By Guest Blogger Josh Roland, Critical Care Paramedic, Wake Forest Baptist Health

Not everyone can imagine a job like mine. For that matter, there was a time when I couldn’t have imagined it either. I was always the quiet, soft-spoken one, who was more prone to caution than adventure. But now, I’m a critical care paramedic for AirCare 1, one of three aircrafts that serve Wake Forest Baptist Health’s Critical Care Transport Services. My job is often fast paced and high energy, but the most exciting aspect of it is not the adrenaline rush, but the opportunity to make a dramatic difference in the lives of people who are in urgent need.

A Day with AirCare 1

Wake Forest Baptist Health has three AirCare aircrafts stationed throughout the western Piedmont. I work on AirCare 1, an EC-135 helicopter that is based at the Davidson County Airport. AirCare 1 responds to emergency and interfacility calls throughout the Triad, and it also provides interfacility transport for Brenner Children’s Hospital patients.

My day with AirCare 1 begins at 7a.m., when our team relieves the night crew. We have to be ready to go as soon as we walk through the door—although not every morning is going to be busy. If a call is not pending, our team spends time preparing for the day. This includes a briefing with the Brenner team, and a service-wide conference call with the other AirCare teams, the Brenner ground transport team and the AirCare ground transport team. These calls allow us to discuss issues that will have an impact on our flights that day, such as weather, scheduled maintenance, aircraft updates and other details.

After our calls, we break off to work on any computerized training available. We are constantly updating our knowledge so that we can stay at the top of our field and provide our patients the best care possible. If we have significant downtime, my partner and I will often spend time going through procedures and scenarios that help us keep our skills fresh.

Some days, our team will go on what we call a “PR flight.” These flights allow us to interact with fire departments and EMS agencies in our service district. During these events, we teach them landing zone safety, how to set up a landing zone and other pertinent details about AirCare calls.

These are some of the basics of what we do. Like any job, there are meetings, paperwork and other tasks. But once we’re in the air or on the scene, that’s when my job is no longer just another job.


Responding to Calls

AirCare units respond to two types of calls: interfacility flights and on-the-scene flights. Interfacility flights involve picking up a patient from another hospital and bringing him or her to Wake Forest Baptist Medical Center or Brenner Children’s Hospital. AirCare 1 is the only one of our aircrafts that serves Brenner specifically.

On-the-scene flights involve picking up a patient who is injured or in distress at any given location. This can be at a home, business, on a roadway or just about anywhere. And this is when things can become unpredictable.

We have landed in some pretty unconventional areas, including cow pastures, fields with 5-foot tall grass, intersections in the middle of nowhere, major interstates, parking lots and even people’s lawns. I vividly recall landing in a patient’s front yard and being so close to his house that it felt as if I could step out of the aircraft and onto his front porch. Of course we weren’t quite that close, but it felt like it. We’ve also had to contend with wildlife—not just birds near the aircraft while we’re in the air, but frightened deer that we’ve had to avoid when landing.

Some of the places we’ve landed have been so remote that our aircraft was the first emergency personnel team on the scene. Typically a fire department or EMS crew is already on the scene to begin care for the patient and help set up a landing zone, but if not, we’re prepared to circle the scene, find a safe landing spot and begin patient care as soon as we hit the ground. On the other end of the spectrum, we’ve had calls where several aircrafts were on scene.

If a patient’s condition is extremely time sensitive, we’ll conduct a “hot loading,” which means my partner and I will leave the aircraft and load the patient on while the aircraft is still running.

Interfacility flights tend to be less dramatic, but our team is still just as prepared for any contingency. Different air-based critical care units at different hospitals have their own setups, but Wake Forest Baptist Health is one of the few services in the state that pairs a critical care paramedic, like myself, with a nurse on all critical care flights. This combination ensures that we’re just as well prepared to care for a patient on an interfacility flight as we would be for one on an on-the-scene flight.


Safety First

While my job can be action packed, it’s not inherently dangerous—for our crew or for our patients. It’s true that air travel comes with risks that ground travel doesn’t. There are more things that can go wrong, and the stakes are higher. But overall, patients and crew are safer in the air than on the ground. In fact, air transport has fewer accidents than ground transport does. And probably 80 percent of the time it’s a smoother ride than what you would experience traveling in the back of an ambulance.

Still, there are challenges we face in an aircraft that we don’t face on the ground. Space constraints and aircraft noise are sometimes big factors. This is why my partner and I stay practiced in such a wide variety of scenarios. This may mean learning to insert IVs at odd angles, or becoming skilled at using a different hand to administer care.

We want to ensure we’re prepared to treat our patients effectively regardless of the situation. And, ultimately, that’s what my job is all about. It’s not about the excitement of being in the air, or the novelty of landing in an unusual place; it’s about doing everything we can to help a very sick or badly injured person get the care he or she needs.


For more information about AirCare Critical Care Transport Services at Wake Forest Baptist Health, click here.


*Sponsored by Wake Forest Baptist Health