If you had a medical emergency Monday in metro Chattanooga, Doris White was the best friend you never knew you had.
If your child was pulled unconscious from a swimming pool, if your dad fell to the ground with a stroke, if you and your family were trapped inside a twisted auto wreck on Interstate 75 and you needed to get to the hospital quickly, via medical helicopter, White was on the job, getting you to the emergency room as fast as possible.
Monday was hectic. “We had 11 cases in 12 hours,” White said. There was a stroke, a heart attack, someone having trouble breathing, a child in an accident and trauma, trauma and more trauma, accidents all over the place from Athens, Franklin and Winchester in Tennessee to Hiawassee, Chatsworth and Blue Ridge in Georgia, and Murphy, N.C.
“You go from zero to 60 in the blink of an eye,” White said Tuesday.
White is one of about 30 staffers who run Erlanger’s Operations Center, which opened in February, coordinating medical helicopters and ambulances across much of Southeast Tennessee.
The Operations Center itself is dark, about 75 feet by 25 feet, with 16 cubicles. Mounted above those cubicles are huge computer screens, as large as a top-of-the-line flat-screen TV set.
White works in the Life Force pod, a mini air-traffic control center where Erlanger’s five medical emergency helicopters are coordinated. A screen shows a map of East Tennessee, and each helicopter’s location is plotted via satellite. A black icon means a helicopter is at home base. A blue tinge means it is on the way to a patient, and hot pink indicates it has a patient and is hurrying to a hospital. Choppers from Knoxville-area hospitals are shown as well, so the Life Force staff knows if another helicopter is closer to an accident scene.
White can view live video feeds from each of Erlanger’s five helipads, located in Calhoun and McCaysville, Ga., and in Sparta, Winchester and Cleveland, Tenn. (the Cleveland helicopter returns to Chattanooga at night until a new hangar is completed in January). The video feeds allow the staff to confirm that the helicopters have actually left their base or returned home and are on the ground.
The speed with which the operations center staff can get help to the scene or a patient to a hospital can mean the difference between life and death.
“If you’re talking about a patient in Murphy, N.C., it would take two-and-a-half hours to drive or 25-30 minutes to fly,” said Robbie Tester, administrator for the operations center. “From Bradley County, it may take 45 minutes to an hour to drive to Erlanger, or it takes us 16 minutes by air.”
The Life Force helicopters don’t just carry patients.
“We bring the hospital to the patient,” Tester said.
The chopper crew includes a pilot, a paramedic and a nurse. Equipment includes a ventilator, ultrasound gear and more than 100 types of medicine, plus blood plasma.
“We can do some things that an ambulance can’t,” Tester said, although he emphasized that the primary goal of those on board is to stabilize the patient.
The Operations Center’s role is greater than just coordinating the helicopters. Erlanger is the hub for Region 3 of the state’s Dedicated Medical Control Center, covering 10 counties around Chattanooga. The center’s staffers log every emergency ambulance trip in the area. Erlanger doctors can provide medical advice to EMTs in the ambulance, or can connect ambulance personnel to a patient’s doctor via phone if information is needed, such as what drugs a patient may already be taking or other aspects of care.
And in the event of a major emergency such as a tornado or July’s shooting at the U.S. Naval and Marine Reserve Center, the Control Center manages the response.
“If we’re on the scene of a major incident, let’s say we have 15 patients, then the control center takes over,” Tester said. “They survey all of the hospitals, determine how many beds they have available and say here is where you should go.”
Once patients are headed to the hospital, the other side of the Operations Center takes over. There staffers check a screen showing what physicians are on call and match them and their specialties to incoming patients. Another screen shows how many beds are available in key areas such as the intensive care unit or Children’s Hospital.
Another worker contacts a patient’s insurance company and begins the process of figuring out who will pay for the care.
“If they have an HMO where the patient is only covered if they go to Parkridge, then we will stabilize them and transfer them,” Tester said.
Another staffer handles discharges, arranging transportation home or to another treatment facility.
“Marrying the medical control centers with Life Force and the ‘bed desk’ — you get one-stop shopping,” said Dr. James Creel, medical director for Disaster and Pre Hospital Medicine at Erlanger.
Adding the helicopters forced hospitals to coordinate their efforts, and then the state pushed for medical control centers to help paramedics and EMT staffers. While the pressure of making potentially life-or-death decisions can be difficult for Operations Center staffers, they say the rewards make the work worthwhile.
“We had a young man who was in an accident on a motorcycle in Bradley County,” Doris White recalled. “His leg was gone from his hip joint and they gave him only a small chance of surviving. But we got him back here and he did survive and a year later he walked in the door to thank us.”
“It’s rewarding, especially when you get a ‘thank you’ call.”