Missouri towns like St. Clair, Troy, Poplar Bluff, Farmington and Cape Girardeau. Northeast Missouri has coverage from nearby Quincy, Ill., and the southwest corner benefits from Arkansas bases at Springdale and Yellville.

Those who got the operation off the ground in 1985 had a philosophy in mind: “We believe we should be able to live in rural areas,” says Ken Harper, membership director for Air Evac and one of the three original founders. “Why should anyone be penalized by where they want to live?”

Ken came up with a plan that made bringing an expensive service to a town of 9,000 possible. His idea was modeled after a similar service in Switzerland that sold memberships to cover the expense of operations. He took the plan to Bill Chritton, a helicopter pilot and Vietnam veteran who was running a strawberry farm.

“He convinced me to take the business plan and read it,” says Chritton. “I read it and then re-read it. I tossed and turned during the night and the next day said, ‘I believe we can make this work.’”

To keep expenses down Air Evac buys used helicopters and completely rebuilds them in its West Plains maintenance facility.

Air Evac found quarters in a tiny room at the West Plains hospital. “We had three pilots who did everything including being president of the company,” says Chritton, one of the original three pilots and current chairman of the board. To keep the fledgling operation running Chritton poured thousands of dollars of his own money into Air Evac.

From those humble beginnings the service quickly spread until, today, new bases open at the rate of one per month. The service has flown more than 70,000 missions and saved countless lives. Nearly 300,000 have joined. They come in at the rate of 300 per day, Harper says.

That the company is so successful speaks volumes of the dedicated people who refused to believe their task was impossible.

Despite its success Air Evac is far from a gold-plated company, Collins is quick to point out. The 700 employees do whatever they can to keep expenses low.
The same Bell 206 Longranger helicopters are used at each base. The company buys them used, then rebuilds them in a facility located at the West Plains airport. This way parts can be interchanged and pilot training is standardized.

Crew members do routine tasks on the helicopter like refueling after a flight. They sleep in Spartan quarters at the base, which in this case is a mobile home at the St. Clair Airport.

Bases have grown outward from West Plains so they are mutually supportive. If one base gets a call, the neighboring base can offer backup.

Although it doesn’t cover all the costs, the membership base remains the key to the organization’s survival. Membership costs $40 for an individual, $45 for a couple or $50 for a family membership. A $500 lifetime membership is also available.

Members agree to let Air Evac bill their insurance if they have any. Otherwise the service is free.

Non-members are not denied services. However non-members will be billed for the cost of the flight, which can be as much as $8,000.

Clint Hinds of Willow Springs joined Air Evac in 1985. “We joined just to help get the thing going,” he says. “I hoped we’d never need it.”

Recently Hinds was strapped into the helicopter and transported from West Plains to Springfield after he suffered chest pains.

“Things turned out good,” he says. “I was glad to have it available. They just knew I was a member and loaded me up.

Air Evac Lifeteam helicopters can put down just about anywhere, making them perfect for air transport in rural areas. Besides offering rapid transport to critical care hospitals, each helicopter is staffed by a registered nurse and a paramedic with years of emergency training. Photo courtesy of Air Evac Lifeteam.

One woman has made 10 trips in Air Evac helicopters. The service’s crews responded to the tornadoes that struck Missouri in May and to the 2002 Oklahoma bridge collapse. Besides providing the air ambulance service Air Evac is working to improve the level of emergency care in rural areas by offering an intensive training program free for paramedics and registered nurses.

While Collins is proud of the accomplishments Air Evac has made, he says the service is barely making a dent in what needs to be done. “We need more helicopters, five to six more just in Missouri,” he says.

To do that rural people need to become members. “That is how you keep the helicopters out there,” he says. “We want everyone to be a member.”

For more information call 1-800-793-0010, send e-mail to membership@air-evac.com or visit www.lifeteam.net