Commercial, Public Service

Flight For Life: 30 Years and Counting

By By Ernie Stephens, Editor-At-Large | September 1, 2014

FFL’s aft cabins, equipped with the latest technology, are accessible by sliding side doors and rear-mounted clamshell doors. Photo by Ernie Stephens

If you are in portions of Wisconsin or Illinois, and your life is in immediate danger from illness or accident, you won’t just expect a ride from Flight For Life... you’ll want it!

Flight For Life (FFL) was the first air medical program in Wisconsin, as well as the first in the state to receive accreditation from the Commission on Accreditation of Medical Transport Systems. With several other regional air medical programs coming along in the 30 years since its start in 1984, it was able to reduce its service area to a more manageable territory encompassing southeastern Wisconsin and northern Illinois.


General oversight of FFL is provided by the Milwaukee Regional Medical Center (MRMC) board of directors, but day-to-day operations are managed by Jim Singer, himself a registered nurse who joined the program just two years after its inauguration. He became the chief flight nurse in 1991 and the transport system director in 2001, the title he still holds today. He speaks with reverence about the people who founded FFL.

“The person who started this, Barbara Hess, the first program director, had heard about the Denver Flight For Life program, and came together with some community leaders in the Milwaukee area to propose the idea here,” explained Singer. “[She] worked with Drs. Joe Darin and Charles Aprahamian, along with Jim Ryan, executive director of the MRMC, and from that came the flight program.”

The fleet currently consists of two 2008 Airbus (formerly Eurocopter) EC145s, and one 1988 MBB BK117. The operation uses a fourth MBB BK117 as a back-up aircraft, and the hull of a retired BK117 for ground training.

“We’re not a hospital-based company. We’re our own not-for-profit, 501(c)(3) corporation,” Singer explained. “We’re connected with the regional medical center and our board of directors has members on the campus, but we take patients to 25-30 different receiving hospitals across both states.”

Between 25 and 30 percent of FFL’s missions involve flying critically ill and injured patients from locations in the community – called scene transports - to various trauma centers. The rest are inter-hospital transports.

FFL operates two EC145s and one BK117 as line ships, with a back-up BK117. They fly from two bases in Wisconsin and a third in Illinois. Photo by Tammy Chatman, CMTE, Flight For Life

FFL is headquartered in a 14,000-sq. ft. facility at Waukesha County Airport (KUES), 10 miles west of Milwaukee. It also flies out of a northern base in Fond du Lac, Wis., and has a southern hangar in McHenry, Ill. The program is staffed by 80 men and women, 19 of whom are contracted from Air Methods, the Englewood, Colo.-based provider of FFL’s 13 pilots and 6 mechanics.

Caring for its patients are the highly trained and experienced flight nurses and paramedics employed by the program – usually one of each per aircraft, and a pilot. Sometimes, two nurses will be onboard, but Wisconsin and Illinois licensing regulations require at least one flight nurse accompany patients who are ill, as opposed to injured.

Applicants for positions as flight nurses must have a minimum of five years’ experience working in an intensive care unit or emergency room. Paramedics must have an equal amount of time in the field before applying.

“Because of our relationship with the Medical College of Wisconsin, we might have an emergency medicine resident in their second or third year of residency [onboard] looking for this as part of their education,” added Singer.

At the disposal of the medical care providers is a suite of equipment that effectively turns the cabin into a flying emergency room. Included is a Propak 106 monitor, a Zohl defibrillator, intra-aortic balloon pumps, and a video laryngoscope, not to mention plenty of bandages, splints, medications and surgical tools.

FFL personnel are not, however, independently set up for neonatal work, but will fly a neonatal team and isolette from Children’s Hospital of Wisconsin when called upon.

The pilots have their own high-tech equipment helping them with their duties, too. All aircraft are outfitted with Garmin 430 and 530 GPS units, GMX-200 multi-function displays, Honeywell Mark XXI EGPWS, XM Satellite weather, Technisonic TDFM-7000/NV VHF-UHF-800 MHz radios, and wire strike kits. WAAS is available in the two EC145s, and all aircraft NVG-compatible.

