DHART: 20 Years of Critical Care Transport

DHART is the only helicopter EMS within Vermont and New Hampshire. We provide a service like few others across the United States. We have the equipment and the training to handle life support missions. We take care of the sickest and most badly injured patients, and to be able to help those people on a daily basis is incredibly rewarding. And now I’ve got to go.

DHART 1, modify scene, meet EMS at Cheshire Medical Center – That’s us, so…We’re on our way the plan right now is to land at your facility for a head injury coming out of Surry. We should be landing in about 10 minutes. If that changes, I will certainly let you know, okay? As soon as we get the call, we move out to the helicopter, and we like to be off the ground in under five minutes. Lebanon tower, DHART 1 is at the hospital, going southeast. DHART-1, Lebanon tower, good afternoon altimeter 2 niner 86, transition approved, report clear the delta.  Once we get the mission activated and the vehicle leaves the here, then our primary function turns into keeping track of that vehicle.

All of the programs in the northeast belong to Feet Eyes which is keeping track of where the aircraft are all the time to keep from running into each other.  We have the landing field set up in a ball field.

The only hazards are on the west side of the highway. There are powerlines. DHART provides critical care transport when time is going to make a difference in the outcome of the patient.

We bring the hospital to the patient and continue that level of care till they arrive at the receiving hospital. I like to describe DHART as an outstretched hand, extending the reach of DH and the quality care that is known for our organization.  The DHART program really stresses safety. They have all the safety features on this aircraft. They have all the rules in place, and so that, to me, speaks to the desire for Dartmouth Hitchcock to provide a safe environment, not only for the people that work for them, but also for the patients that we’re moving around.

Yeah DHART 1, we’re about five minutes out from landing, if you could let security know please.

It’s a fantastic resource, and it gets us to the patient in the most appropriate, safe way.

DHART was the brainchild of a number of individuals here at the hospital who saw the need to have a helicopter transport service based here at Dartmouth-Hitchcock Medical Center to transport patients from the rural regions of both New Hampshire and Vermont. My interest in the DHART program came up the day it was born because I was in the military at the time, and I heard, “Hey, they’re starting a helicopter “program”, in the place that I wanted to retire. It was in development for a couple of years before July 1, 1994, which is the day that DHART went into service.

And once it got going, it became quite obvious that every year you have more and more patients to move as more and more people become aware of this service.

Now we have transported just slightly over 24,000 patients by both helicopter and by ground ambulance. The vast majority of our missions are to rural hospitals and back here. Clearly the most fun are when you go up into the mountains and you have to find some little, tiny space to land or put the skids down on uneven rocks. To be able to land somewhere pretty remote is pretty challenging and very exciting.

People will first notice that it is quite small inside the aircraft. Everything that we have is within arm’s reach, and so we can always pass equipment back and forth to each other. We have an array of equipment that makes it more like a flying intensive care unit. One of the new pieces of equipment that we carry is a portable I-STAT, which can get a complete readout on the patient’s blood chemistry through a drop of blood that we process through this machine.

The red bag we consider kind of our primary bag.

One of the things in the top of our red bag here is a video laryngoscope that helps facilitate placing breathing tube into a patient. We carry three units of O negative blood, and we transfuse blood to our critically injured patients. We have it, if the patient needs blood we can deliver it in the aircraft. It can be a lifesaving intervention in the field.

So, really there are benefits in working in an environment that is smaller like this.

This is a good size for what we do, and as you can see, it’s pretty well equipped. You doing okay, Ruth? Is this painful here? No. – The aircraft are operated by Metro Aviation.

So, every time we take off, Metro Headquarters, in Shreveport, is authorizing that flight, and they look at every single take-off, and they monitor our progress throughout the flight, and they also handle all of the mechanical issues with the aircraft, and all of the normal scheduled maintenance. DHART’s ground team provides the same level of service that we do by air.

They often back me up. They will do the time-sensitive critical care transports that I can’t get to. There’s no delineation between the level of care you would get from the helicopter or from the ground unit.

One of the things we are challenged with is the enormous differences in weather. We fly in all sorts of weather that can change throughout the day, let alone the week or the month. We have implemented a number of safety features, not only to the staff in the helicopter, but then, also the patients that they’re caring for. First, they switched the type of aircraft to the EC135. We have added a new base in Manchester, New Hampshire, with a second aircraft.

We also added night vision goggle capability, which greatly enhances our safety margin because we can now see the mountains looming out there in the darkness, and then we added terrain awareness, and it will set off an alarm if you get too close too fast.

Caution, terrain. Caution, terrain. And then, finally, traffic awareness which looks for other aircraft around us, so some great safety advantages that expanded our ability to conduct missions in poorer weather. – We’re the first in the nation, GPS approaches, into various hospitals and helipads, and various navigation routes.

It’s low-level IFR instrument flight rules hospital to hospital, so we don’t necessarily have to have an approach from airport to airport, primarily in New Hampshire and Vermont. We can go to all of our local hospitals and local landing zones to get patients where other times weather, in the past, may have precluded that. DHART, be just a moment on the ground here and take off here momentarily. The training that we have and the equipment that we carry, and ultimately the speed of the helicopter is what certainly saves lives, and it makes me very proud to be associated with such a great team of people.

I feel like I’m living my purpose by being able to positively impact other people’s lives.

Having a group of individuals that’s ready to go at a moment’s notice for whatever they’re called to, is very, very rewarding. I’m impressed by what we are able to accomplish each and every day.  Lebanon tower, DHART 1’s about nine miles to the south, inbound for the hospital.

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