King Air is a Flying ICU for Children’s Mercy Hospital

MARCH 2013 • VOLUME 7, NUMBER 2 • $4.50 A MAGAZINE FOR THE OWNER/PILOT OF KING AIR AIRCRAFT

Just for Kids

MARCH 2013 KING AIR MAGAZINE • 3

helped prepare her for her current role as a Transport RN and Outreach Coordinator for Children’s Mercy Critical Care Transport team.

“We bring everything with us to begin ICU care the minute we reach the patient,” she said. “As soon as we walk in, the specialized care begins and we provide that care throughout the transport process. That means the patient isn’t waiting for care until we get to Children’s Mercy.” Advanced therapies such as high frequency ventilation, inhaled nitric oxide and neonatal whole body cooling, for example, are available during transport.

In this instance, once the baby boy arrives at Children’s Mercy, a team of specialists evaluates him and a treatment plan is put into action. One parent has

flown with him, the other later drove to Kansas City and will take the family home to Hays. The King Air B200 will likely be used for any of his future care at the hospital.

Children’s Mercy is the only pediatric hospital in a region bordered by St. Louis, Denver, Omaha and Little Rock. The hospital in Hays is one of more than 250 regional medical facilities that regularly transfer patients using the Critical Care Transport team at Children’s Mercy, ranked by U.S. News & World Report as one of “America’s Best Children’s Hospitals.”

There are other medical transport flight services available in the region, but this is the only one with an airplane dedicated to transporting babies and children and with a crew specialized in providing neonatal and pediatric critical care.

In addition to the cases of medical illness and traumatic injuries, the team responds to regional and national disasters. In 2005, they flew to New Orleans and brought pediatric Hurricane Katrina victims back to Children’s Mercy. In 2011, they responded to the catastrophic EF5 tornado in Joplin, Mo., and helped stage care there.

Children’s Mercy has been providing medical transport to young patients since the 1960s and has offered fixed-wing transport for more than 20 years – first with a King Air C90, then a 1981 King Air B200 and today a 1996 King Air B200.

The Children’s Mercy Critical Care Transport team has more than 90 staff members and uses three modes to transport approximately 5,000 patients a year: about 400 on the King Air, nearly 325 on a dedicated American Eurocopter EC-145 and the remainder via a fleet of nine ground ambulances.

Once a mission reaches about 120 miles one-way, the team begins to consider using the King Air. Besides distance, weather and passenger weight or equipment capacities are determining factors.

While the majority of the missions are in Missouri and Kansas, the team has transported patients to and from Boston, Atlanta and beyond. Most often patients are brought to Kansas City for treatment, but there are times they are called upon to take patients to other medical facilities.

Children’s Mercy has had a dedicated fixed-wing aircraft since 2005; prior to that it chartered aircraft. According to the Association of Air Medical Services, only 10 U.S. pediatric hospitals have their own dedicated helicopters and only four – Children’s Mercy and three in Texas – have a dedicated fixed-wing aircraft.

“Having a dedicated aircraft offers a number of benefits,” McCool said. “The interior of the aircraft specifically fits our pediatric and neonatal equipment and uses custom mounts rather than just strapping the equipment into an aircraft designed to transport adult patients.

The interior of the Children’s Mercy Critical Care Transport team’s King Air B200 is custom-designed for pediatric and neonatal equipment and passengers. A Lifeport sled system makes it easier to load stretchers or portable incubators.

4 • KING AIR MAGAZINE MARCH 2013

“And our response time is much quicker because we have an aircraft and crew waiting for that call. It could take up to two hours if you have to wait for an airplane to be available and to have its configuration switched to meet the mission. With a dedicated airplane, we’re off the ground within 30 minutes.”

The AircraftThe Children’s Mercy Critical Care Transport team

began using the 1996 King Air B200 last year. The aircraft is owned and operated by PHI Air Medical, a specialist in hospital-based medical transport programs. The pilots

and airplane are based at Charles B. Wheeler Downtown Airport (KMKC), a 10-minute ambulance ride from Children’s Mercy.

McCool says that the newer model King Air offers more power with PT6-42 engines and more advanced avionics to enhance safety. She pointed out the Traffic Alert and Collision Avoidance system, state-of-the-art weather radar and GPS tracking. The aircraft also has an Iridium satellite phone allowing transport team members to be in constant communication with a pediatric intensivist or neonatologist.