Aircrews at all three bases work 12-hour shifts, with the north and south bases reporting for duty at either 6:30 a.m. or 6:30 p.m., and the central base starting its tour at either 7:00 a.m. or 7:00 p.m. (The 30-minute difference ensures that the operation isn’t completely out of service at the same time.)

FFL aircraft – callsign “Trauma 1” – open house. Photo by Ernie Stephens

Two Air Methods maintenance technicians are assigned to each base. They mostly work daytime hours and are responsible for doing a daily inspection on the aircraft, as well as most scheduled maintenance. They take turns being on call for any after-hours issues, and can have the aircraft delivered to the main hangar in Waukesha for heavy maintenance and assistance from the lead mechanic.

Keeping track of the aircraft are the people assigned to FFL’s communications center, a small room with colorful, wall-mounted data and video monitors that make it look like a micro-mini control center at NASA.

“This is our [Honeywell Aerospace] Sky Connect Tracker,” explained Cory Lund, one of the operation’s dispatchers. “All four of our aircraft have satellite tracking on them, so we can see when they lift, when they land, when they’re flying - it updates every two minutes, so whenever they’re in the air we can see what they’re doing.”

Air Methods uses the same technology to monitor the status of FFL operations and the health of its aircraft. “[They] can actually see exactly what I’m typing and where [the aircraft] are going. It’s kind of like their operational control over their pilots,” he said. “All the information they need to know is right in this program.”

FFL also uses DeLorme Street Atlas to pinpoint destinations for crews. If they get a scene request for a helicopter, the system will use the address of the incident to generate latitude/longitude coordinates that can be sent to the flight crews via their smart phones.

Of course, weather information is also at Lund’s fingertips, along with the latest information on tower cranes, malfunctioning obstruction lights and other obstacles. But, of course, safety aboard the aircraft is ultimately the responsibility of the pilots. Overseeing them is Vince Freeborn, FFL’s program aviation manager.

Freeborn, a retired Army Cobra pilot with additional experience as a contract pilot for the United Nations and an air medical aviator in Rockford, Ill., described the weather minimums for FFL’s pilots.

“For Class G airspace, our minimums are 800-ft. ceilings and 2 miles visibility during the day because we’re in a non-mountainous area,” said Freeborn. “Our cross country minimums are 800 and 3 during the day, our nighttime global minimums are 800 and 3, and 1,000 and 3 for cross country.”

FFL’s night minimums are tied to the use of NVGs and HTAWS. So, if a pilot loses those capabilities, nighttime minimums go up to 1,000-ft. ceilings and 5 miles visibility.

Flight minima, communications data, and crew qualification are part of the deep culture of safety that has been the foundation of FFL since its inception. Still, every month, each base holds a series of in-house safety meetings, followed by larger conferences that will, at one time or another, involve every member of the team at all levels.

Janis Sierra is the first EMS pilot in the U.S. Photo courtesy FFL

“The team sets some direction and looks at a project’s bigger-picture items – all the issues that were brought forward,” explained Singer. “Are there any trends? Are there any areas that we may see as risks ahead of time to try to be a little more proactive than reactive?”

While all members of the FFL team are appreciated by Singer, the board of directors and the people they serve, pilot Janis Sierra received additional recognition as the winner of the National EMS Pilots Association’s Pilot of the Year for 2013.

Sierra began her flying career as one of the first female Army pilots, where she earned 7,000 hours in the UH-1 Huey, OH-58 Kiowa and CH-54 Skycrane. When she was hired in 1987 to fly for FFL, she became the first female EMS pilot in the U.S..

When asked about FFL’s 30 years of accident-free flights, more than 33,000 patients transported, and countless thousands of lives saved, Singer attributed it to the dedication of every individual associated with the organization, plus one more thing. “We don’t skimp on safety here.”

Related: EMS News



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