by Eve Jacobs
After 10 years, NorthSTAR still makes heads turn as it comes in for a landing atop University Hospital. In the confines of the "ship," a life-and-death drama is unfolding, with time mercilessly reeling forward.
"There are no slow times here," says Bartholomew Tortella, MD, medical director of Emergency Medical Services and NorthSTAR, University Hospital, "only anxious waiting."
With 800 to 1,000 calls each year - 75 percent trauma cases and 25 percent inter-hospital transfers of critically ill patients - the helicopter's crew of two New Jersey State Police pilots, one flight paramedic and one flight nurse is kept pretty busy. They work 12-hour shifts, 7 to 7.
Flight nurse Carl Corriere has been part of the crew since NorthSTAR's first take-off in the summer of 1988. He says emergency rescue in the state used to be far more haphazard: "If you were in a car wreck, an ambulance would come for you and it would take you somewhere." Now injured New Jerseyans - and those seriously hurt while visiting the state - are transported to a trauma center to optimize their chances of survival.
New Jersey's trauma network is a model for the nation, says Tortella. "Here, the state-owned system puts the patient's welfare first." In many states the medical helicopter services are owned by hospitals, and operated as business ventures by those facilities.
The network includes paramedics, who come to the scene of an accident to provide immediate care; NorthSTAR and its counterpart in southern New Jersey, SouthSTAR, for rapid transport to a trauma center and to provide lifesaving treatment en route; and hospital trauma teams to give medical directives to the helicopters' crews, and to rapidly diagnose and treat the critically injured patient.
University Hospital has six trauma surgeons. At least one is available to communicate via radio and cell phone with the flight paramedic and flight nurse on each mission.
"It's all about getting there safely and as soon as possible," says Corriere. It takes about four minutes for the helicopter to take off from the rooftop heliport after the call comes in, he comments. Clearance from Newark International Airport is required, although "lifeguard" flights are given top priority.
Weather is a major concern. "We won't send the helicopter out if we don't have three miles of visibility between where we are and where we're going," states Tortella. "Our primary concern is safety." The State Police have never had an "injury accident," he says, although outside of New Jersey, helicopters have crashed during rescue efforts.
"Patient care is our second mission," he explains. "Who have we helped if we can't get there and back safely?"
NorthSTAR's travel time to the patient can be as little as two to four minutes, but is never more than about 20 minutes. On-ground time is kept to under 10 minutes and air-time to the nearest appropriate trauma center is generally under 10 minutes.
"We ask two questions," says Tortella. "One: Does this patient need to go to a trauma center? If yes, then how should we get him there? If the drive time is more than 15 to 20 minutes, we should consider the helicopter. It's not a question of distance, but of time."
Everyone works furiously during what's termed the "golden hour," the most critical period for treating severe injuries. "The helicopter is a link in the trauma system chain, with the enemy being the clock," he says.
For Corriere, the last 10 years have flown by quickly. He hasn't lost any of his initial enthusiasm for his work. Remembering the case of 10-year-old Jackie Kelly, who incurred serious head trauma when she was hit by a van, he says: "When there's a positive outcome and I was a part of it, it makes me feel very good, especially if it's a child. I have children, too.
"A successful outcome also reinforces the fact that the system works," says the flight nurse. "There are so many people - including local EMS workers, firefighters and public safety officers - and they all do their jobs. It's a lot more than flying in at 160 miles an hour to do a dramatic rescue."
Happy 10th birthday, NorthSTAR.
And we hope you have many more.