These days, trauma patients are transported to the hospital not just by ambulance, but by air. And when a flight is required, chances are it will take place on a CalStar helicopter.

The nonprofit California Shock Trauma Air Rescue ambulance flies patients to trauma centers for treatment when ground transportation isn’t feasible or when a patient needs a faster response. Noozhawk recently caught up with Adam Pettit, CalStar’s Region Seven chief flight nurse, to see how it all works.

Pettit has been a flight nurse with CalStar for five years, and previously worked in critical care at both Santa Barbara Cottage Hospital and Marian Regional Medical Center in Santa Maria.

There are several criteria that determine whether a CalStar helicopter will be dispatched.

CalStar is activated automatically for more remote locations, like the Cuyama Valley, 60 miles east of Santa Maria, where it might take over an hour to get an injured person to a hospital.

When a 9-1-1 call comes in, emergency dispatchers will decide whether to alert CalStar.

The criteria have been set by various Santa Barbara County stakeholders and they determine where patients go. The county’s policy includes an algorithm that factors in elements like vital signs, level of consciousness and type of injury.

That policy changed slightly last October, but Pettit couldn’t say whether the adjustment has resulted in more transportation calls.

If a fire engine arrives at the scene first, firefighters can assess whether a patient meets the criteria and can cancel CalStar.

If CalStar must land, county firefighters help the pilot determine a safe place to touch down. Pettit said the baseball field in Los Alamos has been used in the past.

“Our goal is to be on the scene in less than 10 minutes,” Pettit said.

When CalStar helicopters do land, the nurses do a quick assessment of the patient and any interventions that need to be done right then. The helicopter then takes to the air to get its passenger to a trauma center as quickly and safely as possible.

Currently, anyone with a trauma injury will be flown to Santa Barbara Cottage Hospital, which has a trauma center. Marian Regional Medical Center is applying for a trauma center designation, but has not received approval yet.

“There’s just a level of care that (patients) get at a trauma hospital that they wouldn’t get elsewhere,” Pettit said. If someone has a major motorcycle accident, “they need about 10 different surgeons in a matter of about an hour and a half,” he added.

CalStar’s contract with the county states that it will be available to fly patients 24 hours a day, 365 days a year.  Pettit also said that safety is a priority for the organization. 

They’ve been operating for 28 years, and have transported 70,000 patients, and have had no accidents resulting in injury or death during that time, he said.

“We are a community air ambulance service, but we’re also a nonprofit,” said Pettit, adding that CalStar doesn’t take patients to one place, and that the organization is separate from hospitals and counties. He said CalStar does not receive tax dollars directly.

Patients who use CalStar for transportation are billed, just as with a ground ambulance. Insurance companies may cover some of the bill or none at all, and CalStar also has a member service that helps cover the cost of transport.

Pettit said that the cost for flights start around $12,000 and go up from there based on distance and number of medical interventions needed.

As with hospitals, many of CalStars flights are charity calls.

CalStar has nine bases throughout California, each with four pilots, eight nurses, a mechanic and a chief flight nurse like Pettit.

In Santa Barbara County, that base is at the Santa Maria Airport. There, CalStar has two helicopters, one in service and one as a backup.

CalStar nurses, like firefighters, work in 24-hour shifts, and have a second home at the base where they wait between calls.

The Region Seven group conducts an average of 15 trauma transports a month in Santa Barbara and San Luis Obispo counties, Pettit said.

If a patient is already at the hospital and too sick to move to another facility by ambulance, CalStar will transport that patient as well.

“If you’re a patient who has been seriously burned, the only burn units are in Los Angeles, Fresno or Irvine,” Pettit said.

Pediatric specialty centers are also very limited, so CalStar transports many children in need to other facilities throughout the state.

County helicopters also factor in to the picture because they have a hoist, which comes in handy in sheriff’s Search and Rescue operations that often are conducted in challenging backcountry terrain. The county also can deploy rescue swimmers.

CalStar helicopters don’t have a hoist, but “we have two nurses and everything equipment- and drug-wise that you would find in an intensive care unit,” Pettit said.

“Sometimes we work together to hoist and then transport somebody,” he said. “Every call is very different.”

— Noozhawk staff writer Lara Cooper can be reached at lcooper@noozhawk.com. Follow Noozhawk on Twitter: @noozhawk, @NoozhawkNews and @NoozhawkBiz. Connect with Noozhawk on Facebook.