Flying ERs Change First-Response Treatment for Many

Since the end of the Vietnam War, in which helicopters were used to rescue injured men on the battlefield, the concept of rapid evacuation of civilian patients has flourished.

Fast (cruising speed is 150 miles an hour) and crammed with intensive-care equipment, small helicopters costing more than a couple of million dollars apiece are flying emergency rooms.

They have become an integral part of the way hospitals and physicians treat the sick and save lives.

"It's particularly helpful in Southern Illinois and southern Missouri, where there are no Level I trauma centers," said Karen Zahn, manager of transport at Cardinal Glennon Children's Medical Center, adding that Level I centers include cardiac and neurosurgery facilities.

In the St. Louis area, Arch Medical Services Inc. is the leading air-evacuation company. It grew out of a service started in 1979, evolving into Area Rescue Consortium of Hospitals (ARCH), which was owned by Barnes Hospital, St. John's Mercy Medical Center and St. Louis University Hospital.

In 2000, the service was acquired by Air Methods Corp. of Englewood, Colo., a national air-rescue firm.

The area headquarters, dispatch center, repair facility and landing pads are just southwest of Union Station at 2207 Scott Avenue.

Motorists driving on Highway 40 may notice the boxy Eurocopters BK117 abruptly rising above the city and whizzing off on a mission.

Arch, which logged 6,600 flights in 2005, has 12 helicopters and two fixed-wing airplanes positioned at 10 bases around the St. Louis area and the Midwest. The aircraft are located so that they can deliver a patient to a hospital within 20 minutes, said Monica Loggins, a dispatcher.

The other major company serving the area is Air Evac Lifeteam, based in West Plains in south-central Missouri.

That service operates Bell 206 LongRanger helicopters from 62 bases in 11 states.

Air-evac helicopters often give very sick children and adults a second chance at life.

"What's neat about it is, you pick up a child, and you're not sure they're going to survive, and then they come back to see you," said Linda Behrens, manager of St. Louis Children's Hospital transport team.

Today, a few Vietnam-era pilots, such as Terry Wilund, 59, are still flying helicopters and saving lives. Wilund flies the brightly decorated "kid copter" for Arch Air Medical Service Inc.

Wilund dropped infantrymen into hot landing zones in Vietnam and brought them out.

Today, he loves flying children, usually from hospitals in outlying areas in Missouri and Illinois to St. Louis Children's Hospital or Cardinal Glennon Children's Hospital.

"I carry my wings here," said Wilund, pulling an Arch pin out of a pocket of his jumpsuit. "I give 'em to the kid, or if it's an infant, I give them to the parents."

Air Evac sells annual memberships to individuals, couples and households for $50, $55 and $60, respectively.

For that fee, said Julie Heavrin, members are assured they will be transported to a hospital.

Such a service is valuable and comforting, she said, for residents who may live two hours or more by car from a well-equipped and -staffed hospital.

Arch does not charge a subscription fee and, like Air Evac, gets paid through private and public health-insurance plans. Heavrin estimated that an air-evacuation flight can cost $6,000 to $8,000.

Neither Arch nor Air Evac would reveal its revenue or profit.

Bob Abrams, Arch spokesman, said it costs $600 an hour, plus the expense of the crew, mechanics and overhead, to operate the company's helicopters. Arch and Air Evac both buy used machines and refit them, stripping them down to the airframe and replacing the engines and electrical parts.

They may have 4,000 to 5,000 hours on them when they go onto the market and are bought by the air-rescue companies through brokers.

One Arch helicopter on the St. Louis pad, for example, bought for about $2.5 million, had been used by the sheriff's department of Suffolk County, N.Y.