Under Our Wings

(Airwaves Issue 6 Spring / Summer 2008)

Under Our Wings In the skies above New Zealand, a dedicated team of health professionals provide a 24 hour lifeline that links patients to critical medical care facilities- and they don’t even qualify for Frequent Flyer points!

While some of the more obvious and visible aspects of our air rescue operation centre around the missions flown by the Westpac and Solid Energy Rescue Helicopters, a vitally important third part of our air ambulance service quietly goes about its business from the seclusion of a dedicated hangar at the rear of Christchurch International Airport.

From here, the two fixed-wing pressurised Cessna aircraft of the New Zealand Flying Doctor Service provide a vital air ambulance lifeline for outlying regions around the South Island and further afield to the extended medical facilities available in the larger metropolitan centres.

For 24 hours a day, 7 days a week, the New Zealand Flying Doctor Service provides exactly that - qualified, skilled medical practitioners in the aircraft alongside patients who are being transferred to medical facilities for any number of reasons. From critical care burns victims, spinal injury patients, neonatal transfers, or accident trauma victims to routine elective surgery transfers, organ delivery, blood or equipment supply, the New Zealand Flying Doctor Service offers a fast, efficient and effective transfer facility with specialised care and attention every step of the way.

"In that sense alone, the service is quite unique," says Shane McKerrow, Clinical Nurse Coordinator for the Canterbury District Health Board. "Where paramedics and ambulance crew are trained to GET the patient to a hospital, they are still limited as to the skills and/ or medicines they are authorised to use. If a patient is transferred to another hospital by conventional ambulance, for whatever reason, any on-going treatment is sometimes put on hold for the duration of the journey," she says. "The Flying Doctors team not only continues treatment throughout the trip - but can initiate and carry out further treatment on the way, should it be necessary. With a doctor and nurse on-board the aircraft, they are fully equipped and able to manage the worst case scenario should it arise. We think of the whole system as a mobile care facility."

The Team

Shane's position as Clinical Nurse Coordinator requires the accurate assessment of all relevant information in order to pull together the right team for each job. As well as her position as flight team coordinator, the service has a full time doctor who provides 24 hour on-call cover.

Doctors currently working in the Christchurch Intensive Care Unit and anaesthetic departments also make up an important part of the flight retrieval team. The Service may also take specialty staff on board such as Paediatric doctors as required. There are a total of ten experienced nurses who currently work in the Christchurch Hospital Emergency Department, ICU and Recovery who are scheduled a separate 24 hour shift as part of the air ambulance retrieval team. During Monday to Friday the flight nurse arrives at the hospital and works an 8 hour shift doing duties as required for the retrieval team. After the 8 hour shift, the nurse is then on call until 0800 the following morning. During the weekend, the nurse is on call for 24 hours from home.

An Intensive Care Consultant from the Christchurch ICU oversees all transfers and provides an on-call service after hours. St John paramedics are also an important part of the team when a mission integrates with the rescue helicopters. And certainly not to be forgotten are the highly trained and experienced fixed-wing pilots.

Together, this extended network of professionals ensure that the level of care afforded to the patient throughout the transfer is NEVER decreased.

Where does NZFDS operate?

The New Zealand Flying Doctor Service is part of a nationwide network of integrated air ambulance services providing specialist medical care for patient transfers and retrievals.

As such, the Service operates from its base in Christchurch to Invercargill in the South and to Auckland in the North. As well, the Service extends as far off shore as Norfolk Island and the Chatham Islands.

West Coast

Greymouth Hospital on the West Coast is our most frequent destination. Flight time from Christchurch Airport is approximately 30 minutes. While for daylight flights, the Greymouth Airport is situated adjacent to Greymouth Hospital, there is no direct air access at night. In this case the team lands in Hokitika and takes a 40 minute ambulance trip up to Greymouth.

Greymouth provides the New Zealand Flying Doctor Service with a variety of work including paediatric, obstetric, trauma and nurse escort missions. The West Coast population of 31,000 becomes considerably larger during tourist season and there is a sharp increase in the number of transfers involving road trauma, particularly from overseas tourists who traditionally drive on the other side of the road. During this time, the Service often flies across the Southern Alps 4 to 6 times a day!

Buller Hospital is Westport’s Primary hospital providing general medical services. Flight time here from Christchurch is approximately 40 minutes. Buller is a GP run hospital and most patients get transferred to Greymouth.

Canterbury - Population 465,000

Christchurch Hospital is the largest hospital facility in the South Island and as such becomes the central focus for our service to transfer patients from outlying regional facilities and back again.

At the same time, the Service also transfers patients from Christchurch to specialist facilities in other urban centres such as Wellington or Auckland.

In the case of closer facilities such as Ashburton, Timaru, Waiau and Kaikoura, the Service utilises the Rescue Helicopters for patient transfers.

Ashburton Hospital This hospital has 74 beds and annually admits just under 5000 people. Helicopter flight time between Ashburton and Christchurch is approximately 25 minutes either way. Ashburton has tertiary diagnostics (CT and MRI) and a consultant surgeon and physician run the hospital with house officers. Trauma patients are usually stabilised and transported to CHCH Public Hospital. No long- term ventilation is available at Ashburton.

South Canterbury - Population 54,000

 Timaru Hospital This hospital offers trauma services with specialist cover for general surgery, orthopaedics, gynaecology and level 4-5 ICU/ CCU (8 bed unit) run by an anaesthetist. The ICU can provide long-term ventilation. Helicopter flight time is approximately 45 minutes each way. There is limited cardiology support.