“I’m very comfortable knowing the King Air can get us to the patient and get us back, so we can

give them the care they need.”– Todd McCracken, emergency medical missions pilot

A custom-designed medical interior was installed to prepare the aircraft for the medical missions of the Children’s Mercy Critical Care Transport team. The King Air can transport patients ranging in age from premature infants to adolescents and has room for two neonatal or pediatric patients simultaneously, twins for example. A Lifeport sled system makes it easier to load

About Children’s Mercy Hospitals and ClinicsChildren’s Mercy Hospitals and Clinics, located

in Kansas City, Mo., has been recognized by the American Nurses Credentialing Center with Magnet designation for excellence in nursing services and ranked by U.S. News & World Report as one of “America’s Best Children’s Hospitals.”

The 351-bed hospital has a faculty of 600 pediatricians and researchers across more than 40 subspecialties to provide care for children from birth through the age of 21. For more information, go to childrensmercy.org.

Representing a typical Children’s Mercy Critical Care Transport team mission on the King Air B200 (left to right): Dave Craner, pilot; Jason Greer, EMT; Tiffany Ihnen, RN; Rob McKeone, pilot; Amy Wilderman, RRT, C-NPT; and Tom Ceruzzi, RN.

In 2012, the Children’s Mercy Critical Care Transport team earned the Neonatal/Pediatric Transport Award of Excellence designation from the Association of Air Medical Services.

�

6 • KING AIR MAGAZINE MARCH 2013

stretchers or portable incubators and it locks them into place during flight for enhanced safety.

The cabin configuration allows three medical crew members access to the patient and allows a parent to accompany the patient on most flights. There are hooks for hanging monitors, IV bags and other equipment, and cabinets containing medical supplies. A third of the cabin is used for storing additional neonatal- and pediatric-specific equipment the crew might need.

The exterior color scheme of yellow, red, orange and blue was chosen for safety as well as peace of mind for the patients and their families. Cartoon animals were drawn and airbrushed onto the tail by the hospital’s in-house artist Donald “Scribe” Ross.

“The custom paint makes it quite the conversation piece at airports,” said Todd McCracken, a pilot who has flown emergency medical missions with PHI for the past decade. “We get a lot of people stopping to take photos.”

Eight pilots employed by PHI take shifts being stationed with the airplane 24 hours a day. Children’s Mercy Critical Care Transport team missions are always flown with two pilots, also for enhanced safety. The pilots have been trained in how the specialized equipment mounts and how to load equipment onto the aircraft, as well as in general infection control since they are essentially piloting a flying intensive care unit.

“There’s a very close relationship between the pilots and the medical crews. The pilots treat the medical professionals on board as crew not passengers, so a lot of time is spent on communication and relationship building,” McCool said.

An Award-winning CombinationIt’s easy to imagine that needing emergent medical

transportation for a child can be a parent’s worst day. Having the right team and the right transportation, however, can help relieve anxiety for parents and the patients.

Of the 5,000 neonatal and pediatric patients it transports every year, the Children’s Mercy Critical Care Transport team uses the King Air B200 for about 400 patients. Once a mission reaches about 120 miles one way, the team begins to consider using the King Air.

Donald “Scribe” Ross, the in-house artist at Children’s Mercy Hospitals and Clinics in Kansas City, designed the King Air B200’s exterior. Ross is shown here airbrushing cartoon animals onto the tail.

MARCH 2013 KING AIR MAGAZINE • 7

McCracken says that the King Air is the ideal tool to get the transport team to the patient and allow them to do their jobs. He said the King Air B200 delivers in every way: it’s got the size and the performance needed and the reliability that’s essential to medical transport.

“The cabin compared to other EMS aircraft is fairly big. The medical crew has room to move around and take care of the patients,” he said. “It’s got a pressurized cabin so the patient won’t even feel the climb or the descent. It’s fast enough at 300 miles per hour that having a jet wouldn’t really make a big difference for the distances we are traveling, usually 100-to-300 miles each way. You can get up high over the weather if you need to, and it’s got on-board radar so we can get around weather or other obstacles.

“It’s a very stable and reliable aircraft,” he said. “I’m very comfortable knowing the King Air can get us to the patient and get us back, so we can give them the care they need.”

In 2012, the Children’s Mercy Critical Care Transport team earned the Neonatal/Pediatric Transport Award of Excellence designation from the Association of Air Medical Services (AAMS).

Including this most recent award, AAMS has honored the team with four different awards in the past eight years. The other honors: 2007 Transport Program of the Year, 2006 Fixed Wing Award of Excellence and 2005 Ground Award of Excellence.

“One of the things that makes Children’s Mercy Critical Care Transport unique is that we have available every possible mode to provide critical care. We not only have a helicopter and ambulances, we also have the King Air,” McCool said. “That makes us unique and, more importantly, it means we can get specialized neonatal and pediatric care to the patient no matter where they are.”

The Children’s Mercy Critical Care Transport team is one of just four in the U.S. that has a dedicated fixed-wing aircraft in addition to a helicopter and fleet of ambulances.

KA